Lowering the fluid volume in your inner ear can help prevent attacks. Excess salt in your diet causes your body to retain fluid, which can build up in your inner ear. Your clinician may recommend a low-salt diet or a diuretic (water pill) to decrease fluid retention.

Some people report reduced episodes by limiting or avoiding alcohol, caffeine, and smoking. You can also prevent attacks by recognizing triggers such as emotional stress, fatigue, illness, or allergies. By avoiding your triggers and maintaining good overall health, you may have better disease control.

Your clinician may prescribe medications to use when you have an attack. These medications do not lower fluid pressure in your inner ear, but they do provide symptom relief. They include:

• Antiemetics to reduce nausea and vomiting
• Vestibular suppressants to reduce vertigo and anxiety associated with attacks

Medications can also help prevent and reduce the frequency of Ménière’s disease attacks. They include:

• Diuretics to reduce fluid build-up in the inner ear
• Migraine medications, due to the overlap of migraine and Ménière’s disease

Doctors may inject medications into the middle ear to treat Ménière’s disease:

• Steroids may reduce dizziness and are safe to use, but their effect varies.
• Gentamicin helps control vertigo but may cause permanent damage to the hair cells in the inner ear that help you hear and maintain balance. This damage may cause irreversible loss of balance and hearing. 

We typically perform surgery when other treatments have failed and symptoms are causing severe disability. Surgical options for Ménière’s disease include:

• Endolymphatic sac operation: The endolymphatic sac regulates the volume and pressure of fluid in the inner ear. Doctors think Ménière’s disease may be due to compression of the sac. Endolymphatic sac operation removes bone from around the sac to reduce pressure.
• Labyrinthectomy: This surgery involves removing the inner ear’s vestibular system (semicircular canals and vestibule). A side effect of labyrinthectomy is hearing loss in the affected ear. Though highly effective, it is typically an option only for people who have already lost hearing in that ear.
• Vestibular nerve section: In this procedure, the surgeon cuts the nerve that sends signals from the semicircular canal to the brain. Doctors rarely use this procedure since it is not always effective.

You may benefit from a hearing aid if you have hearing loss from Ménière’s disease. Options include:

• Amplification devices that make the sound around you louder
• Implants, such as bone-conduction hearing devices and cochlear implants

Balance therapy is a specialized exercise program to help you improve your balance and manage vertigo and dizziness. A physical therapist teaches you exercises, such as: