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Linking Reflux with Ear Infections



by Debbie C. Lindgren


Ear infections are the number one reason children and infants visit their physician or emergency room.[1] When a child has repeated ear infections, parents and doctors become concerned because the child may be experiencing temporary hearing loss which could affect their speech and language development. The concern arises since some ear infections are accompanied by effusion (more commonly known as glue ear) caused by the build up of mucous cells that cannot be cleared. There are a number of reasons why glue ear can occur: bacterial and viral infections, allergies, and more recently discovered the presence of stomach acid.[2]

The Acid Reflux/Ear Infection Connection

In one study, the middle ear fluid of 83% of children tested positive for pepsinogen, a digestive enzyme produced by the body to break down food proteins. This enzyme was present in concentrations that were approximately 1000 times higher than those found in the blood. The conclusion of the study was that childhood reflux was to blame.[3]   It appears that when a child lies on his back, pepsin can flow up to the throat and drip into the middle ear. This could cause inflammation and set up a breeding ground for bacteria.


Another study published in 2004 followed 34 children, from 7 months old through 7 years old. This study found that 67% of the children also tested positive for pepsinogen in their middle ear fluid.[4] Further, this study indicated that very few children had symptoms of reflux and none had heartburn, sour taste in the mouth or pain while swallowing, making it difficult for parents to identify the problem.  


In 2006, an Italian study indicated that a chronic cough that is unresponsive to widely used medicines is actually a sign of reflux and in most cases the only sign of reflux.[5] The researchers stated that the cough creates a vicious cycle in which the cough relaxes the sphincter, thus favoring reflux, which then triggers more coughing. In this study 91% of participants had pepsinogen present in their middle ear fluid.   Another study reported in the Otolaryngoly Head and Neck Surgery in March of 2007, concluded that controlling the reflux may be an essential piece of controlling middle ear infections.[6] 


In January and May of 2007, studies were conducted with adults who presented with middle ear effusion and again the conclusion was once the reflux symptoms were controlled, relief from effusion followed.[7]   Further, success has been seen by using an antireflux medicine to reduce the reflux symptoms thereby eliminating or reducing middle ear complaints.[8]


Treating Reflux Naturally

There are some natural remedies that help soothe the symptoms of reflux and can in turn help to reduce the number of ear infections being experienced. 


1. Drinking small amounts of water throughout the day.  Water is an important part of the digestion process as water will help dilute the acid in your stomach. [9]

2. A digestive enzyme taken just prior or with meals helps break down proteins that could lead to reflux[10]. Digestive enzymes are available in either capsule or powder form that can be sprinkled on food or mixed in with water.


3.  Probiotics are helpful as they encourage the growth and colonization of healthy bacteria in the intestines. Healthy gut flora is essential to proper digestion and can be beneficial in treating acid reflux. A good probiotic should contain at least 5 billion microorganisms in each serving and be dairy free.  Better probiotics contain FOS (fructooligosaccharides), which help to increase beneficial gut flora in the body. A study with 130 children indicated probiotics reduce recurrences and complications of ear infections.[11]


4. When sleeping, keep your child’s head elevated. Having the head higher than the stomach allows gravity to keep stomach acid where it belongs.  Infants and small children may be more comfortable napping in a car seat that keeps their head elevated.


5. Check for allergies[12]. This can be done through food rotation. Remove commonly offending foods such as dairy, wheat, soy, and eggs and see if they ease symptoms. If symptoms reoccur once the food is reintroduced, you will know which foods to avoid.


Treating and Preventing Ear Infections Naturally

If your child is prone to ear infection, adding xylitol to their diet may be a good proactive strategy. Xylitol has been studied and proven to help keep ear infections at bay. Xylitol gums, candies, and rinses are available for older children, while nasal sprays may be more convenient for younger children. The Pediatric Infectious Disease Journal recommends a dosing of 5 times per day of xylitol in order for it to be effective against ear infections[13]. The same journal found a dosing of 3 times a day to be ineffective.


If your child already has an active ear infection, Vitamin C, A, Zinc, and Echinacea have been shown to aid in the reduction of inflammation and enhance immunity.[14] Ear drops (mullein oil) are also helpful but should not be used if the ear drum is perforated. Since it can be difficult for a parent to determine if perforation has occurred, I prefer to use supplementation, homeopathy, and apply a warm compress to the ear.


Homeopathic Remedies help with Ear Infections

Following are some commonly used remedies for ear infections. As with all illnesses, please consult your health care practitioner to see if there are a good fit for your child.

Aconitum Napellus: This remedy is helpful if an earache comes on suddenly usually after exposure to cold and wind, or swimming. Fever may be high and thirst is strong. Symptoms are often worse near midnight, and can even wake the person up.

Belladonna: This remedy is indicated for intense throbbing earaches that come and go very suddenly. Fever is present and the child will typically have a flushed face, eyes that are sensitive to light and skin that is hot to touch.

Chamomilla: This is a great remedy to use with earaches associated with teething. These children have such intense pain that they will hit, scream and be very agitated. They will typically have one red cheek.

Ferrum phosphoricum: This remedy is helpful to always have on hand as it soothes the aches and inflammation associated with ear infections. The child will appear flushed with fever will be tired.

Hepar sulphuris calcareum: This is helpful in the more advanced stages of an ear infection even with pus or a bulging eardrum. The child may feel stabbing or sticking pains in their ear and are very sensitive to colds and drafts

Mercurius solubilis:   If the earache is accompanied by swollen glands, sweating, and offensive breath, than mercurius will be helpful. The child will be sensitive to hot and cold temperatures and may drool while sleeping. 

Pulsatilla: This is good for ear aches that follow or accompany a cold. The child will dig at their ear because they feel the need to itch deep inside. The child is typically weepy and will want to be held. The external ear may appear red and swollen.


If your child suffers from chronic ear infections, please schedule an appointment with Sima Ash to help discover the root cause and treatment plan for your chlid.

[1] National Institute of Health

[2] National Institute of Health

 [3] Innovations Report

[4] Medical News Today

[5] Dr. Benedetto

[6]National Institute of Health

[7]   Prediction of gastroesophageal reflux in otitis media with effusion in adultsand Otitis media in adults as a symptom of gastroesophageal reflux 

[8] Cat.inist and Science Direct 

[9] Natural Acid Reflux Remedies

[10] http://nutritherapy.wordpress.com/2008/04/26/acid-reflux-right-digestive-enzymes-wrong-anti-acids/

[11] Nourishing Connections

[12] How are Allergies and Gerd Related? 

[13] National Institute of Health

[14] Nourishing Connections


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