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A Case of Otitis Media

by June Butlin(more info)

listed in infections, originally published in issue 58 - November 2000

Otitis media is a middle ear disorder, resulting in fluid and bacteria build-up, mainly of Streptoccocus pneumoniae, Haemophilus influenza and beta-haemolytic Streptococci. The infected fluid causes middle ear swelling, inflammation and infection, which in extreme cases can perforate the eardrum.[1] Otitis media is the most commonly diagnosed ear infection in children; US statistics reveal that two-thirds of American children are affected by age two; otitis media affects two-thirds of children under the age six.[2]

Causes of otitis media are enlarged adenoids, upper respiratory infection, exposure to cigarette smoke, high altitude, cold climate, bottle-fed babies, food allergies, and bacteria and viruses. Abnormal Eustachian tube function (auditory tube connecting the middle ear with the upper portion of the throat), is fundamentally the underlying cause in most cases of otitis media.[3] The Eustachian tube is responsible for regulating gas pressure, protecting against nose and throat secretions and bacteria, and clearing fluid from the middle ear.

An obstruction in the Eustachian tube results in increased mucus flow in the nose and throat, poor sleep, mouth breathing, snoring, sniffing, shortness of breath, wheezing, recurrent sore throats, temporary decrease or loss of hearing, and pain on the affected side.

Standard treatments are antibiotics, antihistamines and painkillers. Failure to respond to drugs may result in surgery in which a tiny plastic myringotomy tube is placed through the ear to drain fluid into the throat via the Eustachian tube. Studies show little or no effects with antibiotics; surgery is drastic and unnecessary for most children. Antibiotics may cause further problems due to immune suppression and destruction of the normal flora in the upper respiratory tract.[4-5]

I have seen many children with otitis media and would like to tell you five-year-old John's story. His mother contacted me for an appointment in the summer as John had bubbly, blistering rashes attacking his elbows, knees and hair. Before attending the appointment she filled in a specially prepared questionnaire for children. This revealed a three-year history of intermittent otitis media with repeated antibiotic therapy, disturbed sleep pattern, allergy to cow's milk and hearing difficulties. He hadn't been breast-fed as a baby and possibly had not built up immunity against otitis media. Research reveals that breast-fed babies have a thymus gland about 20 times larger than formula fed infants.[6-7] Over the last year, John had changed from being a lively, inquisitive, verbally adept child to one who was insular, uncommunicative, and lacking in concentration. His schoolwork had also deteriorated and his teacher had aired her concerns with his mother.

On the first consultation, the picture became much clearer. John's rash indeed was very severe and he was mouth breathing heavily and seemed totally distracted. The rash had all the characteristics of dermatitis herpetiformis, which is associated with coeliac disease (inability to digest gluten grains) as well as other allergens. Both his skin condition and middle ear infection are indicated in food allergy and it seemed likely that this was the cause.[8-10]

A kinesiology test (using his mother as a surrogate), urine and saliva analysis revealed the bacteria Streptoccocus pneumoniae, a weakened immune system, a compromised liver, and food sensitivities to wheat, rye, oranges, tomatoes and potatoes. Environmental sensitivities to grasses and pollens were indicated, which explained why John's condition became worse in the summer months. The test also suggested that he was stressed by his condition, which was further compromising the immune system.[11]

Although I do not like to suggest avoiding food groups in children, in John's case he did eliminate the suspect foods for one month. He also reduced sugar foods, which can lead to a depleted immune system.[12] His diet was well balanced and varied, consisting of organic wholefoods rich in carotenes; vitamin E, zinc and selenium for their antioxidant effects; and zinc, vitamin C and B6, which are required as antioxidants and for the manufacture of thymic hormones.

He ate porridge oats, banana and soya milk for breakfast, took vegetable pasta salads and fruit to school, and had fish or chicken, vegetables, rice and fruit at teatime. For treats he chose fruit and nut bars made with apple juice, toasted rice bread with sugar-free jam and gluten-free biscuits. His favourite food was custard tarts and a compromise was gluten-free tartlets filled with vanilla soya dessert. He drank lots of water and pineapple juice with sparkling spring water. John coped very well with the diet, especially as he understood why he needed to avoid certain foods.

I gave him some breathing exercises to strengthen the diaphragm and taught him how to breathe through his nose, which, with his mother's help, he practised daily. Swimming and extremes in temperature were avoided, a humidifier was placed in his bedroom, and his chest and back were massaged with eucalyptus oil before he went to sleep.

After ten days his skin problems cleared, which made him feel less stressed and two weeks later his teacher commented how much livelier, happier and attentive he was. The otitis media still caused him problems and further support was given in an immune tincture (5 drops 3 x daily) consisting of Echinacea purpurea, pau- d'arco, Unicaria tomentosa, garlic, cayenne, goldenseal root, Astragalus membranaceus, false unicorn root, black walnut bark, suma, red clover, elderberry, and dandelion root and leaf.

After four weeks, his breathing and sleep pattern were much easier and he was able to add potatoes, oranges and tomatoes back into the diet. It took ten weeks for his otitis media to clear completely and his breathing pattern to normalize. Prophylactically he now takes a teaspoon of quality aloe vera juice twice daily.

References

1. Cotran Kumar Robbins. Pathologic Basis of Disease W B Saunders & Company. 16: 746. ISBN 0 7216 5032 5. 1994.
2. Daly KA. Epidemiology of otitis media. Otolaryngol Clin North Am 24: 775-786. 1991
3. Tortora Grabowski. Principles of Anatomy and Physiology John Wiley and Sons Inc. p532. ISBN 0 471 36692 7. 2000.
4. Williams RL, Chalmers TC and Stange KC. Use of antibiotics in preventing recurrent otitis media and in treating otitis media with effusion. JAMA 270: 1344-1351. 1993.
5. Froom J et al. Antimicrobials for acute otitis media? A review from the international Primary Care Network. BMJ 315: 98-102. 1997.
6. Duncan B et al. Breast feeding in otitis media. Pediatrics 91(5): 867-72. 1991.
7. Elbach Jeppesen Engelman. Decreased thymus size in formula fed infants compared with breastfed infants. Periatr 85: 1029-1032. 1996.
8. Hurst DS. Association of otitis media with effusion and allergy as demonstrated by intradermal skin testing and eosinophil protein levels in both middle ear effusions and mucosal biopsies. Laryngoscope 106: 1128-1137. 1996.
9. Nsouli TM, Nsouli SM and Linde RE. Role of food allergy in serous otitis media. Annals Allergy 73(3): 215-219. 1994.
10. Garioch Lewis Sargent. 25 years' experience of a gluten free diet in the treatment of dermatitis herpetiformis. Br J Dermatol 131: 541-545. 1994.
11. Rose R. Endocrine responses to stressful psychological events. Psych Clin N Amer 3: 251-275. 1980.
12. Ringsdorf Cheraskin Ramsay. Sucrose neutrophil phagocytosis and resistance to disease. Dent Surv 52: 46-48. 1976.

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About June Butlin

June M Butlin PhD is a trained teacher, nutritionist, kinesiologist, aromatherapist, fitness trainer and sports therapist. She is a writer, health researcher and lecturer and is committed to helping people achieve their optimum level of health and runs a private practice in Wiltshire. June can be contacted on 01225 869 284;  junebutlin@btinternet.com

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