Meniere’s Disease

Meniere’s disease is a disorder of the ear that results in loss of hearing, in one ear. It is known as idiopathic endolymphatic hydrops, and is a problem associated with the fluid balancing system in the inner ear.
The exact cause of this condition is not known, but it occurs when the amount of fluid in the inner ear rises. What exactly causes this fluid level to rise is not known.

It is experienced as pressure building up in one ear with increasing tinnitus and a drop in hearing. After this vertigo comes suddenly. This can last for a few hours to several days. When the vertigo attack is over the hearing improves.
There is no cure for Meniere’s disease; but there are a few way to alleviate the symptoms.

1. About Meniere’s Disease

Meniere’s disease is a disorder of the ear and is a problem associated with the fluid balancing system in the inner ear. The exact cause of this condition is not known, but it occurs when the amount of fluid in the inner ear rises. Its symptoms include: vertigo; severe dizziness; tinnitus (a roaring sound in the ears); fluctuating hearing loss, and the pressure or pain in the affected area of the ear known as aural fullness.
Possible cause include: allergy, abnormal immune response, trauma, etc

The symptoms are cyclical and follow a pattern: usually a sensation of pressure building up in one ear, with increasing tinnitus and a drop in hearing. vertigo comes quite suddenly, which may last for a few hours to several days. When the vertigo attack is over the hearing improves.
there is no cure for this disease; but the different methods can help in alleviating the symptoms. Following a strict diet regularly is one of the methods.

2. Causes of Meniere’s Disease

The portion of the inner ear known as the labyrinth, contains fluid. The labyrinth has two parts: the membranous labyrinth and the bony labyrinth. The membranous labyrinth, required for hearing and balance, is encased by bone, and filled with a fluid called endolymph.
When we move our heads, the endolymph fluid moves, causing nerve receptors in the membranous labyrinth to send signals to the brain about the body’s motion.
An increase in endolymph, however, can cause the membranous labyrinth to balloon or dilate. This condition is known as endolymphatic hydrops.

Perilymph, is another fluid that occupies the space between the membranous labyrinth and the bony inner ear. It is the belief of many experts, that a rupture of the membranous labyrinth allows the endolymph to mix with perilymph. This results in the symptoms of Meniere’s disease.
This explains what happens, but not why it happens. The exact cause of Meniere’s disease remains unknown.
A connection has been found between the onset of Meniere’s disease and recently suffered head injury, middle ear infection, and/or syphilis.
Other factors that increase the risk, include, allergies, alcoholism, fatigue, recent viral illness, respiratory infection, smoking, stress, and use of certain medications like aspirin. Genetics also play a role.

3. Symptoms of Meniere’s Disease

The symptoms of Meniere’s disease come with little or no warning at all.
One of the most debilitating symptoms is vertigo, which is dizziness accompanied by a rotating feeling that forces the person to lie down. Vertigo attacks can lead to severe nausea, vomiting, and sweating, and often come with little or no warning.
In addition to the vertigo, most attacks are accompanied by tinnitus, a loss of hearing and/or a feeling of fullness or pressure in the affected ear. The intensity, frequency, and duration of an attack differs from person to person.

The symptoms are unpredictable and can be experienced every day, or as rarely as once a year. In some patients, symptoms start with tinnitus, which is a sensation of a ringing, roaring, or buzzing sound in the ears or head. Then the experience of diminished hearing or a buildup of pressure in the affected ear.
A person’s hearing usually recovers between attacks, but over time can become worse.
Less common side effects include, headache, abdominal discomfort, and diarrhea.

4. Diagnosis

The physician will take a history of the duration, frequency, severity, and character of your attacks.
He/she might also inquire about whether the hearing loss has consistent symptoms or keeps changing – and if you experience tinnitus or fullness on both ears or just one.
The physician would also ask if you have a history of mumps, syphilis, inflammation of the eyes, an autoimmune disorder, allergies or had ear surgery in the past.
You can expect questions about your general health, diabetes, high blood pressure, high blood cholesterol, and thyroid or any neurologic or emotional disorders. Once the physician has completed the questioning, he/she will conduct diagnostic tests to check your balance functions and hearing.

