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Although there is no cure for Ménière’s disease you
can manage and minimise the symptoms and secondary effects through a careful
combination of lifestyle choices, medication and other treatments:
Get advice first
Inform yourself about Ménière’s
Manage your stress levels
Modify your diet
Take medication if necessary
Try balance therapy
Try ‘complementary’, ‘alternative’
or ‘natural’ therapies
As a last resort you may need surgery
Get advice first
The best treatment for Ménière’s depends on what
stage of the condition you are currently experiencing.
It’s important to seek qualified medical advice from an appropriate
health professional before beginning any treatment.
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Inform
yourself about Ménière’s
Your first step in managing Ménière’s is to learn
as much as you can about the disease and the various ways you can manage
it. The information below provides a starting point.
Medical professionals can provide you with more detailed medical information
about the nature and likely progression of the disease. They can also
advise you on suitable management strategies and medication options.
Talking to other people with Ménière’s can help answer
many questions. Contacting and joining support groups such as the Ménière’s
Support Group of Victoria can help put you in touch with others in
the same boat.
There is also a lot of information available in the form of pamphlets,
brochures, books and videos. See our on-line Catalogue
section.
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Manage
your stress levels
Emotional or physical stress can result in fluid retention in your body.
This can make Ménière’s symptoms worse or act as a
trigger for attacks of vertigo. It’s vital that you manage your
stress levels.
We have several information resources that can
help you with stress management. Your local library will most likely have
lots of information on this topic too.
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Modify
your diet
Low salt diet
Ménière’s symptoms generally result from having excess
fluid within your inner ear. This condition is called ‘endolymphatic
hydrops’. Eating too much salt (sodium) increases this fluid, making
your symptoms worse and even causing vertigo attacks.
Cutting back on salt in your diet is a key strategy in managing Ménière’s.
See our recommended links section for more information. Remember to inform your doctor before commencing a low salt diet especially if you are taking prescribed medications eg diuretics.
An acceptable level of sodium is no more than 120mg per 100g of food. Nearly all fresh foods are naturally low in salt.
Many processed foods are not low in salt. Over 75% of our salt intake comes from the salt (or other forms of sodium such as baking powder) that is added to processed foods.
Download the following guidelines (pdf documents) for choosing low salt foods. These documents were produced with a grant from the Brockhoff Foundation. (You need Adobe Acrobat Reader to view these pdf documents.) 
- Quick Guide (50KB)- shows you how to tell which foods are low in salt
- Bread and Iodine (23KB) -
looks at the importance of low salt bread in controlling salt intake and recommends ways to avoid iodine deficiency. It has copyright information and contact details for the author.
- Shopping List 1 (262KB) - pictures and information on over 50 low salt processed foods.
- Shopping List 2 (299KB) - pictures and information on more low salt processed foods.
- For Doctors (169KB) -
gives the evidence for the benefits of good salt control, plus information on the interaction of diuretics with a low salt intake. It also provides medical references. Your GP or your specialist may be interested in this page.
You can order a range of low salt Australian-made products from Only Australian Groceries. This is an online grocery store that delivers Australia-wide.
See our catalogue for more information resources that can help you
plan a low salt diet.
As reducing salt intake is a key strategy in managing Ménière’s, MSGV have joined AWASH (Australian Division of World Action on Salt and Health). AWASH issue a newsletter called “Drop the Salt Campaign Bulletin”. Download the Bulletin (411 KB pdf)
Low caffeine diet
It is thought that the caffeine found in tea, coffee and cola drinks
can constrict blood vessels and make tinnitus (ringing noise in the ears)
worse. Cutting back on your caffeine intake can be an effective strategy
in managing Ménière’s. Foods that contain caffeine
- like chocolate - are also best taken in moderation.
Avoid excess alcohol
Alcohol affects blood vessels and fluid balance in the body. Excess
alcohol intake may make Ménière’s symptoms worse.
