Ear Discharge – Causes, Symptoms, Ayurvedic Treatment, Remedies

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Ear discharge is explained as a disease by name Karna srava in Ayurveda. Tulsi, onion, garlic, neem oil etc are very useful. In this condition the ear gets afflicted with various symptoms of vata due to certain causes and discharge pus.

Karna = ear
Samsrava / srava = discharges, drainage
Karna Samsrava = discharges / drainage from ear
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Causes, symptoms

Causes of Karna Samsrava

• Head injury (Shiro abhighata)
• Jale nimajjate – jumping into water / pool (as in swimming)
• Vidradeh prapakad – maturation / ripening of abscess

Pathogenesis of ear discharrge – Karna Samsrava – due to the above said causes, the ear gets afflicted by various symptoms of vata and discharges pus. This condition is called karna samsrava.
Read – Abscess Home Remedies – Ayurveda Details

Symptoms of karna srava –

• Sraved puya – discharge of pus from ears
• Anilarditah – various kinds of symptoms of vata vitiation
  Read – Symptoms Of Vata Dosha Increase And Imbalance – Vata Vruddhi Lakshana

Correlation, Sanskrit verse

Modern correlation and analysis
Karna srava can be closely compared to ‘ear discharges’ or ‘otorrhea’ explained in modern medicine. (read more)

Otorrhea is any fluid which comes from ear and not necessarily pus as explained in Ayurvedic texts.

Thus, puya srava i.e. discharge of pus from ears should be taken in a broader sense and applied to other discharges like watery and blood discharges also.

When we look at the causative factors, it includes head injury. If there is head injury there might be discharge of blood from the ears instead of pus. But if the bleeding caused due to head injury is not treated properly or if it takes long to heal, infection may occur and consequentially lead to discharge of pus from the ears.
Read – Vertigo Causes, How To prevent, Ayurvedic Treatment

Another cause is dipping or jumping into the water. Here too, we may not find discharge of pus directly. When a person jumps in water, water may enter the ears and disturb vata. Initially there is discharge of water or fluids resembling water from the ear. This vitiated vata may cause various kinds of pain in the ear and also discharge pus. The water which has entered the ears and hasn’t been removed totally may cause excessive dampness, infection and consequent discharge of pus from the ears.

One more cause is the maturation / ripening of abscess. This will cause discharge of pus from ear. Thus, when all the causes of karna samsrava are analysed together, there would be many kinds of discharges from the ear, but eventually there will be discharge of pus in end stages. Thus, only discharge of pus has been mentioned in the symptoms explained in Ayurvedic texts.

The type of discharge determines the cause, if it is an injury or infection causing the discharge. There may just be a discharge of wax from the ear, which also needs to be considered as karna samsrava.
Read – Tested Remedies For Eye, Ear, Nose, Throat Problems: Ramdas Pai

Treatment, remedies

Treatment of Karna samsrava (ear discharges)
Karna Prakshalana –
Ear should be washed and drained so as to cause its thorough cleansing. This shall be done by using herbal decoctions which can heal the infection and also check discharges.
Read – Oral, Ear And Head Therapy – Ashtanga Hrudaya Sutrasthana 22

Karna Purana –
Aushadha churna purana – The afflicted ear should be filled / dusted with fine powder of medicinal herbs.
Panchavalkala Kashaya purana – decoction of Panchavalkala should be added with juice of fruit pulp (Feronia limonia) and honey and filled in the afflicted ears.
Tidukadi churna purana – powder of Diospyros malabarica (tinduka), Terminalia chebula, Symplocos racemosa, Rubia cordifolia and Emblica officinalis should be mixed in the juice of fruit pulp (Feronia limonia) and filled in the afflicted ears. (Read – Tinduka – Uses, Dose, Research)
Priyangvadi Taila purana – oil processed and prepared with decoction of Callicarpa macrophylla, liquorice, Cissampelos Pereira, Desmodium gangeticum, Rubia cordifolia, lac and fruit pulp (Feronia limonia) should be used as ear drops / ear filling.
Read – Karna Bindu Ear Drops: Benefits, How To Use, Ingredients, Side Effects

Dushta Vrana and Nadi vrana chikitsa –
Master Vagbhata has emphasized on treating ear discharges on the lines of treatment of contaminated wounds and sinus ulcers.

Otorrhea causes

Ear discharge is a common complaint we encounter in the clinical practice. Any fluid which comes out of the ear is abnormal, and is considered as ear discharge. It is also called as otorrhea.

