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Swimmer's ear (otitis externa) is an ear infection caused when bacteria found in water penetrates the ear canal. Occasionally, fungi or viruses may also cause this condition. Swimmer's ear usually only affects one ear and is most common among children, young adults and people who suffer from chronic middle ear infections.
Causes of Swimmer's Ear
Swimmer's ear derives its name from the fact that prolonged exposure to water from swimming, bathing, showering, or increased humidity may cause water to become trapped in the ear canal, resulting in this condition. Excessive moisture provides an environment conducive to bacterial growth and sets the stage for infection of the ear canal. Swimmer's ear can also be triggered by a cut or abrasion, or any skin condition like eczema that allows bacteria to penetrate the skin.
Normally, the ear is protected by the wax, known as cerumen, secreted by its glands and by its natural downward slope. When the area has been cut, however, or when excess moisture accumulates there, the body's natural defenses are not sufficient to keep infection from occurring. Certain sensitivity reactions, such as allergies to hair products or jewelry, may increase the possibility of swimmer's ear.
Symptoms of Swimmer's Ear
Early symptoms of swimmer's ear include pain or itching of the outer ear and a feeling that the ear is stuffed. If the infection is allowed to progress, the patient may experience a worsening of pain that occurs in the face or neck as well as the ear. Pus may begin to drain from the ear and the patient may develop a fever and swollen lymph nodes in the neck. A doctor should always be consulted for swimmer's ear that doesn't resolve quickly. While swimmer's ear is not in itself a serious condition, left untreated it can lead to serious consequences including temporary hearing loss, recurring infections and bone and cartilage damage.
Diagnosis and Treatment Of Swimmer's Ear
Swimmer's ear is diagnosed by a physical examination of the ear with an otoscope. The ear canal commonly appears red and swollen from the infection. Depending on the severity of the problem, the doctor may recommend a thorough cleaning, known as lavage or irrigation, or may prescribe oral or topical antibiotics. Usually the patient with swimmer's ear is advised to avoid swimming and to bathe or shower with care during the period of treatment. Keeping the ears dry and being careful to prevent foreign objects from entering the ear canal can help protect against future infections. Ear drops may also be useful in preventing swimmer's ear.
Nosebleeds, medically known as epistaxis, although a common occurrence, can be alarming. The great majority of nosebleeds, however, are not cause for serious concern. Most people experience one or more nosebleeds during their lifetime, usually during cold, dry weather. While nosebleeds can occur in a person of any age, they most frequently occur in young children and older adults. If an individual has frequent nosebleeds, however, or if a nosebleed is severe, the patient should be examined by a physician to make sure the that there is not an underlying condition that requires medical attention.
Types of Nosebleeds
Nosebleeds are categorized according to their point of origin in the nose. Anterior epistaxis accounts for 90 percent of nosebleeds and is easily controlled. Posterior epistaxis is far less common and may be more complicated to treat. Posterior epistaxis tends to occur in elderly individuals and may require the care of an otolaryngologist or even necessitate a hospital admission.
Causes of Nosebleeds
There are a many reasons for epistaxis, some common and some quite rare. Very often, a combination of factors may lead to a nosebleed. Certain causes may be more frequently observed in patients of a particular age group.
Common Causes Of Nosebleeds
- Dry air, especially dry cold air, that dries out nasal membranes
- Allergies, colds, or sinus infections, resulting in frequent nose blowing
- Nose picking
- Traumatic injury to the nose
- Blood thinners or hypertension medications
- Inhaled chemical irritants or illegal drugs, such as cocaine
Less Frequent Causes Of Nosebleeds
- Anatomical abnormality of the nose
- Hemophilia or other bleeding disorder
- Nasal or facial surgery
- Nasal tumors
- Leukemia or Hodgkin's Lymphoma
While it is best to assume that a single nosebleed is not a cause for concern, it is important to be aware of the more remote serious implications if nosebleeds recur.
