Hearing loss affects over 48 million Americans today. While it can start from birth or come about through injury or illness at any point in a personโs life, it is most common for hearing loss to become a problem for older adults. Indeed, nearly 100% of centenarians have hearing loss, suggesting that if we live long enough, all of us will lose our hearing at some point.
Meniereโs disease is a special kind of ear ailment that can cause hearing loss and a number of other problems related to the inner ear. While it is far less common than other forms of hearing loss (it affects about 615,000 people in the U.S., accounting for about 1.28% of cases of hearing loss), one should be on the lookout for its symptoms in order to aid in diagnosis and treatment when it does occur.
While Meniereโs can happen to people of any age, it most commonly strikes those in their 40s and 50s. While there are techniques to manage the condition, it is unfortunately incurable.
What Is Meniereโs Disease?
Meniereโs disease is characterized by an excessive amount of fluid in the inner ear. While our inner ear is full of fluid under normal circumstances (a fluid called โendolymphโ), Meniereโs seems to be an excess and overflow of this fluid, or could be the result of other fluids breaching the inner ear and becoming trapped there. In addition to or possibly because of this excess fluid, the condition can also involve a swelling of the cochlear tissues.
Meniereโs disease almost always occurs in just one ear, and symptoms tend to be episodic, meaning they occur for a while and then stop for a while (usually they last for 20 minutes to four hours). Here are the symptoms, usually presenting in this order:
- A โfullโ feeling in your ear; a sense that it is pressurized.
- Tinnitus (ringing in the ears).
- Hearing loss (especially in the low frequencies) or muffled hearing.
- Dizziness or vertigo.
- In some cases, diplacusis (double hearing).
To reach a diagnosis of Meniereโs, you must experience tinnitus, hearing loss and vertigo together on more than one occasion. Symptoms will have different severity in each person; it may be that vertigo is the most intense symptom for you, while someone else experiences tinnitus as the dominant symptom.
Some people may mistake the effects of an allergy for Meniereโs disease, though it is possible that the allergy may develop into Meniereโs disease. Diagnosis is complicated, and can take some time to confirm. People with Meniereโs will usually experience a number of episodes in a relatively short span of time, with long periods of remission in between, so it can take a while to determine that there is a chronic illness at work, rather than a temporary condition that has subsided.
Causes and Triggers of Meniereโs
While there is no one thing that causes or predicts Meniereโs, the following list comprises all the possible causes, triggers and risk factors:
- Allergies
- Stress
- Anxiety
- Smoking
- Alcohol use
- Some medications (as a side effect)
- Inner- or middle-ear infections
- Head injury
- Family history of Meniereโs
- Recent viral infection
- Respiratory illness
- Migraines
- Autoimmune conditions
- Fatigue
As you can see, there are a wide range of conditions and behaviors that can predict Meniereโs disease. Modifiable risk factors include smoking (also a strong predictor of sensorineural hearing loss), alcohol use, and some lifestyle choices that can exaggerate stress and anxiety.
Stages and Impact
- Early: The four common symptoms outlined above occur out of the blue, lasting from 20 minutes to a full day. It may occur every day or there may be many days in between episodes.
- Middle: During episodes, vertigo tends to become less severe while hearing loss and tinnitus become worse. For many people, the disease will go into remission for weeks to months at a time.
- Late: Episodes may not include vertigo at all, or it may be much less severe. Tinnitus and hearing loss, however, can become much worse, and patients may generally feel unsure of their balance, especially in darkness.
Because Meniereโs is so unpredictable, patients will frequently suffer from depression and/or anxiety. These conditions are understandable, considering that a person with Meniereโs doesnโt know where or when their next episode will come. Meniereโs frequently causes issues for people at work or in public, and the worry about whether an episode will come at an inopportune time is very disruptive to a personโs daily life and emotional state.
Treatments
Treatments for Meniereโs have not been studied extensively, but there are a few suggestions that anecdotally show promise, seeming to have helped some patients.
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- Consume less salt: Salt helps the body retain water, so consuming less salt may allow for less fluid to be retained in the inner ear.
- Avoid caffeine: Caffeine has been shown to increase the effects of tinnitus, and can also increase stress and anxiety.
- Stop smoking: Smokers who suffer from Meniereโs frequently report decreased severity of symptoms after quitting. Smoking is also a risk factor for hearing loss, heart disease, lung cancer and many other avoidable physical ailments.
- Manage stress: For most people this is easier said than done, but undertaking to find the ways your lifestyle allows for a reduction in daily stress is beneficial for reducing the severity of Meniereโs and, like smoking, many other stress-related illnesses.
- Hearing aids: For the hearing loss associated with Meniereโs, a hearing aid is usually able to reduce the problem. Most modern hearing aids also have the capability to reduce the effects of tinnitus.
Talk to your doctor about Meniereโs and what steps you can take to reduce and treat the symptoms in your case. They will likely suggest that you see an audiologist and procure a hearing aid for the affected ear. Meniereโs can be very disruptive to a personโs life, so please take the necessary steps to reduce its effects as much as you can.