Ear Infections: Diagnosis and Treatment

If you care for children, you likely know already how often they come down with earaches. Adults get them, too, but youngsters have them much more often. That’s because they don’t fight off viruses and bacteria as well, and their little ears aren’t good at draining fluids yet.

You or your child may have a sore throat, stuffy nose, or fever along with an earache. These are signs of a possible infection.

Call your doctor so she can find out for sure what’s going on. If it is an infection, she can recommend the best treatment for your case.

What Is My Doctor Looking For?

Your doctor will ask you about any symptoms you’ve had. Be sure to come to the office with any notes you might need and questions on your mind.

She will look at the eardrum with an instrument called an otoscope for signs of infection. This is a tough task with a fussy infant, so be ready to help calm the little one if it’s your child with the earache.

The doctor may also check for blockage or filling of the middle ear using a different kind of otoscope that blows a little air at the eardrum. This air should cause it to move back and forth a bit. If fluid is there, it will not move as much.

She might also look for signs of infection with another instrument. It’s called a tympanometer, and it uses sound and air pressure to check for fluid in the middle ear.

If needed, a hearing specialist, or audiologist, can be called in. The audiologist will perform a test to find out if there is hearing loss.

Treatments

Often, a virus causes an ear infection, in which case antibiotics won’t help. If, based on the history, your doctor suspects that bacteria may have caused the infection, she will prescribe an antibiotic.

You may also talk to your doctor about things you can do at home.

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Pain Relief

If a virus is causing the infection and you have to wait for it to get better, you don’t need to live with the pain.

Your doctor may recommend a pain reliever, typically acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), which also helps reduce a fever. Aspirin should be avoided in children because of the threat of Reye's syndrome, a rare condition that can cause swelling in the brain or liver.

Pain can also be reduced by using low heat from a heating pad. Be very careful using a heating pad with children.

Antibiotics

If your doctor decides to go with antibiotics, follow all the instructions. Take all of the doses even if you or your child are feeling better. Call your doctor or pharmacist if you skip a dose or feel sick from the medicine.

If you don’t take the whole course, your infection could come back and become resistant to more treatments.

Drainage

If an infection causes serious complications, fluid remains in the ear for a long time, or your child has ear infections that keep coming back, your doctor might want to do a procedure called a myringotomy.

She creates a small hole in the eardrum so fluids such as water, blood, or pus can drain out. In many cases, she will put in a tube so it won’t get backed up again.

The tube, which will usually fall out on its own in about 6 to 18 months, lets air flow through and keeps the middle ear dry. Tubes also:

  • Reduce pain
  • Improve hearing
  • Cut down on the number of infections your child may have

When younger children get these ear tubes, it’s surgery. They will need to go to the hospital and take something to sleep during the procedure, which usually lasts about 15 minutes.

Older children and adults can have it done while they’re awake. For them, it can be done in their doctor’s office.

This surgery rarely leads to infection or scarring and usually provides long-term results. If the tubes come out and the infections return, talk to your doctor about more treatments.

Doctors generally don’t consider the removal of tonsils helpful for ear infections.

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Natural Remedies

You can do things at home to ease your symptoms. Talk to your doctor first about these tips:

Warmth: You may find a heated compress brings comfort.

Feedings: If you feed your baby with a bottle, do it standing up. Don’t put your infant to bed with one. Try to take your child off it as soon as the doctor thinks he’s ready.

Gargling: In older children or adults, salt water helps soothe a raw throat and may help clear the Eustachian tubes.

Stand tall: Holding your head erect can help drain your middle ear.

Fresh air: Smokers should refrain from smoking inside the house or anywhere near your child.

WebMD Medical Reference Reviewed by Dan Brennan, MD on August 27, 2016

Sources

SOURCES:

Mayo Clinic: “Risk Factors,” “Causes,” “Diagnosis,” “Treatments,” “Reye’s syndrome,” “Antibiotic Therapy.”

American Academy of Otolaryngology - Head and Neck Surgery: “Ear Tubes.”

Academy of American Family Physicians.

Merck.

National Institute on Deafness and Other Communication Disorders.

Mount Sinai Hospital: “Myringotomy.”

FamilyDoctor.org: “Eustachian Tube Dysfunction.”

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