Meniere's disease is a disorder of the inner ear caused by excess endolymphatic fluid - a condition called endolymphatic hydrops - that produces episodic attacks characterised by the same three features: rotational vertigo that is genuinely disabling during the attack and lasts from 20 minutes to several hours, tinnitus (a ringing or roaring sound, typically low-pitched, in the affected ear), and a fluctuating low-frequency hearing loss that may worsen with each attack over time. Between episodes, patients may feel entirely well, which makes the unpredictability of attacks particularly distressing. The observation that Goa's coastal climate seems to worsen symptoms is consistent with what many Meniere's patients report worldwide - barometric pressure changes and high ambient humidity can influence the pressure dynamics of the inner ear fluid compartment, triggering or intensifying attacks in susceptible individuals. During the monsoon season in Goa, when atmospheric pressure changes are frequent, some patients notice a clustering of episodes. Management is focused on reducing the fluid pressure: dietary salt restriction, avoiding caffeine and alcohol, diuretic therapy, and betahistine are the established first-line approaches. Vestibular suppressants manage the acute attack. For patients whose attacks continue despite medical management, more advanced interventions including intratympanic injections can be considered. The goals of management are reducing attack frequency, protecting residual hearing, and improving quality of life.
Written by Dr. Nivedeeta Pereira, DLO (Diploma in Otorhinolaryngology/ENT), AASC (Advanced Allergy and Asthma Specialist Course), AAAIC (Advanced Allergy and Asthma in Clinical Immunology), ENT Specialist and Allergy, Asthma and Upper Airway Care, Dr. Nivedeeta's ENT and Allergy Center, Margao, Goa. 11 years, 10,000+ patients. Phone: 8007048189.
