Tinnitus in One Ear — ETD? — Need Help

[om1]

Newbie here, another person whose life has changed a bit from tinnitus.
Some details. I was suffering with stomach pain especially when I ate too much tomatoes pasta etc.

So I went to GP here in Australia, he booked for a Urea breath test, they found H Pylori bacteria infection. And all symptoms of ulcers, endoscopy confirmed it that I have ulcers and erosive antral gastritis.

So they put me on a triple therapy in Mid of Jan 2019 of esomeprazole, amoxicillin and clarithromycin, so this is basically 3 tablets in the morning and evening so 6 in a day for 7 days. Too much antibiotics for my liking. But I was scared of the cancer causing bacteria so I took it and 2-3 days into taking it I started feeling reflux into my throat while sleeping. It was the most horrible taste of bitterness at the back of my throat. It gave me throat irritation some cough and enamel erosion a bit., Also when I woke up one morning (2-3 days after starting course) when mild ringing/hissing in my ears.

So I really don't know if reflux caused it if stomach acid get into inner ear through the round or oval window if the acid goes into Eustachian tube especially since I have the LaryngoPharyngalReflux type or LPR.

Or the antibiotics and the PPIs I took for a few weeks after stopping antibiotics after 4 days caused it?

Gradually this became heard mostly only left ear (I test it as below), which is also the ear I feel like there is some fluid in and constantly try to dig it out with fingers etc... So I am sure there is something happening in my ear due to reflux. As I can feel there is something in my left when reflux happens. I also had gone to an ENT who checked both ears with the scope did the tuning fork test to see if I hear in both and said there is no blockage or infection. But I am thinking he couldn't looking into middle ear, is that right?

Does this point to some Eustachian Tube involvement? I searched here and read quite a bit and am thinking I need to go try the Nasal Spray, are there any non-ototoxic nasal sprays that are safe to try?

Also the test I think tells my I only have tinnitus in left ear is, I play a sound or listen to running shower... I close both ears now I don't hear the sound but only hissing of tinnitus. I open my right ear I can hear some of the shower sound plus tinnitus clearly in the left ear. I open my left ear and close the right ear and now I hear mostly shower sound and very less of tinnitus since left ear is getting both sound in with tinnitus? Is my test right?

 

[Contrast]

Before you assume anything about tinnitus, we need to know if you have a history of over exposure to loud noise? That is the most common cause of tinnitus and ear fullness. You need to check with a doctor to see if those medications are ototoxic.

 

[GregCA]

Or the antibiotics and the PPIs I took for a few weeks after stopping antibiotics after 4 days caused it?

Maybe neither one of these are the cause.

I also had gone to an ENT who checked both ears with the scope did the tuning fork test to see if I hear in both and said there is no blockage or infection. But I am thinking he couldn't looking into middle ear, is that right?

The ear drum is fairly translucent, so an ENT should be able to see what's behind the ear drum (the middle ear) with an otoscope, but not with much detail. In general you can just tell that there's fluid there or not.

You should probably do a hearing test to get a better assessment. Fork tests are very basic.

Also the test I think tells my I only have tinnitus in left ear is, I play a sound or listen to running shower... I close both ears now I don't hear the sound but only hissing of tinnitus. I open my right ear I can hear some of the shower sound plus tinnitus clearly in the left ear. I open my left ear and close the right ear and now I hear mostly shower sound and very less of tinnitus since left ear is getting both sound in with tinnitus? Is my test right?

It's hard to test this because the brain has some "cross talk" going on where sound seems to bleed over to the other side. But based on what you are saying, it does sound like unilateral tinnitus. You don't need such a complicated test though: just think about where you "hear" your tinnitus from. Center? Left? Right?

I suggest you use this flowchart to guide your doctor(s): https://www.tinnitusresearch.net/index.php/for-clinicians/diagnostic-flowchart

Good luck!

 

[eagerUser]

Years ago i was put on different ototoxic antibiotics due to H pylori and also took lots of -prozole s and -tidin s. It was 12 or maybe 14 antibiotics a day including amoxycilin, metronidazole and another one which i can't recall and I was completely fine afterwards. They had no effect on my hearing or whatever.

That was me, you are different. Prazole s have tinnitus as one of their side effects.

I think you should talk to the doctor who diagnosed you with h pylori and also see an ENT ASAP. There might be something curable. If it's not NIHL it may go away soon, even if it's NIHL it may go away or at least improve.

 

[om1]

Before you assume anything about tinnitus, we need to know if you have a history of over exposure to loud noise? That is the most common cause of tinnitus and ear fullness. You need to check with a doctor to see if those medications are ototoxic.

No exposure to loud noise very occasionally used headphones on medium volume. Also ib my left hear since I was a teen I have had this sensation of very small vibration especially if sound is near my left ear. That the sound causes some vibration. Doesn't happen in the right ear

 

[om1]

Years ago i was put on different ototoxic antibiotics due to H pylori and also took lots of -prozole s and -tidin s. It was 12 or maybe 14 antibiotics a day including amoxycilin, metronidazole and another one which i can't recall and I was completely fine afterwards. They had no effect on my hearing or whatever.

