Food allergies linked to ear infections.

Just the mention of otitis media makes many parents of young children cringe. Otitis media -- middle ear infection -- affects two-thirds of children in the United States by age 2 and is the most common cause of acquired hearing loss in children. Many get these earaches again and again, despite treatment with antibiotics.

This recurrent condition does not always cause pain, but just the buildup of fluid behind the eardrum can impair hearing and lead to permanent damage. Consequently, some 670,000 children a year wind up with tubes surgically implanted into the middle ear to keep it ventilated. Overall, otitis media represents a $3.5 billion-a-year U.S. health care cost.

Food allergies may underlie many of these multiple episodes, reports Talal M. Nsouli, an allergist at the Georgetown University School of Medicine in Washington, D.C. He and his colleagues tested 104 children with recurrent ear problems for food allergies. About a third proved allergic to milk, and another third reacted to wheat, with a total of 81 children having some allergy to a food they often ate. The scientists then had parents keep those children from eating the offending food for 4 months. Seventy children got better. "Those who avoided those foods had significant clearance of the ear," Nsouli says.

Then parents added those foods back to the diets of the 70 children. Within 4 months, the middle ears became clogged in 66 of the children, a result that reinforces the link between food allergies and persistent ear problems, Nsouli and his colleagues note in the September ANNALS OF ALLERGY.

During the testing period, the researchers periodically examined the ears, checking the eardrums in particular, and monitored the buildup of fluid inside the ear using an instrument called a typanometer. They tried to account for many of the factors that make the evaluation of treatments for this condition so difficult, Nsouli adds.

"Hopefully, most of the ear, nose, and throat doctors will start looking at these patients in light of allergies," says otolaryngologist Richard E. Linde of the George Washington University School of Medicine in Washington, D.C., and one of the study's coauthors.

Considering food allergies in children with these problems "might prevent surgery and might prevent permanent damage," Nsouli says.