Middle ear infections or chronic suppurative otitis media (CSOM), are common, especially in poorer communities and developing countries. The occurrence ranges from 1% to 46% based on the area and population. Chronic suppurative otitis media commonly affects children but can affect individuals of all ages. 

Ear infections commonly affect your outer ear or middle ear. Viruses, bacteria, or fungal agents are responsible for ear infections. The outer ear infections are called otitis externa. You can get an outer ear infection from damaging the skin in your outer ear by putting objects in the ear like earbuds, key, or pen or from swimming in polluted water. Middle ear infections are known as otitis media and are often secondary to some nose or throat infections. 

The middle ear is situated behind your eardrum and connected to your throat via the Eustachian tube. The middle ear becomes vulnerable to infection when congestion from nose or throat infection or allergies obstruct this passage. The infection from your throat travels to your middle ear through these Eustachian tubes. This results in fluid buildup in your middle ear, increasing the pressure on your eardrum. 

When this infection remains persistent due to long-term inflammation and recurring discharge from the middle ear, it is called chronic suppurative otitis media. It often results from untreated or recurrent acute ear infections.

If left untreated, chronic suppurative otitis media can progress, leading to inflammation or infection of the bones that conduct sound vibrations from your eardrum to your inner ear. This can lead to serious complications and temporary hearing loss. CSOM is treated using antibiotic medications. Surgery is advised in rare cases to repair your ear’s structural issues or remove persistent infection or damaged tissue. 

Chronic suppurative otitis media can be managed with homeopathic medications. Homeopathy offers a holistic approach to CSOM, addressing symptoms like pus discharge from ears, pain, and hearing issues. Constitutional remedies prescribed on individual symptoms for chronic suppurative otitis media can give you long-term relief.

Role of homeopathy in chronic suppurative otitis media

Homeopathy offers good relief from ear infections, including CSOM. Homeopathic medicines boost your body’s natural defense mechanism to fight infection. The medications can increase your immunity and prevent ear infections in the future. 

Homeopathic medicines can effectively manage the pain, pus discharge from ears, and the fever accompanying the ear infection when prescribed on a symptomatic totality basis. They also help in preventing complications resulting from chronic suppurative otitis media, including hearing loss, eardrum perforation, and mastoiditis.

Top five homeopathic medicines for chronic suppurative otitis media

Belladonna (Bell.)

Common name: Deadly nightshade

Belladonna is indicated for acute pain from a CSOM. It helps treat tearing pain in the external and middle parts of the ears. Often, the patient has repeated episodes of ear pain with delirium while sleeping.

This remedy is indicated in cases where fever accompanies chronic suppurative otitis media symptoms. It treats ear infections with sensitivity to the slightest draft of touch or light. This remedy works well for chronic suppurative otitis media of the right ear.

Hepar sulphuris calcareum (Hep.)

Common name: Hahnemann’s calcium sulfide

Hepar sulph. is recommended for CSOM in an advanced state. Difficulty in hearing with pus discharge from ears indicates Hepar sulph. This remedy aids in pus absorption. There is bulging of the eardrum with pus formation due to infection. The person needing this remedy can have buzzing and throbbing in the ears. 

Mercurius solubilis (Merc.)

Common name: Quicksilver

Mercurius solubilis is used to treat offensive and blood stained pus discharge from ears. There is smarting and burning pain in the ears with a foul odor. Stitching type of pain in the ears is characteristic of this remedy. This pain often worsens at night. Inflammation of the middle and external auditory canal indicates this medicine. Merc. sol. is often prescribed for right ear CSOM. Every change of weather triggers inflammation. 

Psorinum (Psor.)

Common name: Scabies vesicle

Psorinum helps manage the tendency for recurrent ear infections. This medicine prevents pus formation in the ears.

Psorinum is indicated in chronic suppurative otitis media with offensive, fetid, and putrid ear discharge. There is brownish pus discharge from ears with intolerable itching. The ear discharge is acrid and irritating.

Pulsatilla nigricans (Puls.)

Common name: Windflower

Pulsatilla is often indicated for CSOM with a history of recurrent colds and coughs. There is a feeling of something pressing out along with a hot and swollen ear. Pulsating ear pains that worsen in the evening and at night call for this remedy. There is itching inside the ear, especially in chronic ear infections. 

