Saturday 19 October 2019

Dear Dr Nina: Ear trouble... annoying sensation has me concerned

Allergic rhinitis may be the underlying condition
Allergic rhinitis may be the underlying condition

Nina Byrnes

QFor the past couple of weeks, I have had a weird sensation in my ear - it feels like there is air trapped or something. It is annoying, but not painful, and only occurs now and then. What could this be?

A Ear discomfort may be due to congestion in the Eustachian tube. This tube runs from the back of the nose to the middle ear. If this is congested, pressure builds up, potentially causing pain.

Allergic rhinitis may be the underlying issue. It causes a sensation of blocked nose, congestion and can cause sneezing, itchy eyes and nasal drip. Other symptoms include reduced taste, red eyes, mouth breathing, snoring, reduced sleep and fatigue.

Rhinitis occurs in about 20pc of the population. It affects all ages. It is more common in those with a personal or family history of asthma or eczema.

Treatment aims at reducing congestion. Using a daily nasal rinse may help. There are many available over the counter in pharmacies. Used correctly, these can flush dust, spores and irritating mucus from the nasal passages, helping to keep them clear and reducing pressure into the Eustachian tube.

Medication can help. Antihistamines reduce the body's allergic response, helping to limit the congestion, swelling and nasal drip associated with rhinitis.

Steroid nasal sprays are essentially the mainstay of treatment for this. They act locally in the nasal passages, so absorption into the body is minimal. They help to reduce swelling in the nasal passages, thus reducing congestion and blockage. This may ultimately help the blocked sensation you are feeling in your ears.

Steroid nasal sprays are generally considered safe and they can be used on an ongoing basis if required.

It is important that remedies are used in the correct way and the correct order. If your nasal passages are very inflamed, using a decongestant such as pseudoephedrine or stronger steroid nasal drop for a few days before starting the nasal spray may render the spray more effective. Pseudoephedrine, however, should never be used for more than a few days and should only be used under medical or pharmacy advice, as it isn't suitable for everyone.

When using a nasal spray, aim straight back into the nose, not up or in, and breathe normally after using it. This reduces the likelihood it will irritate the lining of the nose and also ensures it stays in the nose, where it needs to be. Snorting the spray back delivers it to the throat, reducing its efficacy.

If sprays, rinses and antihistamines aren't working there are other prescription options and it is worth talking to your doctor. Symptoms going on longer than a few weeks or those that affect only one side should be assessed by a doctor to rule out other causes of obstruction. Referral to a specialist is sometimes required.

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