Asked by Nerisa, New York
I had a terrible cold that lasted about two weeks, and my right ear is still clogged with congestion. I find that it gets worse throughout the day, and I get that "popping" feeling when I blow my nose. Should I be on antibiotics?
Living Well Expert
Dr. Jennifer Shu
Children's Medical Group
Thanks for your question, and sorry to hear about your continuing discomfort. The short answer to your question is maybe, but probably not.
If you have a middle ear infection (otitis media) or sinus infection associated with your symptoms, then antibiotics may help. Your doctor can make the diagnosis and prescribe antibiotics if needed.
However, the scenario you describe sounds typical of a problem with the Eustachian tube, which connects the middle ear with the throat.
I consulted Dr. Aaron Rogers, an otolaryngologist in Atlanta, to provide more information about the symptoms you describe. He shares the following:
"The ear feeling clogged and the clicking during a cold or sinus infection are a result of the Eustachian tube, the ear's natural drainage tube, getting swollen shut -- or, more commonly, partly shut.
"That swelling can give you a clicking or popping noise, a feeling of ear fullness, a mild earache or even a sense of disequilibrium (being off balance). The swelling can commonly last a couple of weeks. If the tube stays completely swollen for more than a couple of days, you could even begin to build up fluid behind the eardrum.
"In addition to colds, nasal allergies, sinus infections and even stomach acid reflux can cause the Eustachian tube swelling.
"A middle ear infection from infected fluid behind the eardrum will cause muffled hearing and usually severe pain. This is usually the end result of the Eustachian tube being swollen completely shut for several days.
"Usually, antibiotics are not needed for the sensation of fullness, clicking and mild pressure. In fact, for just plain Eustachian tube dysfunction (or ETD) without infection or allergies, we do not really have a proven medical treatment that is any better than just 'waiting it out.'
"If there are other signs of a lingering sinus infection or the beginnings of an ear infection, antibiotics may be helpful. Other medications such as prescription nasal sprays can at times help treat Eustachian tube dysfunction as well, especially if there is a lot of swelling in the nose from the remnants of a cold or allergies.
"Occasionally, some cold viruses can damage the hearing nerve and may mimic ETD. Other prescription medications may help if started quickly enough.
"Finally, try not to worry about the popping and clicking when you blow your nose -- that is just the Eustachian tube trying to open up to get the ear aired out again. These symptoms will go away once the Eustachian tube is working properly.
"If your ear congestion is not clearing in about three to four weeks' time, then getting evaluated by your primary care doctor or an otolaryngologist may be helpful. If needed, hearing and ear pressure tests can be done to see if draining any fluid is needed or whether medications may help."
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