Do your ears feel like they’re under water, or plugged? Often related to allergies or upper respiratory infection, eustachian tube dysfunction is a common cause of congested ears and brings many of you to the doctor. While you are waiting to get an appointment, there are some good non-prescription options you can start off with.
So what’s happening, why and what can you do about it?
Why do my ears feel like I’m under water?
The eustachian tube runs from the middle ear, the air filled chamber, to the back of your nose. The mantra of ENT (ear, nose and throat) doctors is that “the ears are always tied to the nose” so a congested nose often results in congested ears—feeling like your ears are popped and you can’t un pop them.
What does the eustachian tube do?
This is important to know if you have ear congestion. The eustachian tube’s main function—equalizing pressure in your ear—is controlled by opening and closing of the tube. Equalizing pressure across the eardrum or “gas pressure equalization” is essential for proper hearing.
Super cool fact: the eustachian tube normally opens with swallowing and yawning approximately 84 times per hour in the daytime. When the tube isn’t opening or closing properly due to inflammation or infection—meaning it can’t equalize pressure—you aren’t able to hear well and will have the sensation of fullness in the ears.
How do I know if I have eustachian tube dysfunction?
Not through fancy tests—this diagnosis is based on history and physical examination. Your doctor will hear your story and look in your ears. An ENT doctor is only needed to confirm the diagnosis with nasal endoscopy and audiology (hearing tests) if your symptoms aren’t improving with standard treatment.
Other than my ears feeling “plugged” what other symptoms might I have?
Ear pain, a sensation of ear fullness or pressure, hearing loss, and ringing in your ears (tinnitus) are all signs of eustachian tube dysfunction. Hearing popping and snapping noises is also common and occurs with the opening of the eustachian tube against an unusually large change of pressure. You may have vertigo or dizziness.
Remember that TMJ (temporomandibular joint dysfunction) also produces ear blockage symptoms that are commonly mistaken for eustachian tube dysfunction. With TMJ though, there is often pain deep in the ear, and tenderness within the joint space that occurs with mouth opening.
How did I get eustachian tube dysfunction?
- Allergies: If you’ve had itchy runny nose or sneezing, those may be symptoms of allergy.
- Upper respiratory infections: Colored (yellow, green) discharge from the nose, sore throat and cough are a good sign your eustachian tube dysfunction was a result of infection.
- Heartburn and reflux can do it.
- Smoking and secondhand smoke are also contributing factors.
The treatment of eustachian tube dysfunction should be directed at the underlying cause so start here:
- Decongestants. Sudafed (pseudoephedrine) may be helpful for the ear fullness and pressure.
- Nasal steroid sprays. Flonase, Nasacort, Nasonex, and others will help if your symptoms are due to allergies and nasal congestion.
- Non sedating antihistamines. Again, if you have allergies, adding Claritin, Zyrtec, or Allegra may help.
- Oral steroids like prednisone or methylprednisolone. Oral steroids may be used for persistent symptoms when other options have failed.