Tests for Balance
To test balance the physician may perform Electronystagmography (ENG).
In this procedure, recording electrodes are placed near the eyes in a darkened room. Thereafter, warm and cool air is gently introduced into each ear canal.
Since the eyes and ears work in coordination through the nervous system, eye movements can be used to test the balance system.
Rotational testing or balance platform may also be used to evaluate the balance system.

Tests for Hearing
To test hearing, an audiometric examination is used.
This test typically indicates a sensory type of hearing loss in the affected ear.
If the ear is affected, speech discrimination is often diminished

Other Tests
– Computer Tomography (CT)
– Magnetic Resonance Imaging (MRI)
– Electrocochleography (ECoG), which is used to indicate increased inner ear fluid pressure in a few cases of Meniere’s disease
– Auditory brain response (ABR), which is a computerized test used to test the hearing nerves and brain pathway

5. Treatment

There is unfortunately no cure for Meniere’s Disease, but the symptoms can be controlled by reducing the body’s retention of fluids, through dietary changes (which include low-salt or salt-free food and no caffeine or alcohol) or medication.
Eliminating tobacco and reducing stress levels also help lessen the severity of the symptoms.
There is no known prevention, but prompt treatment of ear infections and other related disorders may be the best way to avoid this disease.
The goal of the treatment is to reduce pressure in the inner ear, and relieve symptoms.
This can be achieved through:

Dietary changes (such as a low-salt or salt-free diet, and no caffeine or alcohol)

Medication to control allergies, or improve blood circulation in the inner ear may help.
Water pills (diuretics) that can relieve fluid pressure in the ear could also help.

Lifestyle changes such as reducing stress levels, and stopping the intake of tobacco have proved effective in managing the symptoms.

Certain surgical procedures are also recommended for patients with persistent, debilitating vertigo.
One procedure, called Labyrinthectom, involves the removal of the inner ear sense organ, effectively controlling vertigo.
However, this procedure sacrifices hearing, and is reserved for patients with non-functional hearing in the affected ear.
Another option, Vestibular neurectomy involves selectively severing a nerve from the affected inner ear organ, and controlling vertigo while preserving hearing. However, it carries certain surgical risks.
In recent times, an option that is gaining popularity, is the administration of the ototoxic antibiotic – gentamicin directly into the middle ear space, which helps control vertigo.

i. During an Attack

During an attack, it is advisable to lie flat on a surface keeping your eyes aimed at an object that is stationary. Do not eat or drink anything. When you feel that the symptoms have gone away, get up slowly. At this time you may want to sleep for several hours.
Remember to call your doctor, if you keep vomiting for more than 24 hours, and are not able to keep down any liquids.

6. Meniere’s Disease Diet

Following a diet can also help in bringing the symptoms of the condition under control.

The aim of the Meniere’s disease diet is to limit the intake of foods that affect the fluid level in the ear.
There are certain foods like those containing large amounts of salt and sugar, which affect the fluid level in the ear. Studies have proven that having a salt free diet helps in reducing the severity of the symptoms to a great extent.

As always, it is essential to consult the doctor before making changes in your daily diet.
You should also reduce smoking and drinking.

The following is a list of foods that you need to avoid if suffering from this disease:

– Salt containing foods like chips, crisps, etc.
– Processed foods, preserved foods, canned foods
– Pickles, soy sauce, MSG containing foods
– Preserved meats
– Foods containing high amounts of sugar like desserts, ice cream, chocolates, etc.
– Caffeine containing foods and chocolate

– Your diet should consist of fresh fruits and vegetables, whole grains and other healthy and fresh foods.
– You should read the labels before buying any food.
– Avoid foods that are high in salts and sugar. You should add very little salt while cooking and avoid using salad dressings and sauces as they contain salts which are used as preservatives or in the form of MSG.
– Ask the chef to make your food low in salt and sugar, when eating out.
– Coffee and other caffeine containing foods trigger off the symptoms of this condition and can even induce migraine. Therefore, it is wise to avoid it completely.
– You can have herbal tea, green tea, fresh fruit juices, etc.
– You should have adequate amounts of water, i.e., 8-9 glasses every day.

When following the diet for Meniere’s disease, you should remember that it is very essential to have same amount of food and at same time every day. Along with the diet, the doctor will also prescribe medications to treat symptoms like vertigo and nausea. At the same time, you should also avoid stress and try to prevent the conditions that can trigger off the symptoms.
Lastly, remember that the condition can be treated if one follows the diet, medication and lifestyle changes properly.

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