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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34678
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I took Claritin and squirted Afrin (2 doses) for ETD and now

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I took Claritin and squirted Afrin (2 doses) for ETD and now my ears feel warm on the I side and when I speak loud or cough it sounds muffeled in my right ear like when I try to do the valsalva manuever.

Greetings Jeremy.


Dysfunction of the Eustachian tube (or eustachian tube disease) can occur due to swelling of the mucosa (internal lining) in the nasopharynx or in the Eustachian tube, which in turn may occur because of


1) infection or

2) allergy.


Your symptoms can be due to a concomitant infection of the ear drum (middle ear infection or otitis media). Otitis media is defined by the presence of infected fluid in the middle ear cavity; it must be distinguished from otitis media with effusion, which is defined by the presence of uninfected fluid in the middle ear cavity. The key to distinguishing between both is the performance of pneumatic otoscopy using appropriate tools and an adequate light source by the ENT specialist. Usually the treatment is oral antibiotic with anti-histaminics (anti allergy medications). Thus you may discuss this possibility with your specialist.


This swelling of the middle ear internal lining can impede the Eustachian tube function. Following medications are used:


1) Decongestants; Sudafed (over the counter)

2) Antihistamines; Chlorpheniramine (Singlet) has best result and available without prescription

3) Steroids; prescription drugs

4) Analgesics; Motrin, Advil, Aleve


Valsalva maneuver (positive pressure against a closed nasal airway) usually equilibrates pressure in the middle ear to the outside and can be helpful if done 5-7 times in a day (which you are already doing).


All the above combination may be able to give you relief. The key may be a course of antibiotic.


Please feel free for your follow up questions.


I would be happy to assist you further, if you need any more information.


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Customer: replied 4 years ago.
Thank you so much for helping me. I went to 2 ENTs - 1st one said it might be patulous eustation tube due to the feeling if air or water rushing in my ear when I talked loud or coughed heavy. This scared me to death and he recommended antihistamine and Flonase. I didn't t use them because I thought it would make ETD worse.

The 2nd said ETD because my ear drum wasn't moving and my ear drums were slightly retracted. He gave me the same prescription and said to do the valsalva manuver a couple of times a day. This seems to help it a bit.

What do you think? I haven't had tr weird water/air rushing feeling in a long time but get a slight popping when I talk and the feeling that I'm pushing air in my ears when I talk. Have I scared myself trying to self diagnose i the Internet and waited too long to do the original treatment

You are very welcome, Jeremy.

I am sorry for the delay in answering. I was on another question. I apologize for your wait.

Actually there is nothing serious or significant in your case and medications may take 3-4 days to show the effect. Since you have been seen by the two ENT specialists, I would not be anxious as any infection would have been detected. Continuing the same treatment should resolve the issue. If the symptoms do not get better in 3 days, you may seek a prescription of antibiotic. Please do not read internet, meanwhile, as most of the sites do not impart authentic information and unnecessary create anxiety.

It is privilege assisting you.

Customer: replied 4 years ago.
and the patulous eustation tube? Is this a possibility? When I speak loud (I teach and do this for a living) or cough loud it causes movement of air in my ET. Will this resolve with the meds in 3-4 days? It's been happening off and on for over a month but just started to use the meds full time whilst blowing my ears open.

Hello Jeremy,

A patulous eustachian tube is another term for the inflammation and edema (which is a usual change in the tube due to allergy / infection). So nothing alarming here. In 3-4 days, you would start feeling improvement and usual recommendation is to continue the medications for 7-10 days, according to your rate of relief.

Customer: replied 4 years ago.
I did have a nasty upper respiratory infection that caused me to lose my voice for a few days and cough/spit up thick yellow mucus before the ears started. I never treated it (little anxious of docs and didnt want to take off work) and it eventually (after 2-3 weeks) went away but I had this persistent little cough thst would t go away. Then I got a UTI that I did go to the doc because it hurt bad and I had an fever for 2 days. Once again i did take off work. Antibiotics cleared it up immediately. One day I went swimming and after a hard work out did t feel refreshed but kinda weird. Things seemed hazy and I really wore myself out (which I thought was good) but felt weird thst morning. Later that day as I was teaching the ears started.

