Can gastroesophageal reflux disease (GERD) cause tinnitus?

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Dainyal Siddiqui, MD

Internal Medicine

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Manuel Jimenez, MD

Cardiology

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Franz Pierre-Louis, MD

Infectious Disease

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Last updated: May 7, 2025 • View editorial policy

From the Guidelines

Acid reflux is a potential cause of tinnitus, and treating the reflux may alleviate the symptoms, as suggested by the 2023 study on extraesophageal gastroesophageal reflux disease 1. To determine if acid reflux is contributing to tinnitus, it is essential to consider the possible extraesophageal manifestations of GERD, which include ear disease, as listed in Table 1 of the study 1. Some key points to consider when evaluating the connection between acid reflux and tinnitus include:

  • The concept of extraesophageal symptoms secondary to GERD is complex and often controversial, leading to diagnostic and therapeutic challenges 1.
  • Patients with EER may not complain of heartburn or regurgitation, making it crucial for clinicians to determine whether acid reflux is a contributing factor to the symptoms 1.
  • A simple trial of proton pump inhibitors (PPIs) may not provide accurate diagnostic information regarding the contribution of acid reflux to EER symptoms, including tinnitus 1. Given the potential link between acid reflux and tinnitus, treating the reflux with lifestyle modifications and medications, such as over-the-counter proton pump inhibitors, may help alleviate tinnitus symptoms. It is recommended to:
  • Take over-the-counter proton pump inhibitors like omeprazole (20mg daily) or pantoprazole (40mg daily) for 2-4 weeks 1.
  • Use antacids like Tums or Rolaids as needed for breakthrough symptoms.
  • Elevate the head of your bed 6-8 inches, avoid eating within 3 hours of bedtime, and eliminate trigger foods such as spicy foods, caffeine, chocolate, and acidic foods. If symptoms persist after 2-4 weeks of treatment, consult a healthcare provider as you may need prescription-strength medication or further evaluation to rule out other causes of tinnitus.

From the Research

Tinnitus and Acid Reflux

  • Tinnitus, a condition characterized by ringing or other sounds in the ears, has been linked to various factors, including acid reflux 2.
  • Research suggests that gastroesophageal reflux disease (GERD), which involves the regurgitation of stomach contents, may disrupt the homeostasis of the middle and inner ear, potentially leading to tinnitus 2.
  • A nationwide population-based cohort study found a significant association between GERD and tinnitus, although the use of proton pump inhibitor medication in GERD patients did not show a significant decrease in the onset of tinnitus 2.

Treatment of Acid Reflux and Tinnitus

  • Proton pump inhibitors (PPIs) are commonly used to treat acid reflux, but their effectiveness in reducing tinnitus symptoms is unclear 3, 4.
  • Studies have shown that PPIs can be effective in relieving heartburn and other symptoms of acid reflux, but their impact on tinnitus is less well understood 4, 5.
  • One study found that PPI use was associated with an increased risk of sensorineural hearing loss or tinnitus in patients with type 2 diabetes 6.

Mechanisms and Associations

  • The exact mechanisms by which acid reflux may contribute to tinnitus are not fully understood, but it is thought that the regurgitation of stomach contents may disrupt the balance of the middle and inner ear 2.
  • Further research is needed to fully understand the relationship between acid reflux and tinnitus, as well as the potential effects of treatment with PPIs and other medications 3, 6.
  • The association between acid reflux and tinnitus may be influenced by various factors, including the severity of acid reflux, the presence of other health conditions, and the use of certain medications 2, 6.

References

3
Research

Combination drug therapy for gastroesophageal reflux disease.

The Annals of pharmacotherapy, 2002

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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