At-A-Glance
- Acid reflux can cause tinnitus (ringing in the ears) by irritating the openings of the eustachian tubes. There are more common causes of tinnitus, but it occurs in about 10% of people with respiratory reflux.
- Symptoms like ear fullness, ear pain, popping, muffled hearing, and tinnitus can accompany respiratory reflux, which often occurs without heartburn, making it easy to overlook.
- Treating reflux may relieve ear-related symptoms, including tinnitus, in some patients. Includes a real-world case study of a patient whose tinnitus was resolved with reflux treatment.
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More Patients Are Discovering That Acid Reflux Can Cause Tinnitus
Can acid reflux cause tinnitus? It’s a question more people are asking as awareness grows around lesser-known symptoms of reflux. When most people think of acid reflux, they picture heartburn or indigestion. But there’s a lesser-known form—laryngopharyngeal reflux (LPR), also known as silent reflux or respiratory reflux—that often goes unrecognized.
Respiratory reflux usually doesn’t involve heartburn. Instead, it travels up into the throat and upper airways, affecting areas far beyond the digestive tract.
What most people don’t realize is that respiratory reflux is actually the more common form of reflux, and its symptoms can show up in surprising ways. It can cause issues in the throat, sinuses, and even the ears.
One symptom that rarely gets linked to reflux is ringing in the ears. But as someone who works regularly with reflux patients, I’ve often seen acid reflux cause tinnitus—especially in cases where inflammation affects the upper airways.
While tinnitus is typically associated with hearing loss from noise exposure or aging, inflammation caused by reflux can also contribute to the sensation of persistent ringing. For some patients, treating the reflux is what ultimately brings relief.
Understanding the Connection: How Reflux Affects the Ears
The upper part of the throat—known as the nasopharynx—sits at the intersection of several important structures. It connects the back of the nasal passages to the upper airway and esophagus and is also where the Eustachian tubes open. These tubes help regulate pressure in the middle ear and allow fluid to drain properly. When they aren’t functioning well, symptoms like ear fullness, popping, hearing changes, or tinnitus can develop.
In cases of respiratory reflux, acid and the digestive enzyme pepsin can travel up from the stomach and reach the nasopharynx. This can irritate the surrounding tissue, leading to inflammation and swelling around the Eustachian tube openings. As a result, the tubes may no longer equalize pressure effectively, creating sensations of blocked ears, fluctuating hearing, or persistent internal ringing.
Because these symptoms don’t match the classic profile of reflux, this type of Eustachian tube dysfunction is often overlooked—especially by providers unfamiliar with respiratory reflux as a possible cause.
It’s worth emphasizing that reflux is not the most common cause of tinnitus; high-frequency hearing loss remains the leading factor. But in patients with ongoing throat, sinus, or ear symptoms, respiratory reflux is increasingly recognized as a contributing factor—one that’s easy to miss without the right context.
One patient’s experience illustrates just how easily this connection can be missed—and how addressing reflux can sometimes bring unexpected relief from persistent ear symptoms.
Case Study: How Treating Acid Reflux Cured My Tinnitus
A 29-year-old shares his experience of misdiagnosis, persistence, and recovery.
For almost three years, I lived with an invisible but constant presence: a high-pitched ringing in my ears that never stopped. I also had a strange, uncomfortable fullness in my ears, like I was perpetually descending in an airplane, and they just wouldn’t pop. Add in some mild hearing loss, frequent popping sounds, and facial pressure, and I felt like I was stuck in a loop of discomfort I couldn’t get out of.
At first, I saw an ENT who ran a hearing test. The results showed some high-frequency loss, but not enough to explain my symptoms. He actually told me, “I wouldn’t expect you to have tinnitus from this.” Still, the ringing persisted, especially at night when it was quiet—but it could happen any time.
Some nights I couldn’t sleep at all. I’d lie awake, staring at the ceiling, listening to that piercing tone and wondering if it would ever stop.
I began to suspect it might be reflux-related. I’d read about silent reflux and had many of the symptoms—facial pressure, postnasal drip, trouble swallowing, and that constant lump-in-the-throat feeling. I even tried Dr. Jamie Koufman’s reflux detox diet, but at that point, the tinnitus didn’t budge.
Over the next year and a half, I saw multiple specialists. One gastroenterologist told me I didn’t have reflux. One ENT told me reflux had nothing to do with ear symptoms. Another said maybe I was imagining it, and that I should see a psychiatrist. But I knew this wasn’t just in my head.
Eventually, I saw Dr. Koufman herself. I told her everything and said, “I think my issues are coming from reflux.” She took me seriously. After an exam and testing, she confirmed that I had severe respiratory reflux. My Reflux Symptom Index score was 20 (normal is below 5), and a 24-hour double-probe pH test confirmed it: acid was reaching my throat and nasopharynx.
She put me on a structured plan:
- Eat dinner by 5 p.m.
- Avoid eating within 4+ hours of bed
- Sleep in a recliner to stay upright
- Drink alkaline water and use it as a throat spray
- Follow a strict low-acid diet
And within just a few weeks, something incredible happened. The ringing started to fade. The pressure in my ears released. My postnasal drip eased up. And then one night, I realized: it was quiet. Truly quiet.
After nearly three years of non-stop tinnitus and a frustrating trail of dismissals, I finally found relief.
Final Thoughts: Can Acid Reflux Cause Tinnitus? Yes.
Tinnitus is a complex symptom with many possible causes, but in patients who experience it alongside sinus congestion, postnasal drip, throat discomfort, or swallowing issues, it may be worth exploring whether respiratory reflux is playing a role.
When inflammation near the Eustachian tubes is addressed, pressure can normalize—and the related ear symptoms may gradually improve. While healing takes time and often requires a dedicated treatment plan, this case highlights how recognizing the upper airway effects of reflux can lead to meaningful relief—sometimes from symptoms that seem entirely unrelated to digestion.
For more information about diagnosis and treatment of acid reflux, see two companion books on Amazon: Dr. Koufman’s Acid Reflux Diet and Dropping Acid: The Reflux Diet Cookbook & Cure. If you would like to receive personalized guidance and strategies for lasting relief, consider scheduling an online consultation.
