Therapy | Meniere’s disease

Therapy

The treatment of Menière’s disease is still strongly discussed from today’s point of view. The reason for this is that the exact cause which led to the development of the disease is largely unknown. However, the pathomechanism, i.e. the active form of the disease, is understood and can be treated, so that the patient’s suffering is alleviated.

In some cases, Menière’s disease can even be treated so well that seizures do not occur at all. In this case, an improvement of the symptoms can also be achieved by surgical procedures. For example, a tympanic tube can be inserted through the eardrum, which acts as a link between the external auditory canal and the middle ear.

As a result, the pressure fluctuations of the middle ear, which are particularly pronounced in Menière’s disease, are no longer as pronounced. The pressure fluctuations of the middle ear are in fact related in a complicated way to the pressure conditions in the inner ear, which in turn can influence the attacks of Meniere’s disease. Alternatively, an improvement can be achieved by changing one’s lifestyle.

Relaxation and balance exercises in particular, but also psychotherapy, can often help those affected. In addition, nutrition should be taken into account. It is advisable to consume a lot of potassium and little salt.

Stress, alcohol, smoking and loud noise levels should also be avoided as far as possible. In acute cases of Meniere’s disease, treatment is limited to the symptoms. Dizziness and vomiting in particular can be treated with medication.

Antiemetics (drugs against vomiting) such as dimenhydrinate (Vomex®) or metoclopramide (MCP drops) can be used for this. Endolymphatic hydrops, the direct cause of Meniere’s symptoms, is treated with betahistine. Betahistine is effective against nausea, vomiting and dizziness by promoting blood flow to the inner ear and improving the regulation of balance.

However, it is controversial whether the drug is really effective, as various studies doubt the effectiveness of betahistine. Potassium-saving diuretics are used as alternative drugs. Diuretics are drugs that inhibit certain transporters in the kidney so that more water is excreted. Taking diuretics in Meniere’s disease is intended to flush out the accumulation of fluid in the inner ear, which in turn improves the symptoms

Sports for Meniere’s disease

Since acute attacks of Meniere’s disease are accompanied by severe dizziness, it will hardly be possible to do any sports during an attack. But in stable phases, sporting activities should no longer be a problem. Even during long-term treatment, it is recommended to do sports and exercise.

This can have a positive effect on balance, metabolism and general well-being. The function of the muscles and the sense of touch can also be strengthened through sport, which can be helpful for patients with illnesses. In particular, the leg muscles should be built up, as patients often tend to lunge and fall during dizzy spells.

These falls and lunges can be better absorbed by stable musculature of the legs. Also the increased well-being and the reduction of stress through sport helps to avoid stress situations, which in turn can trigger seizures. The neurotransmitter (messenger substance) serotonin is released, which leads to a feeling of happiness and reduces tension and stress.

Overall, it can be said that sport is certainly helpful in Menière’s disease as long as it is compatible with the disease. Swimming or cycling involves certain dangers, as in the case of an acute attack, life can be in danger. For this reason, it is better to do these types of sports in company.