Your guide to acid reflux and ear pain

Key Takeaways

• While uncommon, ear pain may be a symptom of acid reflux because of the way the tubes in your ears are interconnected, with the tubes going to your throat.
• Sometimes, acid reflux can cause sore throats and the pain from these sore throats can radiate out to your ears, known as referred ear pain.
• For some people, a type of GERD known as laryngopharyngeal reflux (LPR) can lead to ear pressure and pain. Other symptoms can include feeling of ear fullness, hearing difficulties, and ringing or popping in the ears.

Heartburn is an uncomfortable burning sensation that happens just behind the breastbone. It happens when digestive acid moves into the esophagus, which is the tube between your throat and stomach. People may experience heartburn:

• after eating
• in the evening
• after lying down

While uncommon, ear pain may be a symptom of acid reflux because of the way the tubes in your ears are interconnected with the tubes going to your throat. Note that the symptoms of reflux don’t affect your hearing, and it’s uncommon to find correlations between the two.

How does acid reflux affect your ears?

If you have frequent heartburn that interferes with your day-to-day activities, you may have a condition called gastroesophageal reflux disease (GERD). There is also a GERD variant called laryngopharyngeal reflux (LPR), which some people call silent reflux.

GERD occurs when stomach acid backflows and irritates your esophagus. LPR occurs when stomach acid backflows higher and irritates your larynx, or voice box, and pharynx, which sits behind the mouth and nasal cavity.

Sometimes, acid reflux can cause sore throats. The pain from these sore throats can radiate out to your ears, known as referred ear pain. This may happen because of the shared nerves between your ears and your head and neck area.

More recently, some healthcare professionals have defined LPR as an inflammatory condition involving the tissues of the upper aerodigestive tract — the upper parts of your digestive system and airways. This could relate either directly or indirectly to the effects of gastric or duodenal reflux.

When it comes to the ears, each has a eustachian tube that connects the middle ear to the nasopharynx. The tubes balance the pressure in your middle ear to the air pressure outside of the body.

LPR symptoms

Typically, LPR symptoms will appear in your throat, such as:

• feeling as though there’s a lump in your throat
• feeling as if you need to clear your throat
• throat soreness
• swallowing difficulties
• hoarseness
• persistently coughing
• postnasal drip
• larynx irritation

Effects on the ears can include inflammation of the middle ear, also known as otitis media. Researchers believe this may be due to the inflamed mucosal lining of the eustachian tube and middle ear.

Eustachian tube obstruction

For some people, LPR can lead to ear pressure and pain, often in the form of eustachian tube obstruction (ETO), also known as eustachian tube dysfunction.

According to an older 2017 study, there are correlations between LPR and ETO. And some 2022 research suggests that LPR is a possible cause of ETO in people with a form of otitis media.

ETO also causes fluid to not drain properly from the middle ear into the throat. This fluid can build up in the ear and cause an infection.

The eustachian tube connects your middle ear and throat, and when these tubes become blocked, swollen, or inflamed, you may experience the following symptoms:

• ear pain
• a feeling of ear fullness
• hearing difficulties
• ringing or popping in the ears
• dizziness
• referred ear pain

Treating acid reflux

If you have heartburn and ear pain and a diagnosis of acid reflux, a doctor may recommend over-the-counter (OTC) or prescription medications, surgery, or lifestyle adaptations.

OTC medications

For symptom relief, a doctor may recommend the following:

• Antacids: These drugs help neutralize stomach acid and may include:
  • Tums
  • Rolaids
  • Mylanta
• H2-receptor blockers: These medications help reduce stomach acid production and include:
  • famotidine (Pepcid)
  • nizatidine (Axid)
  • cimetidine (Tagamet)
• Proton pump inhibitors: These drugs block acid production and include:
  • omeprazole (Prilosec OTC)
  • lansoprazole (Prevacid 24 HR)

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Prescription medications

If OTC medications don’t provide enough relief, a doctor may suggest:

• prescription-strength H2-receptor blockers, like nizatidine and famotidine
• prescription-strength proton pump inhibitors, such as:
  • omeprazole sodium bicarbonate (Zegerid, Konvomep)
  • dexlansoprazole (Dexilant)
  • pantoprazole sodium (Protonix)
  • esomeprazole (Nexium)
  • rabeprazole (Aciphex)
• medications to help empty your stomach quicker, like metoclopramide (Reglan) or bethanechol (Urecholine)

Online care for acid reflux

GERD, LPR, and acid reflux can be uncomfortable, especially long term. Starting a treatment plan can help reduce painful symptoms, including ear pain.

Online care services, including Optum Perks Online Care, may make getting treatment easier. With these services, you can submit an online form answering a few questions about your symptoms, and a US-licensed healthcare professional will respond soon after to prescribe a treatment plan.

Lifestyle adaptations

To lower the frequency of acid reflux, your doctor may suggest that you try:

• reaching and maintaining a moderate weight
• eating slowly and thoroughly chewing food
• avoiding lying down until 3 hours after eating
• identifying and avoiding trigger foods, which may differ for everyone but could include alcohol, caffeine, and fried foods
• stopping smoking, if you smoke

If you’re concerned about your symptoms of heartburn and ear pain, contact a doctor or healthcare professional as soon as possible to ensure they provide appropriate treatment.

Summary

Ear pain and heartburn can both be symptoms of acid reflux.

If you experience ear pain, it may indicate laryngopharyngeal reflux (LPR). Other symptoms of LPR may include persistent cough and feeling as though you need to clear your throat.

If you have a recurring earache or experience heartburn often, talk with a doctor, either in person or through online care services. They will be able to help you find a treatment plan that works for you.

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