-IBIS-1.7.6-
tx
eyes/ears/nose/throat
Otitis Media
Integrative Therapies

Home Care

Otitis Media is a bacterial or viral infection in the middle ear. The middle ear can not be seen without using medical equipment. It is an air-filled space which opens into the inner ear. Otitis media often can occur after an upper respiratory infection like, for example, the common cold. While it can occur at any age, otitis media is most common in young children, particularly aged 3 months to 3 years. The peak age of problems occurs at 6 months of age.

The child usually has an earache or irritability as well as possible chills and fever. The pain may be sharp, stabbing, dull, or throbbing. The pain is due to inflammation, swelling, or infection in the middle ear. This can be a chronic (ongoing) problem or an acute (short term) problem.

The cause is usually due to problems with the eustachian tube (a tube that goes from the middle ear to the throat). When this tube is blocked for any reason, otitis media can result due to a buildup of pressure. The fluid, which normally drains through the tube, backs up because of blockage and creates pressure.

Ear infections can be quite serious. Because the ear drum may break, hearing problems may result, or the infection may spread, consult your physician.


REGARDING THE PROPER DIET FOR OTITIS MEDIA:

1. For infants, breast feeding is important for many reasons. First of all, if the infant is not breastfed, he or she may have problems digesting the formulas used, no matter what the source. Cow milk, soy, and corn, which are the basic ingredients in many formulas, may not be easily digested. The baby may even develop an allergy to the formula. The irritation and inflammation that result can cause or aggravate otitis media.

Breast milk is the most natural food source for an infant. It is protective because it de-creases inflammation, is rich in nutrients, and is easily digested. A minimum of 6 months of breast feeding is recommended.

2. With children, teenagers, and adults there are other considerations. Certain foods seem to be more likely to cause or aggravate ear infections. Eliminating these foods from the diet is a good way to determine if one or several of them are responsible for the problem. The main problem foods are dairy products (including milk, cheese, ice cream), eggs, wheat, corn, and sugar.

After eliminating all of those foods from the diet, and the symptoms have gone away, 1 food at a time can be reintroduced to see if the symptoms reoccur. A new food would be introduced each week. If you need more information, refer to the artiocle on food allergies.


THE FOLLOWING SUPPLEMENTS CAN BE TAKEN UNTIL SYMPTOMS IMPROVE:

1. Vitamin A – 5,000 Units a day times the age (with a 50,000 Unit maximum in one day). Pregnant women (or women who may become pregnant) should not take more than 10,000 units per day of vitamin A.

2. Vitamin C – 250 milligrams times age per day, given in 3 or 4 divided doses.

3. Zinc picolinate – 2.5 milligrams times age per day (with a 15 milligram maximum in one day)

4. Bioflavonoids – 50 milligrams times age per day. (250 milligram maximum in one day)

5. Evening Primrose oil – 1 capsule per day for an infant and up to 3 capsules for an adult.

6. Thymus extract – Age times 50 milligrams per day, up to 1,000 milligrams.

Do not use supplements for more than 2 weeks without consulting your physician.


HERBS USED FOR OTITIS MEDIA:

Ear drops should only be administered if the ear drum is intact. These may be used in oil form or as a tincture, which is a liquid herbal extract. Only in cases when the ear drum is undamaged, the following applications are used:

1. An ear drop tincture that contains 4 parts Verbascum (also called Mullein) and 4 parts Golden Seal – 3 to 4 drops are put in the ear at night or as needed. Consult your doctor if symptoms persist.

2. Ear oils – with equal parts of Garlic, Mullein, and St. John's Wort in olive oil. Two to 3 drops are put in the ear 3 times a day. Commercial preparations of this mixture are readily available in health food stores.

3. A tincture of 2 parts Echinacea, 2 parts Golden Seal, and 1 part Poke Root – 5 drops times the age per day, given with a small amount of juice or water every 2 hours.


AN ADDITIONAL MEASURE FOR OTITIS MEDIA:

Heat application – A warm towel or a hot water bottle wrapped in a towel is placed over the ear. Check the ear after the first couple of minutes to make sure the towel is not too hot. Children may not be able to judge this due to pain.


HOMEOPATHY
From the following homeopathic medicines, the one that best matches the symptoms is chosen. Dissolve 3 pellets under the tongue. These can be given every hour or 2 for the first 6 hours, then 2 to 3 times a day until all symptoms are gone.

• Aconite 12C: For sudden onset, particularly when the right ear is affected and especially if the earache occurred after being exposed to the wind.

