Ear Infections

In my last newsletter, I covered how Chiropractic care is extremely important for children as well as adults. The feedback I received was excellent, but there was a prevailing theme: “we want more information.” So, in the coming months, I would like to take some time to explain how some common childhood ailments are specifically addressed through Chiropractic. This is the first in a series of newsletters each focusing on an individual ailment.

Ear Infections (Otitis Media): In order to better understand how Chiropractic is, in my opinion, the best and first line of defense against childhood ear infections, we need to understand the anatomy of children’s ears. The ear is broken up into three distinct anatomic regions: the external, middle, and inner ear. The external ear mainly consists of the areas that you can see. This includes the pinna (part you can touch), the ear canal, and the outer surface of the eardrum (which is what the doctor examines when he looks into your child’s ears). The middle ear is a hollow, air-filled space from the ear drum to the oval window (another membrane that separates the middle ear from the inner ear). The middle ear is connected to the pharynx (upper throat) by the Eustachian tube, which is vitally important in middle-ear health. The middle-ear also contains three small bones that work in concert to transmit vibrations from the ear drum to the oval window, which then vibrates fluid in the inner ear and shakes the hair-like receptors within it to create sensory signals to the brain. The inner ear is securely housed within the skull and contains several fluid filled cavities and specialized sensory receptors that turn sound and movement into electrical impulses to the brain for interpretation. Sound waves enter the ear canal and vibrate the eardrum, which then transfers motion to the three small bones of the middle ear, which in turn transmit the vibrations into fluid waves in the inner ear. Needless to say, this is an extremely intricate system.

Now, why are children more susceptible to middle ear infections? The issue lies with the shape of children’s heads and how it affects the Eustachian tube and its function. This tube opens whenever you swallow, or when there is a pressure difference between the middle ear and the outside atmosphere. Otherwise, it remains in its collapsed state. This is the cause of your ears “popping” when traveling on an airplane or going over large hills in a car. Without this tube, we would be unable to equalize pressure. However, this exchanging of air comes with a price: the middle ear is open to the environment. Much as we have mucous membranes in our mouths as they are open to the outside world, we have mucous membranes lining the middle ear. Thus, there is a constant flow of secretions to help flush down the Eustachian tube to prevent anything from getting into the middle ear. In adults, the aforementioned Eustachian tube runs down from the middle ear to the pharynx, so it is essentially gravity drained. In children, due to the shape of their heads, this tube is much shorter and nearly horizontal. Even worse, as infants spend most of their time on their backs or in a reclined position, gravity actually feeds material up into the middle ear. Naturally, this makes infants more prone to ear infections, and explains why those with recurrent otitis media “grow out of it.”

How they are treated:

· Allopathic Model:
o Antibiotics: The traditional allopathic model of treating ear infections begins and ends with antibiotics. The intended goal is to kill the offending organism and thus quell the infection. However, recent studies have shown that treatment of middle ear infections with the antibiotic amoxicillin has a much higher rate of recurrence than in a placebo group. In the study, otitis media recurred in 63% of the antibiotic treated children as opposed to 43% in the placebo group.[i] Furthermore, objective observation of the tympanic membrane in children treated with amoxicillin versus those with placebo revealed “no otoscopic differences were observed at days four and 11, and tympanometric findings at six weeks were similar in both groups.”[ii] In another study, the researchers found that “Co-amoxiclav has no significant benefit over placebo in treating children over 2 years with acute otitis media.”
[iii] Co-amoxiclav is modified amoxicillin resulting in a broader spectrum. It is a very powerful antibiotic. These studies strongly suggest that antibiotics are being improperly prescribed in a vast majority of cases as there has been no demonstrable benefit to using antibiotics long term, or in some studies even short term as acute otitis media is often viral in origin and thus cannot be helped by antibiotics. Recent figures show that as many as 10 million prescriptions for antibiotics are improperly given in the U.S. annually. Furthermore, use of a broad-spectrum oral antibiotic will dramatically affect the population of beneficial bacteria systematically. This allows for unchecked growth of pathological bacteria (leading to recurring infections, which explains the higher recurrence rate) and can cause severe complications in children’s digestive health.
o Fever Reducing Medications: These medications are simply used to control the child’s temperature. However, physiologically, reducing the fever limits the immune system’s response to the problem. Your body uses a fever to slow bacterial growth. Reducing the fever handicaps the child’s immune system.
o Tympanostomy Tubes: In extreme cases, the treatment will be to insert tubes into the eardrum to artificially equalize pressure in the middle ear and provide a path for drainage. Significant side effects of inserting tubes into the eardrum include recurrent infection and retardation of speech and hearing development. Rupturing the eardrum in this manner reduces its ability to convey sound waves, and thus reduces the child’s ability to hear at what is generally the most important time of the child’s life for speech development.