Many times you may experience an earwax discharge. This might just be a common condition and if it doesn’t occur regularly or repeatedly, it is a mechanism by which your ear is trying to throw out the dust, bacteria and other foreign bodies it has filtered by oil called earwax it naturally produces. When it occurs repeatedly and troubles you, even earwax is an abnormal ear discharge.
Read – Watery Eyes: Causes, Ayurvedic Treatment, Remedies

If there are other types of discharges occurring from your ears i.e. watery, bloody or pus discharges, they are threatening. They are signs that alert you that your ears have been either infected as in pus discharges or that there is an injury in your ear or head or a ruptured eardrum as suggested by bleeding ears. These are also the signs that you need medical attention and you should consult a doctor as quickly as possible. Many times, the ear discharges are not as simple conditions as we think they are.

Causes of Ear Discharge / Otorrhea
Ear discharge, many times comprise of ear wax trying to make its way out of your ear and this is natural.
Other major causes of ear discharge of different kinds are either an infection or injury.
Below elaborated are the common causes of ear discharge –

Otitis Media / Middle Ear Infection – It is one of the most common causes of ear discharges. It occurs due to the infection of the middle ear from bacteria or viruses making their way into the middle ear. Due to middle ear infection, fluids will accumulate behind the ear drum. When these fluids accumulate beyond limits, they impart pressure on the eardrum consequentially causing its rupture. Following the rupture of eardrum, the fluids rush into the outer ear from the middle ear and get discharged from ears.
Read – Chaturvidha Netra Srava – 4 types of eye discharges, symptoms, treatment

Trauma / injury to the ear canal – When the ear canal gets injured it will cause discharges from the ear. One should be careful while cleaning the ears. Pins, needles, pencils, pens, wooden sticks etc should not be used to clear the ears. Buds too need to be used with caution. There is a chance of injuring the eardrum and also the ear canal if these things are pushed deep into the ear.
Below mentioned may be causes of ear canal injury –

• Putting foreign substances into the ear to cleanse the ears will injure and rupture the eardrum.
• Increased pressure in the ear canal as happens during scuba diving or when you have taken a flight can lead to rupture of eardrum.
• Damage to the ear due to exposure to very loud noises i.e. acoustic trauma will cause rupture of eardrum.
  Read – Allergic Rhinitis: Causes, Remedies, Ayurvedic treatment, Herbs

Otitis externa – It is the inflammation of the external ear. It is also called as Swimmer’s ear usually caused in swimmers. It usually occurs in those who spend lot of time in water and water related activities including swimming. This entertains water into the ears. Water flow into the ears with great velocity might cause eardrum rupture. Excessive dampness in the ear can become source of infection. This allows bacteria and fungus to infect your ears. The ear canal and the skin on its walls may give way due to increased moisture inside the ear canal. This allows the bacteria or fungus to enter the ear canal, accumulate there and cause infection.

It is not a rule that otitis externa occurs in swimmers exclusively. Even in others, when there is breakage in the skin lining the ear canal it might occur or when one has eczema in the ears leading to an irritated skin. In either cases, the skin exposed to water while taking a head bath, with water accidentally entering into ear canal and not been wiped out, coming in contact with torn skin of ear canal becomes a source for infection. They can cause otitis externa even in the absence of contact with water.
Read – Eczema: Causes, Ayurvedic Treatment, Medicines, Home Remedies

This condition also occurs when you damage your ear canal by frequently inserting foreign objects into your ear canal leading to its damage, which in due course of time becomes more susceptible for infection.

Other less common causes of ear discharge

• Skull fracture following accidents
• Mastoiditis (infection and inflammation of the mastoid bone, the bony mass behind your ear
• Malignant otitis externa – it is a complication of swimmer’s ear, it causes damage to the bones and cartilages in the base of the skull
• Psoriasis and polyps
• Fungal infections
  Read – Psoriasis – Ayurvedic Treatment, Medicines, Herbs, Remedies

Signs, symptoms

Right time to see the doctor / Warning signs
When there is ear discharge you need to see your doctor and seek medical attention as soon as possible when you have the below mentioned complaints –

• When the discharges are white, yellow and bloody red in color
• If the discharge occurs for 4-5 days
• If you have any accompanying symptoms like pain, fever, deficit hearing etc
• If there is severe pain along with swelling of ears, or redness or loss of hearing
• If you know that the discharge from your ear has occurred due to injury / Recent major head injury
• Presence of neurological symptoms which included difficulty in seeing, swallowing and talking, vertigo etc
• Diabetes
• Compromised immune system.
  Read – Complete Guide to Fungal Infections, Its Types And Preventions

