Ear Infection (Otitis Media)

Acute otitis media is a viral or bacterial infection of the middle ear, usually secondary to a URI. It is most common in children six to 36 months old and then again at 4-7 years old. It is the most frequent diagnosis of children in a clinical setting, and it is estimated that about 2 billion dollars spent each year for conventional medical and surgical treatment of the condition.

Etiology

The eustachian tube is the focal point of concern in most cases of acute otitis media. The eustachian tube protects the middle ear from nasopharyngeal secretions, regulates gas pressure in the middle ear, prevents bacteria and viruses from having easy access into the middle ear from the mouth and nasopharynx, and clears secretions from the middle ear. In the child, the tube is at a horizontal level in the head (the tube becomes slightly vertical in the adult), making it easier for organisms to move from the nasopharynx into the middle ear. The tube opens during the act of swallowing due to the contraction of the tensor veli palatini muscle. Obstruction of the tube and/or abnormal patency are the initiating factors causing acute otitis media. Obstruction may be:

Function: Due to an abnormal opening mechanism and/or increased tubal compliance.

Mechanical: Due to abnormal hyperplasia of the tissues around the tubes opening into the nasopharynx or swelling of the tube itself.

Infection/Allergy: Affecting nearby tissues causing them to swell and occlude the tube.

In infants, the bacteria most involved are E. coli and S. aureus; in older children (but less than eight years old), the most common bacteria are S. pneumonia, H. influenza, Group A-beta hemolytic streptococci, and S. aureus. Over eight years of age H. influenza is less involved in infections of the ear and the other three bacteria are the main causes. Otitis media usually begins when a viral URI or acute otitis media experiences secondary invasion by one of these bacterial organisms. Causative factors involved in susceptibility include substituting early bottle feeding for breast feeding. Human breast milk seems to have a prophylactic effect on a baby, although the exact reason why is not understood: that is, whether it has more to do with an intolerance to the cow’s milk or the natural immune boost provided by mother’s milk, or a combination of both. A related factor to bottle feeding is that supine feeding with the bottle has been shown to cause regurgitation of the milk which then has a chance of entering the eustachian tube. Another

very common etiological factor in children is one or more food or inhalant allergies. Allergens may cause acute otitis media by causing mucous production and mucous membrane swelling. Once the allergens are discovered and removed from the child’s environment or diet, health can greatly improve. Common food allergens in children include cow’s milk, wheat, soy, corn, citrus, and egg, although other foods may be implicated on an individual basis. Inhalant allergies include molds, dust, animal dander, and hay fever. Pre-teen otitis media seems to be related to true food allergies, while otitis media in adults (20 years and older) seems to be mostly food sensitivities.

Naturopathic Approach

A naturopathic approach to treating someone with an ear infection is to first eliminate all dairy and sugar from their diet until the symptoms has subsided. If the ear infections are chronic or frequent food sensitivity testing may be recommended to see if there are other offending foods that may be compromising their immune system. This may be done in kids over the age of 3. Garlic oil ear drops are often recommended as an anti-microbial and anti-inflammatory for the tissues of the ear tube. Immune boosting nutrition and botanical medicine may be recommended to the immune system best fight the likely virus and prevent a bacterial infection for co-occurring.