This factsheet is part of our Ears and ear problems range. It is written for people who have Ménière’s disease and would like to find out more about their condition.
Read this factsheet to find out:
- What is Ménière’s disease?
- What causes Ménière’s disease?
- What are the symptoms of Ménière’s disease?
- How is Ménière’s disease diagnosed?
- How is Ménière’s disease treated and managed?
- Where can I get further information?
What is Ménière’s disease?
Ménière’s disease is a long-term progressive condition of the inner ear. See our leaflet Ears and ear health for more information about how the ear works. Ménière’s disease causes bouts – also known as episodes or attacks – of dizziness, hearing loss and tinnitus.
Tinnitus is a medical term to describe noises that people can hear in one ear, both ears or in the head, such as ringing, buzzing or whistling. The sounds can vary from person to person, but the common link is that they do not have an external source. See our range of factsheets and leaflets about tinnitus for more information.
What causes Ménière’s disease?
We don’t know what causes Ménière’s disease, but we do know that:
- It can run in families.
- People with increased pressure in the endolymphatic sac (part of the inner ear) may be more likely to develop it.
- Disturbances involving the balance of sodium and potassium in the fluid contained in the inner ear may lead to the disease.
- People with an abnormal immune response – where the body has problems defending itself from alien bodies such as viruses – may develop the disease.
- Some specific viral infections are linked to its development.
- Stress can make the symptoms worse.
- It may be associated with changes in blood supply to the ear.
- It may also be associated with head injuries.
What are the symptoms of Ménière’s disease?
Ménière’s disease has a range of symptoms. It is thought they are brought on by an increase in the volume of the endolymph fluid, which is found in the inner ear. The symptoms include:
- Nausea, vomiting and occasionally diarrhoea, although these symptoms can get better with time.
- A ‘blocked’ feeling in the affected ear.
- Hearing loss, which tends to come and go in the early stages of the condition (although repeated attacks can cause permanent hearing loss in some people).
- Occasionally, over-sensitivity to loud sounds – this is known as hyperacusis.
If you have Ménière’s disease, you may have bouts of the condition separated by periods when you are not affected by it at all – these periods are known as remission. They may be as short as a few days, or longer than 10 years. Periods of remission vary in each person and over time, which makes Ménière’s disease an unpredictable and often distressing illness.
Dizziness and nausea
When you first develop Ménière’s disease the main symptom is bouts of dizziness. Before a dizzy bout you may feel fullness in your ear and/ or have tinnitus but you can often get bouts without warning. These bouts can last from a few minutes to 24 hours. During these bouts you may:
- Feel sick and, in some cases, actually be sick.
- Get a spinning sensation, which is often very fast and made worse if you move your head.
- Notice a sensation of ‘fullness’ and discomfort in the affected ear.
- Have hearing loss before and during the dizzy spells.
- Notice tinnitus, or an increase of existing tinnitus, in the affected ear.
- Feel anxious, sweat and have palpitations. This can be made worse by the distress you feel at the time.
You will probably get fewer bouts of dizziness as the disease develops. They may eventually disappear altogether. However, some people still feel unsteady and dizzy if they move quickly, or more commonly at night, when it is dark. You may also notice that you have difficulty focusing and reading, but this can be helped by treatment. Between the bouts, your hearing and the feeling of fullness in your ear generally return to normal, although over time your hearing might gradually get worse.
Hearing loss and tinnitus
Ménière’s disease can affect your hearing and you might develop some hearing loss, but usually only in the affected ear. You may not notice the hearing loss at first because it is usually mild. Initially, the hearing loss may come and go, and you may find your ability to hear lower-pitch sounds affected first. Some people notice hearing loss first of all, then develop dizziness later.
As Ménière’s disease develops, the hair cells in the cochlea (in your inner ear) may become damaged, which will result in permanent hearing loss. This will usually only be in one ear, although over time the disease can result in hearing loss in both ears for some people. The tinnitus may become more noticeable as the hearing loss gets worse. It can also come and go with the bouts of Ménière’s disease.
You might find that you are over-sensitive to some sounds – this is called hyperacusis. This may happen at or around the time of the bouts of dizziness. The hyperacusis is not always related to how loud the sound is. You may also get severe discomfort from loud sounds, despite having hearing loss – this is known as recruitment. Recruitment means you have difficulty hearing quiet sounds, but are sensitive to loud sounds. For more information, see our factsheet Hyperacusis.
How is Ménière’s disease diagnosed?
If you are concerned about any dizziness or balance problems you should visit your GP. If your GP thinks you have Ménière’s disease, you may be referred to the ear, nose and throat (ENT) or audiology department of your local hospital for further tests. In some parts of the country, you may also be referred to a specialist balance clinic.
Ménière’s disease usually first appears in people between the ages of 20 and 45 years. If you have your first bout of dizziness in your 70s, it is less likely to be Ménière’s disease.
There is no specific test that is reliable for testing for Ménière’s disease. The specialist will use a series of tests to diagnose it.
Your balance will probably be tested using the caloric test. This involves running water or puffing air, which in turn is slightly hotter, then colder, than your body temperature, into the ear canal. This alters the temperature in your inner ear fluids, making them move in one direction, or the other. Your eye movements then show how well the balance mechanism in each of your ears is working while this is going on. The test may make you feel a bit dizzy, and occasionally sick, but it is not unpleasant if done carefully, and it will not bring on a bout of Ménière’s disease.
If you are concerned that you may have Ménière’s disease contact us today for an assessment. You will be given a series of hearing tests to look at the function of the different parts of your ear. This will help identify if the hearing loss is coming from the inner ear.
Magnetic resonance imaging (MRI) may be used to help rule out any other problems that can also lead to the symptoms associated with Ménière’s disease, such as tinnitus, dizziness and hearing loss.
If you need hearing aids to help with the hearing loss associated with Ménière’s disease, we can take impression of your ear in order to make snug-fitting earmoulds. You will be asked to return to program your new hearing aids later when the earmoulds are ready.
How is Ménière’s disease treated and managed?
There is no cure for Ménière’s disease, but there are ways to relieve and manage the symptoms.
Changing your diet
Some people find that specific foods can make the symptoms of Ménière’s disease worse. Your specialist or GP may advise you to follow a low sodium diet to reduce the body’s retention of fluids. As well as salt added at the table, sodium is in almost all prepared food, especially ready meals.
Several drugs are used to control, and to reduce the frequency of, the bouts of dizziness and sickness that come with the disease. You may be given diuretics to reduce fluid levels in your inner ear and salt levels in your body. Your specialist or GP will be able to advise you about drug treatments.
Counselling and behavioural therapy
The symptoms of Ménière’s disease can be distressing and some people find that it affects every aspect of their lives, including their work and their relationship with their family. Some people worry about having a bout in public, which can lead to a loss of social confidence. Counselling and behavioural therapy may help – ask your GP or specialist for advice.
Vestibular rehabilitation physiotherapy
Balance retraining physiotherapy can help to reduce mild dizziness that is caused by a damaged balance organ. It can help your brain readjust to the way it uses balance information. You will be taught how to do special head and balance exercises.
You may be offered surgery to help you control your dizziness. There are different surgical options available and need to be discussed with your ENT Consultant.