A Literature Review on The Gut-Inner Ear Axis: Implications for Nursing Care Through Neuman’s Systems Model Theory

Abstract

Gut health is an important and topical subject in healthcare, which has received a significant amount of attention in recent years. Recently it has been proposed that gut dysbiosis (a microbial imbalance in the gut) is linked to hearing loss. Hearing loss is one of the most common chronic ailments in the world, affecting millions worldwide, and significantly impacting quality of life, communication, and mental health. This thesis explores the link between the gut and hearing loss and how understanding this connection can improve nursing care. By applying Neuman’s System’s Model Theory, which looks at people as whole systems affected by different stressors, this thesis highlights how a more holistic approach to nursing care can be developed to better support patients’ overall health, including both gut and hearing health.

A descriptive literature review was conducted, identifying 22 peer-reviewed articles from PubMed, CINAHL Ultimate, and Sage Premier, supplemented by complementary manual searches. Clear inclusion and exclusion criteria, PICO-guided keyword searches, and a critical appraisal framework ensured repeatability and upheld the quality, relevance, and reliability of the selected studies. A thematic inductive analysis was then conducted. One main theme that emerged was the underlying mechanisms connecting the gut and inner ear. Systemic inflammation is key causal mechanism, although the gut and inner ear are also linked through various signalling pathways, including the vagus nerve. The second main theme that emerged was the therapy aspect. This included dietary changes, probiotics, and health promotion strategies. High-fat diets and obesity have been linked to hearing loss as well as gut dysbiosis, so promoting anti-inflammatory and Mediterranean diets through health promotion was a key finding. Neuman’s Systems Model Theory was applied to highlight possible therapeutic strategies at primary, secondary and tertiary levels.

This review on the gut–inner ear axis offers valuable insights for nurses by applying Neuman’s Systems Theory, which supports prevention and holistic care. At the primary level, nurses can promote gut and hearing health through education on diet and healthy lifestyle interventions. At the secondary level, recognising early signs of dysfunction in the gut or auditory system can guide timely assessments. At the tertiary level, this understanding supports more integrated long-term care for chronic conditions. Overall, this systems-based approach enhances nursing practice across gastroenterology, otology, and holistic care settings.