Ear problems can present with pain, discharge, change in hearing and tinnitus. Ear pain is common in young children and is often due to viral illnesses but history and examination are vital to exclude infections behind the ear drum (otitis media) and in front of the ear drum (otitis externa), that may require antibiotics.

These conditions frequently affect adults also and the latter is associated with cotton bud use which should be avoided - the ears will in most cases clean themselves, introducing anything to the ear increases the risk of wax impaction, damage to the ear drum or infection in the canal (otitis externa)

Discharge is also a sign of ear infection, and should prompt review with a Doctor 

Changes in hearing can occur for example, with any blockage in the ear. Wax impaction is a common cause and patient's often describe it as being like 'walking around with a finger in your ear, or being under water' - examination is needed to investigate this and if impaction is present, the use of olive oil or otex drops to break down or soften the wax before syringing or microsuction is advised.

Any sudden loss of hearing in an ear is more concerning and best dealt with in A&E as the Ear, Nose and Throat (ENT), Doctor's need to do further investigations, start treatment and arrange follow-up to determine and treat the cause.

Tinnitus is a common condition where the patient complains of 'ringing or hissing' in the ears; most cases are benign and can occasionally be related to medications the patient is taking. Thorough history, examination and assessment should be undertaken and this should be done more urgently if the tinnitus is one-sided and/or pulsatile (throbbing) in nature