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Otitis Media is an infection of the middle ear that 80% of the pediatric population will experience at least once in their lifetime. Ear infections can occur at any age, but they are most commonly seen in children aged 6-24 months. Studies show that without treatment, 80% of ear infections clear up on their own. Despite this, many ear infections are treated with antibiotics in The United States each year.
While many conventional practitioners treat ear infections with antibiotics, functional medicine aims to find the root cause of why the symptoms are occurring in the first place.
Ear Infection Signs and Symptoms
Symptoms of an ear infection in an adult are ear pain (sharp, sudden pain, or dull, continuous pain), a sharp stabbing pain with immediate warm drainage from the ear canal, a feeling of fullness in the ear, nausea, muffled hearing, and ear drainage.
Serous otitis media (fluid blocks the eustachian tube) can cause fullness in the ear, diminished hearing, or popping.
Symptoms of an ear infection in kids are tugging at the ear, fever, fussiness, poor sleep, rubbing or tugging at the ear, irritability, diminished appetite, and crying at night when lying down. (10)
Ear Infection Possible Causes and Risk factors
There are many possible causes of an ear infection. It is important to recognize the root cause of the infection and try to eliminate or decrease exposure.
- The most common risk factor of an ear infection in children is a preceding upper respiratory infection.
- Bacterial pathogens- streptococcus pneumonia, Haemophilus influenza, and Moraxella (Branhamella) catarrhalis are responsible for more than 95%.
- Viral pathogens such as respiratory syncytial virus, influenza virus, parainfluenza virus, rhinovirus, and adenovirus.
- Allergies- environmental or food. A study showed 86% improvement in serous otitis media when children eliminated their food allergies. When the food was reintroduced, there was a 95% recurrence rate.
- Family history of recurrent otitis media in parents.
- Decreased immunity.
- Mucins which include abnormalities of a specific gene expression.
- Anatomy issues with the palate and tensor veli palatini.
- Ciliary dysfunction (little hair-like structures that move fluids and particles around in the body).
- Cochlear implants.
- Vitamin A deficiency.
- Lack of breastfeeding.
- Passive smoke exposure.
Functional Medicine Labs to Test for Root Cause of Ear Infections
- CBC w/diff - complete blood count with white blood cell count differentiation. This can aid in detecting low-lying infections, anemia, bacterial infection, and a suppressed immune system.
- Full Immunology Panel to check for food, inhalants, mold, and spice allergies and sensitivities, and celiac disease
- Autoimmune panel- individuals with autoimmunity are more likely to develop infections since their immune system is suppressed.
- Genetic testing - an insight into specific genetic mutations can allow us to understand how the body works for or against you and if you have any predisposition to autoimmunity or detox issues.
- Nutraeval- check for nutrient deficiency, which can contribute to overall immune system changes.
- Comprehensive Stool Test: Since immunity starts in the gut, it's always important to get an overview of the patient's gut health in case of recurring infections.
Imaging Tests
- CT scan of the temporal bones: this is only indicated in complicated otitis media but can diagnose mastoiditis, epidural abscess, sigmoid sinus thrombophlebitis, meningitis, brain abscess, subdural abscess, ossicular disease, and cholesteatoma. These are rare complications but are sometimes necessary to rule out. (1)
- MRI: This can check for tumors and fluid collections (1)
- Tympanocentesis: Tympanocentesis may be used to determine the presence of middle ear fluid, followed by culture to identify pathogens. (1)
Conventional Medicine Treatment of Ear Infections
There is a lot of controversy surrounding the treatment of ear infections with antibiotics. Clinicians are hesitant to follow the most recent guidelines for acute ear infection treatment.
A survey performed in 2007 after the 2004 new recommendation released by The American Academy of Pediatrics (AAP) showed that most primary care physicians accepted the concept of an observation option for acute otitis media. According to the AAP, their consensus is that treatment with antibiotics is recommended for only severe ear infections. For mild ear infections, antibiotics could be recommended, or a "watch and wait" observational period can be initiated. Avoidance of tobacco smoke exposure and recommendations for breastfeeding children until at least six months is also recommended.
For adults, there are not many studies evaluating the patient's age in relation to otitis media treatment success.
Anti-inflammatories or Tylenol is commonly used to treat the pain.
In severe or chronic cases, ear tubes are placed to allow drainage from the inner ear.
Functional Medicine Treatment of Ear Infections
Functional medicine treatment is all about finding the root cause. In order to do that, a thorough medical history needs to be obtained. It is also essential to understand the patient's lifestyle, food intolerances, type of diet, exposure to allergens or toxins, and immune system. These will give a better perspective on risk factors and predisposition to develop an acute ear infection.
Run the lab tests listed above. If there are issues with deficiencies, immunity, or allergens, those can be addressed at the root.
9 Evidence Based Remedies That Help Alleviate Acute Ear Infection Pain
1. Belladonna homeopathic: homeopathic ear drops can be a useful adjunct treatment to decrease antibiotic use.
2. Garlic Oil Ear Drop: Garlic oil ear drops are a commonly used naturopathic choice for Otitis Media. Garlic's health benefits include antiviral, antibacterial, antifungal, and pain-relieving properties. This double-blind prospective study shows garlic oil ear drops improved symptoms and reduced bacteria compared with lower improvement by neomycin.
3. Vitamins: Overall, the vitamins A, B6, B12, C, D, E, and folic acid and the trace elements iron, zinc, copper, and selenium work together to support the protective functions of the immune cells.
4. Elderberry: mono-herbal preparations of S.nigra berry (Elderberry), when taken close to the onset of symptoms and for up to two weeks, may assist in relieving the common cold and influenza symptoms. This can assist in helping with ear infections since they typically come on after an upper respiratory infection.
Lifestyle Changes
5. Remove yourself or children from secondhand smoke: smoking is a known risk factor for developing ear infections.
6. Get good sleep: Good rest is essential for healthy immune function.
7. Anti-inflammatory diet: Many practitioners promote anti-inflammatory diets to decrease inflammation and boost immune function. The most common anti-inflammatory diet that has been scientifically researched for lowering inflammation and boosting immunity and longevity is the Mediterranean diet. This way of eating includes whole, fresh foods and limits processed foods, dairy products, and gluten.
8. Try an elimination diet. If ear infections keep occurring, there may be an underlying food allergy or intolerance. You can find out exactly what the patient is reacting to by doing a food allergy and sensitivity test or by testing an elimination diet.
9. Stay hydrated. Hydration is important to maintain good immune function.
Summary
80% of children will have an ear infection at some point in their lifetime. They are most common in children, but adults can get them too. Standard treatment is antibiotics or watch and wait if it is a mild infection.
A functional medicine approach to treating ear infections includes a comprehensive overview, eliminating triggers, and building immunity.
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