The most common ailment that I witness in the OPD nowadays is the itchy ears with discharge. Patients usually come from all backgrounds and ages, male and female, complaining of an earache. They complain of earache, itching and also discharge from the ears.

Upon after examining the patient, it is seen that they are suffering from some kind of ear infection, which can be of two types -- Otitis Externa and Otitis Media.

Otitis Externa occurs in the outer canal of the ear. Rain water, flood waters, or just water from bathing in ponds may enter the ears. We have a bad habit of scratching our ears or just introducing things like cotton buds, clips or even the ends of clothes into our ears, which allows the entry of bacteria or fungus into the canal.

Patients then will complain of pain, itchiness and discharge. Sometimes, there may be swelling and the pain may become intense and unbearable. The patient should definitely go and see a doctor at this stage. Otherwise, the infection may spread to the ear drum that can perforate it and cause hearing loss. After examining the ear, the doctor prescribes a local antibiotic and some other oral medication. Sometimes, if there is swelling, a pack soaked with antibiotics may be placed in the canal for 24 hours after cleaning, and removed later.

If the ear drum is involved and perforated, the patient has to be careful about not getting water in the ears. The patient must use an ear plug during bathing or some cotton soaked with olive oil or coconut oil or simply petroleum jelly. You must remember that if there is repeated discharge from a perforated ear drum, then there will be hearing loss, which is irreversible. So keeping the ear dry is very important.

Otomycosis -- also known as a fungal infection of the ear -- is also very common in this hot, humid weather. It is caused by an organism known as Aspergillus Niger and Candida Albicans. The symptoms are irritation, itchiness and a dull pain in the ear. Some patients also complain of a sense of blockage or heaviness of the ears and some discharge as well. The infection is usually caused by scratching the ear with damp cotton buds, clips or even nails that allow the entry of bacteria and fungus. The hot, humid environment is a very good breeding place for fungus and some bacteria. When the doctor examines the ear, there is the presence of fungal debris that looks like wet newspaper. This has to be thoroughly cleaned and an antifungal drop prescribed. If there is a superadded infection, oral antibiotics also have to be prescribed. If the infection is there for a long time, the ear drum may get perforated and so, extra care has to be taken to treat the ear.

Otitis Media occurs in the middle ear.  If there is a perforated ear drum, and there is an entry of water into the ear, it goes directly to the middle ear as there is no drum to protect it. This water is dirty and contains bacteria, which in turn causes an infection in the ear. If the ear was dry before, due to the presence of bacteria, there is pus formation, and discharge from ears. The patient complains of earache and a discharging ear. The doctor, after examining the ear, will clean it and prescribe drops and oral meds. It is important to remember that there is a hearing loss due to this kind of an infection and if it becomes chronic, then there will be permanent hearing loss.

If the patient is an elderly person with diabetes or any other immunocompromised condition, these infections seem to get more severe than usual and have to be treated faster. Sometimes, the patient may even need to be hospitalised.

Whether the infection is bacterial or fungal, in the external ear or middle ear, keeping the ear dry is the most important advice besides taking appropriate medication. Repeated infection of the ear causes damage to the ear drum, which in turn causes hearing loss. The introduction of dirty objects like hair clips, cotton buds, pieces of cloth and nails should also be avoided. Hearing is a valuable function for our living and so, we should make sure we protect it as best as we can.

Photo: Collected