The middle ear and throat are connected to each other via the eustachian tube. This is to keep the normal pressure in the ear, equal to the throat and atmosphere. An upper respiratory infection (usually are viral in origin) or allergy do affect the eustachian tube and middle ear. As a matter of fact, they are integrally connected as they work as a single unit (the anatomical description tends to separate them just for the ease). So upper respiratory infection (URI), may have been the initiating event and a lingering inflammation may have been persisting. If your nose or sinus issues are persisting, you may consider following;

1) Nasal steroid; decrease inflammation and open up obstruction.
2) Oral decongestants such as pseudoephedrine are often helpful.
3) Topical decongestant for short duration.
4) Antihistamines
5) Steam vaporizer
6) Eucalyptus oil may help
7) Nasal saline irrigation
8) Vitamin C

Following can increase the body immunity so help in overcoming the infection inflammation;

1) Omega 3; Fish oil capsule and flaxseed oil capsule.
2) Ginkgo Biloba
3) Zinc 30 mg.
Customer: replied 4 years ago.
Could the fever have affected my ears at all? I got dehydrated cause I was drinking juice instead if water. Orig ally I thought I had water in my ears because thst is what it felt like. Plus, when I would lean over I would get this strange feeling of water or air rushing Inside my ears. It we t away but the stuffy was and popping persisted as well as my ears being super sensitive to harsh noises (clanking keys, dishes, etc) it's like they almost buzz or react to certian noises. Could all this be related to ETD too?
Yes, all of these symptoms are related to ETD and middle ear affection & are usual manifestations of it. A URI can affect the ear. A UTI usually do not affect the ear unless it is quite severe (any severe infection in the body may affect the other organs).
Customer: replied 4 years ago.
Even the sensitivity to sound? Also, why do my ears slowly leak air at loud noises or when I cough?
Yes, the sensitivity of the sound can be due to ETD and middle ear complex. When we cough or speak, there are subtle change in pressure of the throat, which normally equilibrates with the ear. With ETD . ear drum inflammation; this function is sub optimum and is responsible for it.
Customer: replied 4 years ago.
Huh - didnt know that. I had been swimming and wore silicon putty ear plugs. I put a lot of pressure on my ears. Should I wear the plugs or just use oil in my ears to lube them up?
Ear plugs during swimming are recommended. Water clogging in the ear canal during swimming can predispose for the ear infection, so that is advised.
Customer: replied 4 years ago.
I was also taking b12 (6 pills a day) and after a couple of days I started getti g heart palpitations. They eventually went away but had to quit any and all vitamens and flush my system out. I was taking 6 b12, plus 2 fish oil, plus 1 multi vitamen and melatonin to sleep. I was also super anxious about my ear popping and tinnitus.

Anxiety can increase / aggravate the symptoms. You were taking too high dose of B 12. Just one or two pills a day are sufficient. Is there any specific diagnosis about which you are worried for your symptoms? Just curious!
Customer: replied 4 years ago.
I was trying to fix my tinntius. I was having the tinnitus, heart palpitations, and ear popping when I talk/cough/speak all at once and something had to give. I couldn't take all 3 at once. It caused some bad anxiety.
The commonest cause of palpitation and tinnitus (also caused by ETD) is anxiety! Please do not worry as there is nothing worrisome. Once ETD is resolved tinnitus also would go away.
Customer: replied 4 years ago.
What vitamens do I need to take? What I thr ETD doesn't resolve?
Resolution of ETD is a rule not exception. A negative thought of this kind may cause harm to your anxiety issue. Just an over the counter multivitamin would suffice. Nothing very specific supplement is essential as it is a self resolving issue.
Dr. Arun Phophalia and other Health Specialists are ready to help you
Customer: replied 4 years ago.
I've been on claritin for about a week and try to pop open my ears 2/3 times a day. The popping has stopped but I still get what sounds like a rush of air in my ears when I talk or cough or use my diafram. ive got an appointment with an ENT next week. Any suggestions before then?
Customer: replied 4 years ago.
Are you there?
Customer: replied 4 years ago.
Relist: Answer came too late.

Hello Jeremy,

I was offline, so could not see your question. Sorry for the delay.

You may continue Valsalva maneuver and steam inhalation which may help in reducing the inflammation in eustachian tube. Chlorpheniramine (Singlet) or any other anti allergic medication (which helps in resolving the residual inflammation), may also be continued.

I apologize again for your wait.