• Belladonna 12C: For sudden onset, particularly when the right ear is affected. The face is dry, flushed. The skin may feel dry and burning. There is restlessness and lack of thirst.

• Chamomile 12C: For the child who is overly sensitive and intolerant of pain, which makes for extreme irritability and even rudeness. The person needing this remedy is never calm. Sometimes one cheek is red and hot, the other pale and cold. Pain is worse from warm applications.

• Ferrum phos 12C: This is the most commonly indicated remedy for the early stages of an earache with inflammation and infection.

• Hepar sulph 12C: For the person who is worse with any draft and wants to be well covered, is irritable, complains of stitching pains, and is sensitive to touch.

• Mercurius 12C: For an earache during damp or changeable weather, worse at night. The person is sweaty and smells sick. A large, flabby tongue shows imprint of teeth on the edges; there is excess saliva and bad breath.

• Pulsatilla 12C: For redness and swelling in the external ear. There may be severe throbbing pains, and the ears feel as if they are stopped up. The condition is worse from warmth and from becoming overheated, worse in the evening and at night. People responding to Pulsatilla often crave fresh air and feel weepy.

Note: A wide range of homeopathic medicines can be helpful for children with chronic or recurrent ear infections. Consultation with a health care professional trained in homeopathic prescribing will usually be the best way to select the correct medicine.

Clinic
Naturopathic HealthCare

Integrative Treatment Guide for Recurrent Otitis Media

Naturopathic Treatment Goals

Treat acute otitis media with non-antibiotic treatment options

Reduce frequency of otitis media

Prevent need for tympanostomy surgery

Prevent chronic otitis media complications

Reduce and eliminate risk factors associated with chronic otitis media

Reduce frequency of other Upper Respiratory Infections

Patient (parent/guardian) education and training

Create permanent healthy lifestyle and diet changes for patient and family

Decrease number of office visits to PCP as overall health improves

Enhance management of chronic otitis media

Naturopathic Assessment

History and Physical

Comprehensive Health Questionnaire, Food Journal

Lifestyle and Diet

Assess risk factors

Diet: high simple carbohydrate, high sugar

Environmental hypersensitivities

Food hypersensitivities-12

Recurrent URI, flu, colds

History of allergy and allergy associated symptoms

Chronic antibiotics3-7, 13

Increased intestinal permeability

Stress

Exposure to second-hand smoke1

Not breast-fed1, 15-16

Early bottle feeding

Family history of allergy

Assess risk of developing other allergy related symptoms and illness

Eczema, hay fever, asthma, etc.

Criteria for naturopathic treatment exclusion and inclusion, contraindication and precaution

Naturopathic Treatment

Therapeutic Nutrition

Botanicals

Homeopathy

Hydrotherapy

Individual diet

Develop permanent healthy diet and lifestyle changes for patient and family

Reduce and eliminate risk factors

Identify health goals

Patient (parent/guardian) Education and Training

Chronic Otitis Media Management and Prevention Information

Recurrent ear Infection information

Treatment explanations

Compliance and agreement

Treatment options and choices

Strategies to reach health goals

Food. allergies and chronic otitis media

Naturopathic Prevention Plan

Naturopathic Health Maintenance Plan

Chronic Ear Infection Information Packet:

Chronic Ear Infection, What Is Naturopathic Medicine?, Healthy Lifestyle Choices, Healthy Food Choices, Hypoallergenic Diet, Elimination Diet, Rotation Diet, General Diet Guidelines, Dairy Substitutions

Forms:

Comprehensive Health Questionnaire, Food Journal with list of food reaction/symptom response

Support Network Resources

Lectures (Southwest Naturopathic Medical Center), Southwest College of Naturopathic Medicine & Health Sciences (books, journals, information about naturopathic medicine, integrative and complementary medicine, references)

Long-Term Naturopathic Treatment Plan

Return to PCP for annual follow-up, physical exam and screening

One year follow-up with adjunctive treatment provider

Report of Findings to PCP

Physical Exam

Vitals

Weight, height

HEENT, Neck, CV, lung, abdominal

Naturopathic treatment plan individualized by selecting from the following therapeutic nutrition, botanicals and homeopathy:

Therapeutic Nutrition

Vitamin A (up to 50,000 IU per day for two days in children under six years of age)

Beta-carotene (age in years times 10,000 IU per day, up to 100,000 IU per day)

Vitamin C (age in years times 50 mg every two hours)

Bioflavonoids (age in years times 50 mg every two hours)

Zinc (age in years times 2.5 mg per day, up to 30 mg per day)

Thymus extract17-19 (500 mg crude polypeptide fraction/qd)

Human Micro Flora (HMF)25-26 (1/4-1/2 tsp/qd)

Colostrum 20-24 (1/8-1/4 tsp/qd)

Botanical Medicine

per individual patient

Homeopathy

per individual patient14

Hydrotherapy

per individual patient



Footnotes

BarShalom R, Soileau J. (eds.) Natural Health Hotline. Beaverton, OR: Integrative Medical Arts, 1991-1999.

