Treatments exist for persistent earaches

Treatments exist for persistent earaches ·

By Seth D. Torregiani, D.O.

Originally published Tuesday, October 10, 2006 online at:
http://delawareonline.com/ in their Alternative Medicine Section.
All Rights Reserved.

Acute otitis media (OM) is an infection of the middle ear that primarily affects children from 6 months to 3 years old. Fifty percent of children in the United States will have at least one middle ear infection by their first birthday, and 80 percent will have an episode by age 3. It is one of the most common reasons for visits to the pediatrician and the No. 1 reason children are prescribed antibiotics.

Symptoms of OM include an sudden onset of fever, pain (otalgia) and irritability. Infants and younger children may pull on the painful ear, and parents may also notice otorrhea, or the drainage of pus, from the affected side as well. There also might be decreased hearing temporarily in the infected ear because of the accumulation of fluid in the middle ear space.

Often, the disease is preceded by a viral upper respiratory infection or allergy attack, which causes swelling of the mucosal tissue in the nasopharynx and Eustachian tube. This swelling prevents drainage from the middle ear and provides a fertile breeding ground for bacteria, setting the stage for infection.

In this country, the standard treatments are antibiotics, most commonly amoxicillin, as well as fever and pain control with pediatric doses of acetaminophen (Tylenol) or ibuprofen (Motrin).

Over the past few years, the reflexive use of antibiotics to treat all (or most) cases of acute OM has been questioned. The millions of antibiotic prescriptions written to treat acute OM are believed to contribute significantly to the emerging antibiotic resistance of many types of bacteria. Furthermore, antibiotics can often cause GI upset and diarrhea, making an already difficult situation worse.

In 2004, the American Academy of Pediatrics issued new guidelines for the treatment of acute OM. For children older than 6 months, 48 to 72 hours of observation and symptomatic treatment (for pain and fever) of uncomplicated, acute OM, without antibiotics, is acceptable. For children younger than 6 months, because of their age, or older children with severe otitis media (high fever, severe pain, etc.) antibiotics are still recommended.

For parents (and physicians) who wish to avoid or delay the use of antibiotics to treat acute, uncomplicated OM, a number of alternative treatments might be effective.

The first is osteopathic manipulation, a form of manual therapy performed by doctors of osteopathy, or D.O.s. With this therapy, gentle forms of soft-tissue, hands-on treatment are applied to the head, neck, rib cage and diaphragm. This encourages flow through the lymphatic channels in the head and neck, as well as improved respiration and drainage through the Eustachian tube, allowing the body to rid itself of infection naturally.

When applied by experienced osteopathic doctors, one study found that children with recurrent acute OM who were treated with osteopathic manipulation had fewer episodes of OM and required fewer surgical procedures than children who did not receive osteopathic treatment. Further, there were no adverse reactions reported during the study.

To find an osteopathic physician who performs osteopathic manipulation in your area, go to the American Academy of Osteopathy Web site at www.academyof- osteopathy.org.

Naturopathic medicine, a form of medicine that emphasizes the use of herbs, nutrition and other natural therapies in the treatment of disease, also offers effective treatment of the symptoms of acute OM.

A naturopathic compound known as Otikon Otic Solution was found to be as effective as anesthetic ear drops for treating ear pain associated with acute OM. This product can be found at health food stores and natural pharmacies.

In terms of prevention, one interesting study reported that children given xylitol gum or syrup experienced fewer episodes of OM during the study period. Xylitol is a form of carbohydrate, or sugar, which inhibits the growth of streptococcus pneumoniae, a common bacterial pathogen in acute OM.

Finally, probiotics, beneficial bacteria that live in our bodies and help fight off pathogenic, or disease-causing, bacteria, also might help prevent acute OM. Consisting of bacteria known as lactobacilli, and other species, probiotics are available in such forms as powders and formulas, and are found in such foods as yogurt, which are safe for children.

Many pediatricians and family doctors may offer a safety net antibiotic prescription to parents who choose observation or integrative medical treatment. This strategy allows the doctor and the parents to observe and treat the child symptomatically for a day or two, but offers parents rapid access to antibiotics if the child worsens.

Dr. Seth Torregiani practices holistic medicine, osteopathic manipulative medicine and acupuncture in Newark.