Understanding ear discharges by seeing the drainage
Earwax – It is a normal drainage. It can be white, yellow or brown. The ears produce earwax to keep the ear clean and healthy. The wax is an oily substance naturally produced from the ears; they act as filters and protect the ears from infection. Earwax mixed with water may look like a running discharge.
Clear fluid – Clear fluid flowing from ear is usually water. This usually collects in the ear after swimming or bathing.
Blood – Bleeding discharge from the ears is caused due to injury or scratch in the ear canal. The amount of bleeding in this case may be small. Bleeding also occurs following eardrum rupture. Eardrum rupture may also cause drainage of blood, pus or even clear fluid from the ears.
Pus or cloudy fluid – It is often a sign of ear infection in the ear canal or middle ear. Ear infections are also the cause of eardrum rupture in about 10% cases. (read more)

Home Remedies for ear discharge

Apple Cider Vinegar –
Having antimicrobial properties, it destroys the microbes in the ear. 1 teaspoon of apple cider vinegar is mixed in equal part of warm water. A cotton ball soaked in this solution should be plugged into the afflicted ear. Patient should be advised to lie down on his side and allow the cotton ball to soak up the discharges. Later, the plug need to be removed and the ears dried. Doing it once or twice a day is usually enough.
Neem oil –
It has antibacterial, antiviral and anti fungal properties. It helps reduce earache and would also destroy the pathogens. Few drops of neem oil is poured in the infected ear. Plug the ear with a cotton ball and the patient is allowed to lie down. After few minutes it shall be removed.
Read – Neem: Benefits, Ayurveda Usage, Side Effects, Research

Garlic –
A study had showed that ear drops containing garlic and other herbal extracts were found to be effective as OTC ear drops. Another study shows that garlic improves antibiotic sensitivity of certain pathogens to antibiotics. Allicin in garlic protects the body against infections. Using it also helps to reduce microbes in the ear and also to reduce infection.

Few cloves of garlic are heated in coconut oil and allowed to cool. Few drops are instilled into the afflicted ear and allowed to get absorbed by lying down. Raw garlic also can be consumed to get rid of ear pain and infection.
Read – Garlic Benefits, Research, Usage, Side Effects

Holy Basil –
A study shows efficacy of instilling basil leaf juice into the ears as remedy for earaches. Juice of basil leaves is prepared by crushing few basil leaves and straining them. Few drops are instilled in the afflicted ear and left for few minutes to be absorbed.
Read – Tulsi – Ocimum sanctum – Benefits, Research, Side Effects

Onion –
They are often used to cure and relieve ear drainage in toddlers and children. After steaming / heating in the microwave for a minute, the onion piece is crushed and its juice extracted. This juice is instilled in the afflicted ear and allowed to stand for few minutes.
Read – Onion Uses, Remedies, Research, Side Effects

Steam Inhalation –
This is a common method used to treat ear drainage and infections. Water is boiled in a pot. Herbal powder is added to the boiling water. The patient is asked to cover his head with a towel or blanket and inhale the steam coming from boiling water.
Warm compress –
Warm cloth, when applied, provides moisture that helps to unclog the ears and loosen the congestion. This can be used few times a day. A washcloth soaked in warm water is squeezed out. This cloth is held over the afflicted ear.
Read – Herbal Fomentation Procedure, Benefits, Variations, Precautions

Gravity –
Gravitational forces will pull out the fluid discharge from the ear when your ear is tilted in the downward direction. With the help of dropper few drops of warm water are dropped into the ears. The patient is asked to tilt his head to let the water to run out, preferably into a sink. Sleeping with infected ear facing the ceiling helps relieve the ear discharge and earache.
(read more)

Prevention of ear discharge

Keep away the causative factors –
Ear discharge can be prevented by avoiding the causes which result in discharges.
Don’t push foreign objects into the ears –
Avoid putting foreign objects into your ears to clean them. This will avoid eardrum rupture.
Protect your ears from extreme sounds –
You can chose to keep away from excessive noise and sounds. When you know that you are supposed to spend time in areas with more noise and sound, carry ear plugs or muffs so as to protect your eardrums from getting exposed to them.
Keep your ears dry –
Make sure to dry your ears and wipe off the water from your ears after swimming, head bath or after being in water for long durations. Drain the water by tilting your head to one side and later to the other side. Later you can wipe off the remaining water or droplets of water.
Ear Drops –
Medicated ear drops available over the counter shall be used or used on medical advice after swimming. This helps in controlling the swimmer’s ear and also to treat the symptoms of the same.
Keep away from diseased people –
Always try to keep away from the diseased people, especially if you have low immunity or prone to ear infections.
Breast feeding –
Mothers should breast feed their infants for as long as they can. This is said to provide infants with protection from ear infections. This happens because the infants receive their mother’s antibodies from mother’s milk (Mayo Clinic). (read more)
Improve your immunity –
Keep your immunity high by maintaining your health, taking good and healthy foods in balanced quality and quantity, good exercise and keeping away stress. Ayurvedic Rasayanas i.e. immune modulators will help in keeping immunity in good balance.
Read – Immunity In Ayurveda: Concept, Diet, Herbs, Medicines, Exercise