· Chiropractic Model:
o Chiropractic Adjustment: As the body is a self-healing, self-regulating organism, Chiropractic focuses on why the infection is occurring in the first place. Unlike using drugs, which only treat the symptom, Chiropractic searches for why the infection occurred in the first place. As I mentioned above, subluxation (misalignment) of the upper bones of the neck can irritate the exiting nerves, and cause reflexive muscle spasm and limit the function of the Eustachian tube. Correcting this misalignment allows the body to drain the middle ear and appropriately fight the infection, thereby healing itself.
o Support the Body’s Response: The human body will only increase its temperature (fever) to fight off an infection, or if its cooling systems are overwhelmed. As bacteria are susceptible to changes in temperature, employing a fever slows bacterial growth and assists the body’s immune system. Although fevers should be monitored as high fevers can be dangerous, allowing the body to use its natural defense mechanisms appropriately can be immensely beneficial.
o Dietary Modifications: Many times, we have found that ingestion of cow’s milk products can predispose a child to ear infections. While studies into the matter are inconclusive, cow’s milk has been known to thicken mucous as well as increase its production. Whether this is due to a cow’s milk allergy must also be determined. The increased mucous production would allow the Eustachian tube to become more easily occluded.

In closing, recurrent childhood ear infections are quite common, and also very easy to treat naturally, without the use of potentially harmful antibiotics or surgery. My brothers, sister, and I have never had an ear infection, and it is exceedingly rare to hear of any children under Chiropractic care having them.

The body is an innate, self-regulating, self-healing organism. You eat a meal, your body disassembles all of the compounds, absorbs them, and takes them exactly where they need to go. Your heart beats on its own, you breathe while you sleep, and your body even heals itself when injured. All of this is done without a single conscious thought. When you support the body and its amazing ability to fight infection and heal itself, the results are amazing. Drugs only cover the symptoms, and silence nature’s protest, all the while allowing the cause of the symptoms to continue unchecked.

I leave you with this quote by L. F. Kebler, M.D.:

“Why should a patient swallow a poison because he is ill, or take that which would make a well man sick?”

To start your path to wellness, please call the office at 207-989-0000 to set up an appointment. My door is always open.

Daniel J. Myerowitz, D.C., Dipl. Ac. (AACA)
Myerowitz Chiropractic & Acupuncture Clinic
291 Main Road
Holden, ME 04429

[i] Bezáková, N; Damoiseaux, RA; Hoes, AW; Schilder, AG; Rovers, MM (2009). “Recurrence up to 3.5 years after antibiotic treatment of acute otitis media in very young Dutch children: survey of trial participants.” BMJ (Clinical research ed.) 338: b2525.

[ii] “Otitis Media With Effusion – American Academy of Family Physicians”. Aafp.org. http://www.aafp.org/online/en/home/clinical/clinicalrecs/otitismedia.html. Retrieved 2009-08-19.

[iii] Co-amoxiclav in recurrent acute otitis media: placebo controlled study. Appelman CL, Claessen JQ, Touw-Otten FW, Hordijk GJ, de Melker RA. Department of General Practice, University of Utrecht, The Netherlands. BMJ. 1991 Dec 7;303(6815):1450-2.

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