By Anthony L. Komaroff, M.D.

DEAR DOCTOR K:

My left ear often gets plugged up. I cough, clear my throat, close my nostrils and blow. Nothing helps. I don't like to bother my doctor with what seems like a silly problem, but it's really annoying.

DEAR READER:

I tell my patients that any problem, no matter how small, is worth a call to my office if it affects their quality of life. So I encourage you to give your doctor a call.

The most common cause of an ear feeling plugged up is when the outer ear gets blocked by earwax. I'll tell you about a simple home remedy in a minute, but first let's make sure it's not a more serious kind of ear problem.

To do that, I'll ask you my "red flag" questions. If you say "yes" to any of these questions, you need to see your doctor. Have you lost any hearing? Are you dizzy? Do your ears hurt? Do you have a ringing sound in your ears? Finally, do you have discharge coming out of your ear?

If you have a red flag symptom, your plugged-up feeling is probably more than earwax. Dizziness, for example -- the room-spinning sort that's the main feature of true vertigo -- points to a fluid imbalance in your inner ear. And ear pain, rather than a plugged-up feeling, can indicate a middle ear infection. A moist discharge from your ear, along with pain, can indicate an infection in your outer ear.

If you don't have a red flag symptom, the problem may be earwax. In my opinion, only one home remedy for this is worth trying. Get a bottle of hydrogen peroxide at the drugstore. Soak a cotton ball with the hydrogen peroxide. Tilt your head and drip the peroxide into your ear. You may hear it fizz as it tries to dissolve the earwax. After about 30 seconds, drain your ear onto a washcloth. If this helps, do it two to three more times.

Above all, DON'T try to remove earwax yourself in any other way. Cotton swabs and pencil erasers can break off in the ear canal, a passage that bends and narrows in spots. Let your doctor take a look before you start digging into the canal on your own.

One other common, usually minor problem causes a plugged-up sensation: a blocked Eustachian tube. This is the small tube that goes from the middle ear to the back of your nasal cavity. If the tissues in your nose are inflamed and swollen, it can block the opening of the tube. This pulls your eardrum inward, which causes a full, plugged feeling. This problem can sometimes be fixed by using over-the-counter decongestant nasal spray.

Ears that feel plugged up are a pretty common problem. Most of the time, they have a simple cause and a simple solution. So I think it will be reasonably easy to pull the plug on this annoyance.

(Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.)

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