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Treatment

Treatment of Meniere’s disease

Although there is no cure for Meniere’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 firstModify your dietInform yourself about Meniere’sManage your stress levelsTake medication if necessaryTry balance therapyTry ‘complementary’, ‘alternative’ or ‘natural’ therapiesAs a last resort you may need surgery

Get advice first

The best treatment for Meniere’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.

Modify your diet

Low salt diet

Meniere’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 Meniere’s. This includes the salt found in many processed foods – often you are not aware it is there and need to check the food labelling. 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 to help you understand the importance of a low salt diet for all Australians and especially for people with Meniere’s who want to control their vertigo.

    • Quick Guide (53KB) – 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 (394KB) – pictures and information on over 50 low salt processed foods.
  • Shopping List 2 (504KB) – pictures and information on more low salt processed foods.

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 Meniere’s, MA have joined AWASH (Australian Division of World Action on Salt and Health). AWASH issue a newsletter called “Drop The Salt Campaign Bulletin”. To find out more about AWASH or to join visit their website www.awash.org.au.

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 Meniere’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 Meniere’s symptoms worse.

Inform yourself about Meniere’s

Your first step in managing Meniere’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 Meniere’s can help answer many questions. Contacting and joining support groups such as Meniere’s Australia 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.

Manage your stress levels

Emotional or physical stress can result in fluid retention in your body. This can make Meniere’s symptoms worse or act as a trigger for attacks of vertigo. It’s vital that you manage your stress levels.

Members are able to access MA’s library at the Meniere’s Resource and Information Centre or via phone or mail order. We have lots of resources that can help you with stress management.

Take medication if necessary

Caution: Seek your doctor’s advice first. Commonly used medications include:

  • Diuretics – increase the excretion of water from your body
  • Urea – quickly reduces 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, 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.

Try balance therapy

Chronic vertigo or dizziness is a major symptom in the later stages of Meniere’s as the body’s balancing (vestibular) mechanism becomes damaged (see Stages of Meniere’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.

Try ‘complementary’, ‘alternative’ or ‘natural’ therapies

There are many ‘alternative’ therapies you can try to help manage the symptoms of Meniere’s. We strongly recommend that you inform your GP or specialist about any ‘alternative’ therapies or techniques you are using to manage Meniere’s.

Common ‘alternative’ therapies include the following:

  • Psychological therapies
  • Dietary measures
  • Energy therapies
  • Physical therapies
  • Traditional medicine

As a last resort you may need surgery

When Meniere’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.

Non destructive Surgery

These procedures attempt to alter the course of Meniere’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 Meniere’s will require surgical intervention for control of vertigo. Usually as Meniere’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.