Fluid in the Ear and Its Causes

Fluid in the ear often occurs with an ear infection, especially in kids. The inflammation or congestion that blocks the eustachian tube, a small drainage passageway in your ear, can also be due to allergies or the common cold. Eardrum injuries, nasal polyps, or even teething in babies can cause fluid to build up in the ear.

The blockage traps fluid in the middle ear in the space behind the eardrum, leading to symptoms like muffled hearing and pressure or pain in the ear. Treatment options vary but can include antibiotics. Some people may need to have tubes placed in the ears or surgery to remove their adenoids.

Symptoms

Symptoms of fluid in the ear can be mild or severe. Possible symptoms include:

• Ears that feel "plugged up" or a sense of fullness in the ears
• Ear pain and discomfort, including not being able to "pop" the ears
• Hearing loss or muffled hearing
• Visible fluid from the ear

Some people may experience ringing in the ears ( tinnitus ) or have balance problems due to dizziness or vertigo (the feeling like everything around you is spinning).

In children, fluid in the ears is common. About 75% of children will get fluid in their ears at some point before age 3. Additional signs of fluid in the ears of children can include:

• Tugging at ears
• Crying more than usual
• Trouble sleeping

Fluid in the ear may not be suspected until a small child exhibits issues like speech delay or difficulty with a hearing exam.

Is Otitis Media With Effusion (OME) an Ear Infection?

Fluid in the ear is sometimes called otitis media with effusion (OME). Fluid due to OME is not infected, but middle ear infections occur when ear fluid has been infiltrated by pathogens like bacteria or a virus.

Causes

Common causes of fluid in the ear include:

• Allergies
• Congestion from a cold virus or infection
• Teething in babies
• Chemical irritants like cigarette smoke
• Enlarged sinus tissue, nasal polyps, tonsils, adenoids , or other growths that block the auditory tube (usually caused by chronic sinusitis)
• Barotrauma to the ears (rapid changes in air pressure or altitude) as well as cold exposure
• Structural differences, such as those that can occur with Down syndrome or cleft palate

Anyone can get fluid in their ears, including adults treated with radiation for head and neck cancer. However, children have smaller auditory tubes that are more horizontal than in adults, which can encourage fluid to pool in the ear.

Earwax and Ear Fluid

White, yellow, or brown earwax is normal but it should only be a small amount. If ear discharge continues or has blood or pus in it, seek emergency care. It may be the sign of a ruptured eardrum.

Diagnosis

Fluid in the ear often goes undiagnosed because it may not cause any symptoms. To identify the cause, an ear, nose, and throat specialist ( otolaryngologist ) may have better training and diagnostic equipment than your pediatrician or other healthcare provider. Tests include:

• Otoscope exam: A handheld, lighted otoscope is gently inserted into the ear. Experienced providers can see either a bubble or fluid level behind the eardrum. They may also see that the eardrum does not move as it should, or that there's an atypical color.
• Tympanometry exam: A tympanometer measures the pressure inside the ear when placed in the outer ear canal. No talking, swallowing, or moving during the test helps with accuracy.
  

Keep in mind that neither exam can diagnose hearing loss but they can point to the need for additional tests.

Treatment

Fluid in the ear usually drains on its own within a few weeks, but other treatments may be needed depending on the cause. Children who are at a higher risk of complications from fluid in the ears, including those with developmental delays, may need earlier treatment.

Possible treatments can include:

• A hearing test and further observation
• Antibiotics to treat bacterial infection
• Placing tubes in the ears
• Surgery for enlarged adenoids

Antihistamines may help keep allergy symptoms and chronic sinusitis from clogging your ears, but they will not necessarily rid your ears of fluid that's already there.

For adults, it can take up to three months for fluid in your ear to go away on its own. If you continue to have problems, your provider may consider additional causes or treatments.

Can You Treat Fluid in the Ear Naturally?

No benefits have ever been shown for special diets, herbal remedies or special diets, chiropractic care, or other complementary or alternative medicine therapies. Research on the safety and effectiveness of these treatments for otitis media with effusion is limited.

Prevention

These steps may help to prevent fluid from collecting in the ear:

• Quit smoking and try not to be around cigarette smoke.
• Stay allergy-free. Avoid substances that trigger your allergies (allergens).
• Limit exposure. If your child is in daycare, consider switching to a smaller daycare. Fewer kids means less exposure to germs, and daycare is a risk factor for developing fluid in the ear.
• Consider breastfeeding if possible, even for just a few weeks. Infants who are breastfed get sick less often and are less likely to get ear infections even years later.

Staying up to date on vaccines may help. The pneumococcal vaccine (Prevnar) helps prevent the most common type of ear infection. Getting a yearly flu shot prevents illness that can lead to fluid in the ear.

Summary

Fluid in the ear (otitis media with effusion) is a common condition, especially in kids, that does not always need to be treated. It can be caused by inflammation, mucus, or a structural problem in the ear that blocks the fluid drainage from your auditory tube.

If you have symptoms, they may include pain, muffled hearing, or a feeling of fullness in your ear. Fluid in the ear may gradually go away on its own but other treatments might be needed. They include antibiotics if there is an infection or surgery to help drain it if the fluid buildup does not get better or gets worse.

Simple strategies may help prevent fluid buildup, such as avoiding irritants and allergens, washing your hands regularly, and staying up-to-date on vaccines.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Penn Medicine. Ear infection (middle ear).
2. American Academy of Family Physicians. Otitis media (with effusion).
3. Johns Hopkins Medicine. Ear Infection (Otitis Media).
4. Hoberman A, Paradise JL, Rockette HE, Kearney DH, Bhatnagar S, Shope TR, et al. Shortened Antimicrobial Treatment for Acute Otitis Media in Young Children. N Engl J Med. 2016 Dec 22;375(25):2446-2456. doi: 10.1056/NEJMoa1606043.
5. Fruhner M. Children's Hospital Los Angeles. What is middle ear fluid and how can this impact my child?
6. Centers for Disease Control and Prevention. Ear infection.
7. Brook I. Late side effects of radiation treatment for head and neck cancer. Radiat Oncol J. 2020 Jun;38(2):84-92. doi: 10.3857/roj.2020.00213.
8. Gao T, Li X, Hu J, et al. Management of traumatic tympanic membrane perforation: a comparative study. Ther Clin Risk Manag. 2017;13:927-931. doi:10.2147/TCRM.S139631
9. Rosenfeld RM, Tunkel DE, Schwartz SR, Anne S, Bishop CE, Chelius DC, et al. Clinical Practice Guideline: Tympanostomy Tubes in Children (Update). Otolaryngol Head Neck Surg. 2022 Feb;166(1_suppl):S1-S55. doi: 10.1177/01945998211065662.
10. Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, et al. Diagnosis and treatment of otitis media with effusion: CODEPEH recommendations. Acta Otorrinolaringológica Española. 2019;70(1):36-46. doi:10.1016/j.otorri.2017.07.004
11. American Academy of Otolaryngology–Head and Neck Surgery. Treating and Managing Ear Fluid.
12. Marom T, Marchisio P, Tamir SO, et al. Complementary and Alternative Medicine Treatment Options for Otitis Media: A Systematic Review. Medicine (Baltimore). 2016 Feb;95(6):e2695. doi: 10.1097/MD.0000000000002695

• Medline Plus. Otitis media with effusion.

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.

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