Meniere's Disease

Explained in simple words

1Meniere's disease is a disorder of the inner ear that causes attacks of severe giddiness along with hearing problems.

2The inner ear contains fluid. In this disease, the pressure of that fluid becomes too high, like a balloon that is over-filled.

3This raised pressure disturbs both the balance organ and the hearing organ, because the two lie side by side and share the same fluid.

4That is why the disease affects hearing and balance together, which helps to tell it apart from other causes of giddiness.

5There are four typical features, and they usually occur together during an attack.

6First, sudden severe spinning that lasts from twenty minutes to several hours. It is often accompanied by vomiting.

7Second, hearing loss in the affected ear, which in the early stages comes and goes.

8Third, a roaring or ringing noise in the same ear, which often becomes louder just before an attack.

9Fourth, a feeling of fullness or blockage in that ear, as if it is stuffed with cotton.

10Many patients get a warning some minutes before the attack — the ear blocks, the noise increases, and then the spinning starts.

11Attacks come without any obvious reason and then stop. Between attacks, a person may feel completely normal, especially early in the disease.

12Over years, if untreated, the hearing loss can become permanent and the ringing may stay all the time.

13Usually only one ear is affected, though in some patients the second ear may be involved later.

14Diagnosis is made from the history, a hearing test, and balance tests such as VNG, caloric and vHIT. A scan may be advised to rule out other causes.

15The exact cause is not fully known. Salt intake, stress, poor sleep, caffeine, alcohol and smoking are known to trigger attacks.

16Treatment has two parts — controlling an acute attack, and preventing future attacks.

17During an attack, the patient should lie down in a quiet, dim room and keep the head still until it passes. Medicines are given to reduce the spinning and vomiting.

18For prevention, the most important step is a low-salt diet. This reduces the fluid pressure inside the ear and genuinely reduces attacks.

19Avoid papad, pickles, packaged and fried snacks, and do not add extra salt to food. Drink water regularly through the day.

20Reducing tea, coffee, tobacco and alcohol also helps, as does regular sleep and managing stress.

21Medicines such as betahistine and mild diuretics are commonly used for long-term control.

22Balance exercises help the brain adjust and reduce the unsteadiness felt between attacks.

23For the small number of patients who continue to have severe attacks despite all this, injections into the ear or surgical options are available.

24A hearing aid may be advised if hearing loss becomes significant.

25Most patients can lead a normal life once the disease is properly diagnosed and the triggers are controlled. Regular follow-up is important to protect the hearing.