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Ear infections occur when one of the Eustachian tubes that connect the ear to the back of the throat becomes swollen, and fluid builds up in the middle ear (the section just behind the eardrum). Bacteria or a virus can also cause an infection of the middle ear. As most of us have experienced at one point or another, ear infection symptoms can be quite painful because of the inflammatory response and the pressure from fluid build-up.
Ear infections can be either acute or chronic. Acute infections are painful, but short in duration. Chronic infections either persist or recur repeatedly, potentially causing permanent damage to the middle and inner ear.
Ear Infection Symptoms
Itching, swelling, pain, and a yellow discharge from the ear are the most common symptoms of ear infection. You also may experience hearing loss from the inflammation or discharge, which can block the ear canal.
In time, your ear may become painful to touch and infection may spread to other ear structures. Middle ear infection symptoms include the sudden development of earache, pain, fever, and feeling sick and irritable. These symptoms might persist, or they can come and go.
Types of Ear Infections
Infections occur either in the outer or middle ear. Outer ear infections are usually from “swimmers’ ear,” where water from swimming (or bathing) has introduced bacteria.
Patricia Bloom, MD, a contributor at Focus on Health Aging, answers a common question about ear infections.
Q: I have a painful feeling of fullness in my ear—is it possible I have an ear infection, or could it be due to ear wax I can remove myself?
A: An ear infection typically causes pain that may be sharp or dull, and you also may notice that your balance is slightly “off.” The most common type of ear infection is called otitis media (middle ear infection), and is caused by fluid building up behind the eardrum—the resulting pressure causes pain. Ask your doctor to examine your ear before you attempt to remove any ear wax that may be present. If there is a build-up of wax (a common problem in older adults, since the consistency of ear wax becomes thicker as we age), your doctor will likely need to remove it with a small suction device so that he or she can view your ear drum for signs of infection.
If there is no infection but you have a tendency to ear wax build-up, your doctor can advise you on the best way to remove it (typically by using ear drops to soften the wax so it drains from the ear—a bulb syringe can also be used to gently flush out softened wax).
Middle ear infections have three categories: acute otitis media; otitis media with effusion; and chronic suppurative otitis media.
What causes the three types of middle ear infection?
- Acute otitis media: A bacterial or viral infection of the middle ear.
- Otitis media with effusion: The presence of fluid in the middle ear without the infectious symptoms of acute otitis media. Most often, this occurs after an acute infection has cleared, but the fluid persists.
- Chronic suppurative otitis media: Causes drainage from the ear for six weeks or longer.
Other causes of infection include:
- Sinus infections
- Excess mucus
- Infected or swollen adenoids
- Tobacco smoke
Ear Infection Diagnosis and Treatment
To check for ear infections, your doctor inspects your ear with a viewing tool called an otoscope, which has a light and magnifying lens.
Treatments your doctor will prescribe can range from home remedies to medications. Most mild ear infections clear up on their own. Applying a warm cloth can help reduce pain and swelling. If medication is needed, over-the-counter eardrops may ease symptoms.
Prescribed antibiotics in the form of eardrops help clear up bacterial infections, antifungal drugs kill fungus, and anti-inflammatory drugs reduce swelling. If antibiotics fail, your doctor may suggest tubes be inserted through the eardrum to drain the fluid. Surgery may be recommended if the problem persists.
How to Prevent Ear Infections
The best way to prevent outer ear infections is to keep water out of the ear canal, even when showering. Place a ball of cotton covered with a layer of petroleum jelly into your ears. After bathing, remove the cotton and air out the ear canals. Also, use earplugs when swimming.
Since acute otitis media occurs most often in children and can recur, you should look for other underlying causes, such as environmental allergens, food allergies, immune deficiencies, enlarged adenoids, chronic sinusitis, and exposure to tobacco smoke. Keeping immunizations up-to-date also can help.
Originally published in May 2016 and updated.
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