Ear infection symptoms, treatment and prevention

Ear infections are a common cause of visits to the doctor. Untreated ear pain and infection can lead to hearing loss.

Ear infections can cause earache, discomfort and temporary hearing loss. They usually subside within about a week, but stubborn infections may need pain relief and antibiotics.

What are the main types of ear infections?

Outer ear infection or swimmer’s ear — Otitis Externa

There are two main types of ear infections. The first occurs when water gets trapped in the ear canal by wax build-up. The bacteria creates inflammation, pain, redness and sometimes fever

Middle-ear infections — Otitis Media

The second type is called a middle-ear infection or otitis media. They are viral or bacterial infections in the middle ear clogging the tubes inside the ears with mucus and fluid. Middle ear infections are often painful. Symptoms can include high fever, difficulty hearing, nausea and vomiting.

What are the main types of middle ear infections?

• Acute otitis media
• Recurrent acute otitis media
• Otitis media with effusion (OME)
• Chronic otitis media with effusion. 

What is acute otitis media?

Acute otitis media is a middle ear infection. It occurs when fluid or mucus caught in the middle ear causes swelling and redness in the ear behind and around the eardrum. It causes ear pain, fever, and partial or complete hearing loss due to fluid or mucus caught in the middle ear.

What is otitis media with effusion (OME)?

Otitis media with effusion (OME) is fluid in the middle ear but without an acute infection. Sometimes, the infection clears up but mucus and fluid continue to build up in the middle ear. This build-up creates a feeling of fullness in the ear that makes it difficult to hear. Otitis media with effusion (OME) usually gets better on its own.

What are the symptoms of middle-ear Infection?

Common symptoms of middle-ear infection include:

• Ear pain, often throbbing 
• Fever 
• Pressure or a feeling of fullness in the ear 
• Pus from the ear 
• Hearing difficulty in the affected ear 
• Nausea and vomiting

Why Do Children Get Otitis Media So Often?

One of the reasons infants and young children get otitis media so often is connected to the eustachian tube. Because the eustachian tube is more horizontal than it is in adults, it prevents fluid to flow smoothly. When it isn't working properly, mucus is unable to drain from behind the eardrum. Instead, it stays stuck and causes pain and pressure. This situation often leads to infection. As children get older, the eustachian tube becomes more vertical and begins to drain better.

How are middle ear infections diagnosed?

It’s important to take ear infections and ear pain seriously. If you have ear pain or hearing loss, proper diagnosis by a doctor is critical to preventing permanent damage. See your GP, paediatrician or an ear, nose, and throat (ENT) specialist immediately for diagnosis and treatment. A health care professional will have the proper instruments to look inside your ear. If you have an acute middle ear infection, your eardrum will be very red. If there is pus inside the inner ear, your eardrum may bulge forward, increasing the risk of eardrum perforation.

Your doctor can determine if the infection causing your ear infection is bacterial or viral.

How are middle ear infections diagnosed?

It’s important to take ear infections and ear pain seriously. If you have ear pain or hearing loss, proper diagnosis by a doctor is critical to preventing permanent damage. See your GP, paediatrician or an ear, nose, and throat (ENT) specialist immediately for diagnosis and treatment. A health care professional will have the proper instruments to look inside your ear. If you have an acute middle ear infection, your eardrum will be very red. If there is pus inside the inner ear, your eardrum may bulge forward, increasing the risk of eardrum perforation.

How are middle ear infections treated?

It’s usual for the redness in your ear to last two to three days, and to be completely healed in two to four weeks.

Your doctor may recommend treatment to protect your eardrum from rupturing and to speed up the healing process. Treatment may include:

• over-the-counter or prescription ear drops to help relieve your symptoms
• antibiotics to clear the infection

Medication can reduce how long the infection lasts, but it’s not always an option as most middle-ear infections are caused by viruses.

Can middle-ear infections be treated at home?

You can try to relieve the symptoms by drinking more water to help your body clear the infection, or by using a home remedy like an onion poultice.

Don’t put off getting medical attention for your ear pain - home remedies can be quite helpful, but they don’t replace the need for a doctor’s visit.

This ancient remedy is a bit of a messy way to relieve ear pain.

1. Chop ½ an onion
2. Gently simmer chopped onion in 1/4 cup of water for several minutes. Stir occasionally to prevent burning
3. Drain the onion and wrap in several layers of cheesecloth or thin, soft cloth
4. Cool the mixture just enough so it doesn’t burn the skin
5. Place the poultice over the ear for at least five minutes
6. Reheat the poultice multiple times and reapply as needed
7. Repeat until ear pain eases

Can ear infections lead to hearing loss or other complications?

Ear infections can lead to temporary hearing difficulty or hearing loss as the build-up of fluid prevents sound from getting through.

How to prevent middle ear infections in adults

Limiting the build-up of fluid in the ear canal is the key to preventing middle ear infections.

• Don’t smoke or expose others to second-hand smoke
• Avoid using cotton buds or tips that pack wax into the ear canal
• During an infection, don’t allow moisture into your ears. No swimming until your doctor gives you the OK
• Heat can also help to ease the pain. Try a hot-water bottle wrapped in a towel or blowing a hairdryer onto the ear

Can middle-ear infections be prevented with a strong immune system?

Prevention can include strengthening your immune system by: 

• a diet free from food allergens like cow’s milk that lead to excess mucus and fluid
• following a healthy diet based on fresh fruits, vegetables, whole grains and high-quality protein
• drinking plenty of clean, quality water to thin mucus secretions
• eating foods rich in essential fatty acids - like cold-water fish, flaxseeds and flaxseed oil - to reduce inflammation
• cutting out exposure to environmental allergens like second-hand smoke where bacteria and virus thrive.

The high potential for complications makes a diagnosis by a doctor critical. Never disregard ear pain or hearing loss, and consult an ear, nose, and throat specialist immediately.