[56M] Experiencing ear congestion and voice changes

Patient Description

A 56-year-old male reports moderate ear congestion persisting for 2 weeks, which is worse in the morning and can be temporarily relieved by blowing the nose. The patient initially had a minor sore throat followed by nasal congestion, which has since resolved, but the ear congestion and a notably lower voice tone remain. The patient experiences difficulty hearing when ears are congested, with hearing returning to normal once congestion clears. There is also a loud ringing in the left ear. The patient has a history of sinus pressure since November of 2023 and was treated with amoxicillin for fluid in the left ear, which resolved the fluid but not the congestion. The patient has type 2 diabetes, managed with insulin, and takes Claritin (10 mg daily) and alternates between OTC Pepcid and Prilosec (20 mg each) following label directions. No known drug allergies. The patient's sister has a history of recurring vertigo.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possible conditions:

  • Eustachian Tube Dysfunction: This tube connects your middle ear to your throat. If it becomes blocked, you may experience symptoms such as ear congestion, difficulty hearing, and tinnitus (ringing in the ears). This condition often follows an upper respiratory infection, like a cold, which you mentioned having had.

    • Treatment typically involves over-the-counter medications to relieve symptoms, such as decongestants, antihistamines, or nasal steroids. In some cases, a doctor may recommend a procedure to drain fluid from the middle ear.
  • Sinusitis: This is inflammation or swelling of the tissue lining the sinuses, often due to an infection. Given your history of sinus pressure and the fact that your symptoms seem to be worse in the morning, this could be a possibility.

    • Treatment typically involves antibiotics if it's caused by a bacterial infection, as well as nasal decongestants and steroids.
  • Gastroesophageal Reflux Disease (GERD): This is a chronic condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and potentially cause voice changes. Given that you're taking Pepcid and Prilosec, which are both used to treat GERD, this could be a possibility.

    • Treatment typically involves lifestyle changes, such as dietary modifications, and over-the-counter or prescription medications to reduce stomach acid.

What you can do

  1. Continue taking your current medications as directed by your doctor.
  2. Try to identify any potential triggers for your symptoms and avoid them if possible.
  3. Keep a symptom diary, noting when your symptoms occur, their severity, and any potential triggers. This can be helpful information to share with your doctor.
  4. Stay hydrated and try to rest as much as possible.
  5. If you smoke, consider quitting as this can worsen both Eustachian tube dysfunction and GERD.

What you should look out for

Please seek immediate medical attention if you experience:

  • Severe pain or discomfort
  • Symptoms that persist for more than a week despite treatment
  • Difficulty swallowing or breathing
  • Fever or chills
  • Dizziness or balance problems

Remember, I'm an AI and this advice is based on the information you've given me. It's always a good idea to consult with a healthcare professional who can evaluate your symptoms and medical history to provide a diagnosis and treatment plan.

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People Also Ask


What is Eustachian Tube Dysfunction and how is it treated?

Eustachian Tube Dysfunction occurs when the tube connecting the middle ear to the throat becomes blocked, leading to symptoms like ear congestion, difficulty hearing, and tinnitus. Treatment often includes decongestants, antihistamines, or nasal steroids, and in some cases, a procedure to drain fluid from the middle ear may be recommended.


Can sinusitis cause ear congestion and how is it managed?

Yes, sinusitis can cause ear congestion due to inflammation or swelling of the sinus tissue, which can affect the Eustachian tubes. Management typically involves antibiotics if it's bacterial, along with nasal decongestants and steroids to reduce inflammation.


How does GERD affect the voice and what are the treatment options?

GERD can cause changes in the voice due to acid reflux irritating the esophagus and vocal cords. Treatment options include lifestyle changes, such as dietary modifications, and medications like antacids, H2 blockers, or proton pump inhibitors to reduce stomach acid.


What are the potential complications of untreated ear congestion?

Untreated ear congestion can lead to complications such as persistent hearing loss, chronic ear infections, or even damage to the ear structures. It's important to address the underlying cause to prevent these issues.


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