Dr. Jacqueline Gerhart: Ear Problems Are Common

UW Health Family Medicine physician Dr. Jacqueline GerhartMadison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that usually appears weekly on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.


Dear Dr. Gerhart: I feel like my ears need to pop, but I can't get them to. I don't feel sick. What's going on?


Dear Reader: It's a common problem to feel like your ears have fluid in them. Often the cause is obvious (like going up in an airplane and feeling the change in pressure). Other times the cause is acute, like a sinus infection or ear infection. But if the symptoms occur without an obvious cause, chances are you may have eustachian tube dysfunction.


The eustachian tubes are small passageways that connect the upper part of your throat (pharynx) to your middle ears. When you sneeze, swallow, or yawn, your eustachian tubes open, allowing air to flow in and out. But, sometimes a eustachian tube gets plugged - causing sounds to be muffled, and feelings of ear fullness, popping, clicking or pain. This is called eustachian tube dysfunction. The most common cause is excessive mucus and inflammation in the tubes, caused by a cold, flu, a sinus infection or allergies. Some people are more prone to this than others. Kids for example, have shorter, straighter eustachian tubes - which makes it easier for germs to get into the middle ear and for fluid to become trapped there. Smoking and obesity are also risk factors. (Smoking damages the tiny hairs that help sweep mucus away from the middle ear; obesity causes fatty deposits around the tubes that can block the tubes and cause eustachian tube dysfunction.)


The best way to treat eustachian tube dysfunction is to decrease the mucous buildup and inflammation in the eustachian tubes. Using a Neti Pot (a saline rinse that goes in one nostril and comes out the other) is a great way to clear out mucous build up. Saline nasal sprays are also popular. But, be cautious with how often you use them. Sometimes you can "over dry" the mucous membranes, leading to nose bleeds.


For inflamed eustachian tubes, antihistamines (like Claritin) and nasal corticosteroids (like Nasonex) help decrease the inflammation in the nasal passageways. If you know you have allergies, talk to your doctor about how you can best decrease inflammation caused by your allergies.


Keep in mind that ear problems depend on your age, your exposure to noise, your family history and other symptoms related to the ear fullness. Other possible diagnoses include: acute ear or sinus infections, hearing loss, or a neurologic disorder. In fact, muffled sounds, ringing in the ears, or feeling "under water" can all be the signs of early hearing loss. So, if it doesn't go away with appropriate therapy, consider seeing an audiologist for a hearing test. And keep in mind that if you have a major hearing change, or if you notice vision changes, weakness, or stroke-like symptoms, you should contact your doctor. This could indicate a neurologic problem needing urgent treatment.


This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.

Date Published: 07/09/2014

News tag(s):  jacqueline l gerhart

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