That was me, you are different. Prazole s have tinnitus as one of their side effects.

I think you should talk to the doctor who diagnosed you with h pylori and also see an ENT ASAP. There might be something curable. If it's not NIHL it may go away soon, even if it's NIHL it may go away or at least improve.

Thank you I'll check with GP for that.

@GregCA Can refluxing acidic contents into ear canal disturb inner ear mechanisms or cause ETD leading to T

 

[om1]

Maybe neither one of these are the cause.

The ear drum is fairly translucent, so an ENT should be able to see what's behind the ear drum (the middle ear) with an otoscope, but not with much detail. In general you can just tell that there's fluid there or not.

You should probably do a hearing test to get a better assessment. Fork tests are very basic.

It's hard to test this because the brain has some "cross talk" going on where sound seems to bleed over to the other side. But based on what you are saying, it does sound like unilateral tinnitus. You don't need such a complicated test though: just think about where you "hear" your tinnitus from. Center? Left? Right?

I suggest you use this flowchart to guide your doctor(s): https://www.tinnitusresearch.net/index.php/for-clinicians/diagnostic-flowchart

Good luck!

Thank you GregCA I have another question
My tinnitus changes intensity/ tone when I sleep or sit down vs standup. It's much less intense when I stand up and walk.

Also it changes tone when I open my mouth wide or clench jaw, does that indicate something structural?

I am more worried if the refluxed stuff like pepsin etc got into my inner ear somehow giving me wet left ear, some irritation with it and some fluid in nose plus slight balance issues. This has happened to me since I have had refluxes and can remember having tinnitus since that time too...

 

[GregCA]

Thank you GregCA I have another question
My tinnitus changes intensity/ tone when I sleep or sit down vs standup. It's much less intense when I stand up and walk.

Also it changes tone when I open my mouth wide or clench jaw, does that indicate something structural?

Not necessarily. It can just mean it has a somatic component, which is fairly common.

 

[InfiniteLoop]

@om1

What are you waiting for to get an audiologist detailed test? You have T only in the left ear (like I do), and most likely you have asymmetric hearing loss. Make sure you get a high frequency hearing test to 16KHz if possible.

 

[JamesAtMvertigo]

PPIs can cause an increase in the concentration of Pepsin, which is quite nasty when it gets into the wrong place...

Reflux Revisited: Advancing the Role of Pepsin

I found this quote interesting:

"Pepsin is produced only in the stomach; hence evidence of its presence in these organs signifies refluxate has reached them. The enzyme has recently been identified within the laryngeal epithelium, in the saliva of patients with suspected reflux laryngitis, and in the exhaled breath of those with airways and lung disease, where reflux is thought to have played a part. Pepsin has also been found in the middle ear in otitis media effusions (where bile acids, too, have recently been identified)."​

I'm wondering if Pepsin in the middle ear would be enough to cause problems.

So can issues with your stomach affect your ears? Most interesting!

I had some unidentified fluid in my middle ear for years that only appeared one morning and would drain away when I got up out of bed. It decreased to a point where I only once in a while feel my Eustachian tube unstick and "go squishy" for a little while.

The same ear developed significant tinnitus and some high frequency hearing loss but only after about 5 months of this sensation.

I've occasionally wondered if that's the side I lie on most...

 

[mohn]

@JamesAtMvertigo, interesting article.

Could you explain how you feel Eustachian tube stickiness? Quite a few folks have crackle sounds in ear due to ETD. Do you feel any liquid trickling / tickling in ears?

By eating few hours before sleep you can avoid acid reflux. Also avoid midnight snacks.

How much hearing loss do you have? Is it in one ear?

 

[JamesAtMvertigo]

Hey sorry for the slow reply.

Periodically (like every few days) I get a feeling that my ET is unsticking as for a few seconds with jaw movement I can get it to crack open after which this noise stops. Sometimes I get a squishing that lasts a bit longer.

The cracking open is so loud even my family has heard it!

Early on this was different. I used to wake up with fluid in my middle ear that would apparently drain away when I got up. Interestingly this started well before my tinnitus started (about 5 months before), the morning after attempting to clean wax out of that ear with a trickle of shower water (yes, crazy!). I became incredibly dizzy and imbalanced for 5 weeks (with no tinnitus), which all resolved except for the fluid sensation which remained for a couple of years.

I have mild high frequency loss in left ear which mirrors my tinnitus. Right ear is mostly fine.

All my symptoms have improved over many years including a reduction in the intensity and frequency of pulsatile tinnitus and I don't feel a pressure in my ear when driving anymore.

The persistent hiss is a bit more unshakeable though!

By the way, my acid reflux episode resolved.