Causes of chronic suppurative otitis media

CSOM is common among children as they are prone to frequent colds, sore throats, and upper respiratory problems. Chronic suppurative otitis media results from an infection or malfunctioning eustachian tube. The eustachian tube helps maintain the pressure difference between your outer and middle ear. However, fluid drainage from the middle ear doesn’t happen as expected in certain conditions. This leads to increased fluid buildup inside your middle ear. An increase in fluid accumulation creates an environment for bacteria and viruses to grow inside your middle ear. The various causes of fluid entrapment inside your middle ear include:


Common cold or sore throat can lead to chronic suppurative otitis media. Swelling and congestion of your throat, nose, or eustachian tube linings due to cold can cause CSOM.


Bacterial or viral ear infections can cause CSOM, leading to persistent inflammation and pus discharge from ears.

Eustachian tube dysfunction

A malfunction in your Eustachian tube is responsible for increasing ear pressure. This can result in fluid accumulation and, subsequently, CSOM.

Poor hygiene

Inadequate ear care practices can contribute to chronic suppurative otitis media. It allows bacteria to grow and trigger chronic inflammation in your middle ear.

Symptoms of chronic suppurative otitis media


The main symptom of CSOM is pain. You might experience mild discomfort to severe aches inside your ear. Earache often begins a few days after catching a cold or respiratory infection.

Fluid discharge

Fluid drainage from your ears is another common symptom of chronic suppurative otitis media. It indicates the presence of infection in your middle ear. This discharge varies from fluid to thick pus discharge from ears. The ear discharge can be white to yellow-green in color and often has a foul smell.

Diminished hearing

CSOM affects the ability to perceive sounds clearly. Hearing difficulties often accompany chronic suppurative otitis media. Sometimes, you hear buzzing or noises in the ear, called tinnitus. 

Sleep disturbances

Lack of sleep or difficulty in sleeping can result from the discomfort caused by ear pain.

Ear pulling

Tugging or pulling at the ear is seen, especially in children, as a response to the discomfort associated with chronic suppurative otitis media.

Loss of balance

You may feel a loss of balance in CSOM, often due to the impact of the infection on your inner ear, affecting your body’s equilibrium.

Pressure in ears

In chronic suppurative otitis media, you might feel pressure in your ears due to fluid accumulation or pus in the middle ear.


In acute CSOM infections, fever may be an accompanying symptom. Fever indicates your body’s immune response to the bacterial or viral infection.


Vertigo, dizziness, or spinning can occur in chronic suppurative otitis media. It happens when infection affects your inner ear, impacting balance and spatial orientation.

Treatment for chronic suppurative otitis media

Pain medication 

Over-the-counter pain medications help relieve ear pain in chronic suppurative otitis media.

Anesthetic drops

Anesthetic drops are prescribed in CSOM to help relieve pain. 


Antibiotics are prescribed for chronic suppurative otitis media with moderate to severe ear ache, in one or both ears with high-grade fever. 

Fluid drainage

In severe cases of CSOM with continuous fluid buildup in the ear, doctors recommend fluid drainage from the middle ear.

Diet and lifestyle modifications for chronic suppurative otitis media


Ensure you drink adequate water to support your immune response against infections, including ear infections.

Vitamin C-rich foods

Consume fruits and vegetables abundant in vitamin C, like citrus fruits, strawberries, and bell peppers. Vitamin C boosts your immune system.

Avoiding irritants

Minimize exposure to smoke and environmental pollutants if you have a history of acute otitis media. These can irritate your respiratory system and worsen ear infections.

Good ear hygiene

Keep your ears dry and clean. Avoid inserting objects like key, pen, cotton swabs or earbuds into your ear canal; this can push wax deeper and increase the chances of ear infection.

Treatment of respiratory infections

Quickly address colds or respiratory infections to reduce the risk of ear infections.


Chronic suppurative otitis media is common in children. It can cause pain and foul discharge. If left untreated, CSOM can lead to hearing loss. A well-selected homeopathic medicine supports your immune mechanism and cures CSOM in a short duration. 

Consulting a homeopathic doctor before taking medications can give you good and safe results.