What to know about heartburn and ear pain

Heartburn is an uncomfortable burning sensation just behind the breastbone. It occurs 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

The symptoms of reflux do not occur alongside hearing symptoms, and it is uncommon to find correlations between the two.

How does heartburn 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 and irritates your larynx, or voice box, and pharynx, which sits behind the mouth and nasal cavity.

More recently, some healthcare professionals define LPR as an inflammatory condition involving the tissues of the upper aerodigestive tract. 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 equalize 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.

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

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 do not 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)

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 applicable

If you are 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 your doctor.

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