Keep away from diseased people –
Always try to keep away from the diseased people, especially if you have low immunity or prone to ear infections.
Breast feeding –
Mothers should breast feed their infants for as long as they can. This is said to provide infants with protection from ear infections. This happens because the infants receive their mother’s antibodies from mother’s milk (Mayo Clinic). (read more)
Improve your immunity –
Keep your immunity high by maintaining your health, taking good and healthy foods in balanced quality and quantity, good exercise and keeping away stress. Ayurvedic Rasayanas i.e. immune modulators will help in keeping immunity in good balance.
Read – Immunity In Ayurveda: Concept, Diet, Herbs, Medicines, Exercise

Diagnosis, treatment

Diagnosis of ear discharge
Your ENT doctor will be the right person to examine your ear discharges and give an expert opinion after taking a thorough history.
The doctor may ask about the causes of ear discharge, past history or history suggesting that you have repeated ear discharges and also history of trauma.
He may also carry out a thorough examination, mainly examination of ear, nose, throat and neurological system. After examining the ears thoroughly in bright light, doctors usually diagnose perforated eardrum, external otitis, foreign objects and other causes of ear discharge. To top up, your history will give a clear cut clue about your discharges to the physician.
Read – Roga, Rogi Pareeksha: Examination Of Disease And Patient

Your ENT doctor will be the right person to examine your ear discharges and give an expert opinion after taking a thorough history.
The doctor may ask about the causes of ear discharge, past history or history suggesting that you have repeated ear discharges and also history of trauma.
He may also carry out a thorough examination, mainly examination of ear, nose, throat and neurological system. After examining the ears thoroughly in bright light, doctors usually diagnose perforated eardrum, external otitis, foreign objects and other causes of ear discharge. To top up, your history will give a clear cut clue about your discharges to the physician.
Read – Roga, Rogi Pareeksha: Examination Of Disease And Patient

He may carry on an audiometry test or CT or MRI to confirm diagnosis. If abnormal tissue is found in the ear canal, a tissue sample (biopsy) is taken. Culture swabs of the fluid are sometimes taken to identify infection.

The instrument used to examine the ear is called an otoscope. It is a lighted microscope to examine the ear and identify the cause of drainage. A test called tympanometry will help doctors examine the health of the middle ear. Doctors may also carry out a hearing test by using tuning forks.
Read – 10 Factors Of Patient Examination – Dasha Vidha Atura Pareeksha

Treatment options for ear discharge
Sometimes ear discharge may not need treatment. If treatment is needed, it depends on its cause. Signs of ear infection start clearing up within first 1-2 weeks without any treatment. To tackle the pain related with infection, pain medications may be needed.

‘Wait and See strategy’ – The American Academy of Pediatrics describes a 48 hour ‘wait and see’ approach. It is accompanied by close follow-up as one of the options for treating mild ear pain in children.

Warm compresses – will help to ease earache.
Analgesics – too can be taken to relieve pain in the ear and inflammation, if pain is present.

Antibiotic ear drops – Doctors may prescribe antibiotic ear drops if ear discharges occur in a child under 6 months old or has fever over 102.2⁰ F.

Antibiotics – To prevent the infection from spreading, your doctor may recommend you to use antibiotic ear drops or oral antibiotic course in severe cases.

Paper patch – Most cases of eardrum trauma also heal without treatment. If the tear doesn’t heal by itself, your doctor may apply a special paper patch to the tear. This patch would keep the hole closed while your eardrum heals.

Ear Tubes – Doctors often place an ear tube in the ears of people who get frequent ear infections. It provides an opening into the middle ear which will allow small quantity of clear fluid to drain from the ear.

Formulations for Karna Roga From Sahasra Yoga Text Book
Asanabilwadi Taila
Bhringamalakadi Taila
Vacha Lasunadi Taila
Nirgundi Rajanyadi Taila
Nagaradi Taila
Kacchuradi Choorna (Brihat)
Villam Pacchotyadi Taila

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