1. Daly KA. Epidemiology of otitis media. Otolaryngol Clin North Am 1991;24:775-86.

2. Kleinman LC et al. The medical appropriateness of tympanostomy tubes proposed for children younger than 16 years in the united states. JAMA 1994;271:1250-5.

3. Froom F et al. Antimicrobials for acute otitis media? A review from the international primary care network. B Med J 1997;315:98-102.

4. Bluestone CD. Otitis media in children: to treat or not to treat. New Eng J Med 1982;306:1399-404.

5. Van Buchen FL et al. Therapy of acute otitis media: myringotomy, antibiotics or neither? Lancet 1981;2:883-7.

6. Williams RL et al. Use of antibiotics in preventing recurrent acute otitis media and in treating otitis media with effusion. JAMA 1993;270:1344-51.

7. Rosenfeld RM et al. Clinical efficacy of antimicrobial drugs for acute otitis media: meta-analysis of 5400 children from thirty-three randomized trials. J Pediatr 1994;124:355-67.

8. McMahan JT et al. Chronic otitis media with effusion and allergy: modified RAST analysis of 119 cases. Otol Head Neck Surg 1981;89:427-31.

9. Viscomi GJ. Allergic secretory otitis media: an approach to management. Laryngoscope 1975;85;751-8.

10. Bellionin P et al. Allergy: a leading role in otitis media with effusion. Allerg Immunol 1987;15:205-6.

11. Hurst DS. Association of otitis media with effusion and allergy as demonstrated by intradermal skin testing and eostinophil cationin protein levels in both middle ear effusions and mucosal biopsies. Laryngoscope 1996;106:1128-37.

12. Nsouli TM et al. Role of food allergy in serous otitis media. Annals Allergy 1994;73:215-219.

13. Diament M, Diament B. Abuse and timing of use of antibiotics in acute otits media. Arch Otol 1974;100:226-32.

14. Friese KH et al. The homeopathic treatment of otitis media in children-comparisons with conventional therapy. Int J Clin Pharmacol Ther 1997;35(7):296--301.

15. Duffy LC et al. Exclusive breast feeding protects against bacterial colonization and day care exposure to otitis media. Pediatr 1997;100(4):E7.

16. Saarinen UM. Prolonged breast feeding as prophylaxis for recurrent otitis media. Acta Ped Scand 1982;71;567-71.

17. Fiocchi A et al. A double-blind clinical trial for the evaluation of the therapeutic effectiveness of a calf thymus derivative in children with recurrent respiratory infections. Thymus 1986;8:831-9.

18. Genova R, Guerra A. Thymo-modulin in management of food allergy in children. Int J Tissue Reac 1986;8:239-42.

19. Cazzola P et al. In vivo modulating effect of a calf thymus acid lysate on human T lymphocyte subsets and CD4+/CD8+ ratio in the course of different diseases. Curr Ther Res 1987;42:1011-7.

20. Tzipori S et al. Remission of diarrhoea due to cryptosporidiosis in an immunodeficient child treated with hyperimmune bovine colostrum. B Med J 1986;293:1276-1277.

21. Butler JE. Immunoglobulins of the mammary secretions. Lactation: A Comprehensive Treatise, Eds. Vol 3. Academic Press, NY. 1974;217-252.

22. Palmer EL et al. Antiviral activity of colostrum and serum immunoblobulins A and G. Medical Virology 1980:123-9.

23. Rump JA et al. Treatmemt of diarrhea in human immunodeficiency virus-infected patients with immunoglobulins from bovine colostrum. Clinical Invest 1992:588-94.

24. Pakkanen R, Aalto J. Growth factors and antimicrobial factors of bovine colostrum. Int Dairy J 1997;7:285-297.

25. Friend BA et al. Nutritional and therapeutic aspects of lactobacilli. App Nutr 1984;36(2):125-35.

26. Anand SK et al. Antibacterial activity associated with Bifidobacterium bifidum. Cult Dairy Pro 1984;6-80.