Symptoms of Nosebleeds
Epistaxis is, of course, a symptom itself. Normally, the bleeding occurs from only one nostril, but if it is heavy enough, the other nostril may also bleed, or the patient may spit, or even vomit blood.
Symptoms of epistaxis that require medical consultation include:
- Blood in the urine or stool
- Frequent bruising
- Inability of the blood to clot
Patients who have a known disease condition or are undergoing chemotherapy should consult a physician if they experience a nosebleed. Emergency medical care is required if a patient experiences a nosebleed accompanied by:
- Lightheadedness, dizziness, or fainting
- Tachycardia or difficulty breathing
- Coughing up or vomiting blood
- Rash or fever
- Repeated nosebleeds during a short period also require immediate medical care.
- Diagnosis Of Reasons For Nosebleeds
In order to determine the cause of the nosebleed(s), the doctor uses a topical anesthetic to numbs the inside of the nose. This medication also constricts local blood vessels and reduces swelling. Blood tests will also be administered to evaluate the effect of any blood thinners in the system, to see how much blood the patient has lost, and to look for any abnormalities in the blood or any underlying disease conditions.
Treatment for Nosebleeds
There are a few simple home remedies for nosebleeds that are generally very effective. When medical intervention is required, packing may be involved.
Home Treatment for Nosebleeds
The following tried and true treatments for simple anterior nosebleeds are, most often, all that is required:
- Lean the head forward while sitting straight
- Pinch the nostrils together for 10 minutes
- Spit out any blood in the mouth
- Avoid sneezing or nose blowing for 24 hours
- Avoid strenuous exercise or heavy lifting for a few days
Methods that are not helpful for nosebleeds and, in fact, may make them worse, include leaning the head back and applying ice packs.
Medical Treatment for Nosebleeds
The first line of defense the doctor has for nosebleeds is to cauterize the affected blood vessel in order to seal it shut. This is usually only possible for anterior nosebleeds. Packing with petroleum jelly on gauze, which applies pressure to the affected blood vessel, may be used for either anterior or posterior epistaxis.
In more serious cases, where a posterior nosebleed requires hospital admission, a balloon or sponge pack may be employed. Since this type of packing prevents normal sinus drainage, is very uncomfortable, and carries a risk of infection, the patient may be given some combination of analgesics, antibiotics, and sedatives. These packings usually remain in place for 2 to 3 days.
If a medication or illegal drug is causing the problem, the doctor will make medication changes as needed, or help the patient seek help for the addiction. If other conditions are discovered, medication, radiologic procedures or surgery may be necessary.
Prevention of Nosebleeds
The most common types of nosebleeds can, in many cases, be prevented. Some effective methods of preventing nosebleeds are:
- Humidifying the air
- Using petroleum jelly, nasal lubricant or saline spray in the nose
- Avoiding picking the nose or blowing the nose too hard
- Avoiding smoking or being in a smoky environment
- Even though not all nosebleeds can be prevented, with a little foresight, many can.
Allergies of the Ear, Nose and Throat FAQs
What Are Allergies?
Allergies are abnormal responses of the immune system to normally harmless substances. These substance are known as allergens. Some of the most common allergens affecting the ear, nose and throat are pollen, dust, mold and animal dander. When the body is exposed to an allergen, it releases a variety of chemicals, including histamine. Histamine is the precipitating cause of the allergic reaction.
What Causes Ear, Nose and Throat (ENT) Allergies?
The precise cause of allergies remains unknown, but a hereditary factor is involved. If one parent has allergies, his or her child is much more likely than the general population to have allergies. If both parents suffer from allergies, a child has a greatly increased risk of developing an allergy. The specific allergen affecting the child may be different from the one affecting the parent. Allergies may develop over time once a threshold of exposure has been reached.
What Are the Symptoms Of ENT Allergies?