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Take medication
if necessary
Caution: Seek your doctor’s advice first. Commonly used medications
include:
- Diuretics (fluid tablets eg Urea) - quickly reduce fluid in the body
and therefore the inner ear
- Anti-emetics (eg Stemetil) - suppress vomiting and reduce nausea
- Vestibular sedatives (eg Valium) - suppress neural output, that is
the confusing messages that the affected ear(s) are sending to the brain
- Vasodilators (eg Serc) - improve blood supply to the inner ear
Remember to inform your doctor if you are taking any ‘over-the-counter’
or natural therapies as these could interact negatively with prescribed
medications.
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Try balance
therapy
Chronic vertigo or dizziness is a major symptom in the later stages of
Ménière’s as the body’s balancing (vestibular)
mechanism becomes damaged (see Stages of Ménière’s
).
Through a series of graded exercises you can re-train your body to balance
effectively by re-training the balance mechanism and/or by using alternative
techniques like visual cues.
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Try ‘complementary’,
‘alternative’ or ‘natural’ therapies
There are many ‘alternative’ therapies you can try to help
manage the symptoms of Ménière’s. We strongly recommend
that you inform your GP or specialist about any ‘alternative’
therapies or techniques you are using to manage Ménière’s.
Salford University (UK) have recently conducted a study on complementary
and alternative therapies for Ménière’s.
Common ‘alternative’ therapies include the following.
Psychological therapies
These therapies include:
- counselling
- psychotherapy
- hypnotherapy
Dietary measures
These measures include:
- nutritional therapy
- working with a dietician
Energy therapies
These therapies include:
- acupuncture
- spiritual healing
- homoeopathy
- flower remedies
- Tai Chi
- yoga
- meditation
- relaxation
- biofeedback
Physical therapies
These therapies include:
- osteopathy
- cranial osteopathy
- chiropractic
- massage
- biodynamic massage
- shiatsu
- kinesiology
- Bowen massage therapy
Traditional medicine
Traditional medicines include:
- Chinese medicine
- naturopathy
- herbal medicine
- aromatherapy
To learn more about a particular therapy and locate a listing of practitioners
who are registered with a professional body (association, society, institute
etc):
- Look up your ‘Yellow pages’ or other phone directory
(try under ‘health’).
- Ask at your local library.
- Ask your local community health service or local council.
- Search the Web for relevant sites. Be aware that some information
on Web sites can be misleading - check the site’s credentials
(see our links section for a suggested starting
point).
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As a last
resort you may need surgery
When Ménière’s symptoms cannot be managed by a combination
of life style measures and medication, surgery may be considered. The
following sections describe the two types of surgery available - destructive
and non-destructive.
When considering surgery it’s wise to research the available options.
If necessary seek further opinions. See our links
section for more information on Ménière’s surgery.
Non destructive Surgery
These procedures attempt to alter the course of Ménière’s
disease.
Endolymphatic sac surgery aims to improve or alter the function of the
endolymphatic sac, which is thought to control either the production or
absorption of the endolymphatic fluid. Long-term studies have shown that
these operations are successful in approximately half to two thirds of
patients.
Destructive Surgery
These procedures destroy the balance mechanism in order to gain control
of vertigo. Only a very small percentage (around 5%) of people with Ménière’s
will require surgical intervention for control of vertigo. Usually as
Ménière’s disease progresses the acute disabling attacks
of vertigo cease.
Chemical Ablation involves injecting the middle
ear with antibiotics (eg Gentamicin, Streptomycin). The drugs are absorbed
through the membranes between the middle and inner ear and are toxic to
balance and hearing nerve endings. This treatment aims to reduce or destroy
the vestibular function of that ear, helping to relieve symptoms of vertigo.
The following procedures are only considered when all other measures
to control vertigo have failed.
Vestibular nerve section involves cutting the
balance nerve of the affected ear to stop the incorrect signals reaching
the brain. Hopefully the hearing nerve is spared.
A vestibular neurectomy aims to destroy the
inner ear and is usually only considered if there is no useable hearing
in the ear.
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Last reviewed March 2008
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