Most allergic reactions involving the ear, nose and throat are relatively mild, but may still interfere with everyday activities. Their symptoms include nasal rhinitis, which causes sneezing, runny nose, congestion and post-nasal drip. Patients with ear, nose and throat allergies may also suffer from headaches, itching, and soreness in the throat or ears. When plant and tree pollens cause these symptoms, the condition is commonly referred to as hay fever. More severe reactions, including anaphylaxis, are rare, but may be life-threatening. Because allergies of the ear, nose and throat are reactions to airborne allergens, sufferers may also experience allergic reactions in the eyes, skin, lungs or gastrointestinal tract.
How Are Allergies Diagnosed?
Diagnosing allergies is done by evaluating symptoms and performing a full physical exam. A skin or blood test may also be done. The skin test is done by placing different potential allergens on the skin, and pricking the skin so the substance can enter the body. If a reaction occurs on the skin, an allergy is diagnosed.
How Can Allergies Be Treated?
The most effective way to treat allergies is simply to avoid exposure to allergens but, of course, this is not always possible. For outdoor allergies, remaining indoors as much as possible during certain seasons may relieve symptoms. Because allergens often enter the body through the eyes, wraparound sunglasses may also prove helpful. Other treatments include antihistamines, decongestants, nasal sprays and eye drops. Allergy shots, a type of immunotherapy, may also be used as treatment. To increase a body's tolerance, an allergen is injected at increasingly larger amounts over time.
Ear infections, also known as otitis media, are one of the most common childhood medical problems. Ear infections are the most frequent cause of doctor visits for children. In fact, three out of four children in the United States will have at least one ear infection by the time they reach the age of three.
Causes of Ear Infections
While ear infections can occur in any of the three parts of the ear, they most commonly develop in the middle ear. Ear infections are caused when fluid builds up behind the eardrum in the Eustachian tubes, the tubes that connect the ears to the nose. This moist environment is conducive to the rapid growth of bacteria which result in the infection. Occasionally, although ear infections are usually caused by bacteria, viruses or allergies may be the underlying factor.
Since children's Eustachian tubes are narrower and shorter than those of adults, children are more likely to develop ear infections. In fact, ear infections are relatively rare in adults.
Risk Factors for Ear Infections
Certain individuals are predisposed to ear infections by heredity or anatomy. Feeding position can also be a risk factor as babies who are bottle-fed tend to develop more ear infections than breastfed babies. Children in group child care may be more likely to develop ear infections simply because they are exposed to more children who may be sick. Children exposed to secondhand smoke are also more likely to develop ear infections, as are children with weakened immune systems or allergies or those who use a pacifier.
Symptoms of Ear Infections
Typical symptoms of ear infections may include the following:
- Ear pain
- Difficulty hearing
- Discharge from the ear
- Loss of appetite or vomiting
- Sensation of fullness or popping in the ears
- Balance difficulties
Since young children often develop ear infections before they become verbal, parents may have to be detectives, alert to symptoms such as ear pulling, frequent crying, irritability and difficulty sleeping, particularly when these symptoms are present during or after a cold.
Diagnosis of Ear Infections
Ear infections are diagnosed through a thorough physical examination. To get a clear view of the eardrum, the doctor will use a small lighted tube called an otoscope. The physician may also perform a hearing test to evaluate whether there is any hearing loss, particularly if the patient has experienced recurrent infections.
Patients should be checked after ear infections to determine whether any fluid remains trapped behind the eardrum, a condition known as otitis media with effusion. Even though this condition may not result in any symptoms, it must be treated to prevent complications.
Treatment of Ear Infections
Treatment for ear infections usually focuses on relieving pain and congestion through oral medication or ear drops since most ear infections resolve on their own within two or three days. Antibiotics are only prescribed if the infection is bacterial, since viral infections do not respond to antibiotic treatment. If an ear infection is severe or resistant to medication, or if a patient develops chronic ear infections, the doctor may recommend the use of corticosteroids or the implantation of ear tubes to promote drainage. If the cause of repeated infections is determined to be anatomical, the doctor may recommend another surgical procedure.