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. 2024 Dec 3;14(1):30106.
doi: 10.1038/s41598-024-81658-7.

Association between gastroesophageal reflux disease and tinnitus in a nationwide population-based cohort study

Sung-Woo Kang #  1 , Min Ho An #  2   3 , Seojung Ha  4 , Min-Gyu Kim  2   3 , Tae Jun Park  3   5   6 , Han Ki Kim  7 , Kisung Sheen  8 , Rae Woong Park #  2   3 , Soon Sang Park #  9   10   11
Affiliations

Association between gastroesophageal reflux disease and tinnitus in a nationwide population-based cohort study

Sung-Woo Kang et al. Sci Rep. .

Abstract

Gastroesophageal Reflux Disease (GERD) is characterized by the regurgitation of stomach contents. Recent research indicates that acid reflux may disrupt the homeostasis of the middle and inner ear through the Eustachian tube. Given this context, we hypothesized that an association between GERD and tinnitus may exist due to the imbalance of the middle and inner ear caused by acid reflux. To explore this connection, we conducted a retrospective cohort study involving 669,159 patients registered in the National Health Insurance Service-National Sample Cohort (2012-2019) in South Korea. Our data showed that GERD and tinnitus are highly associated. Nevertheless, the use of proton pump inhibitor medication in GERD patients did not show a significant decrease in the onset of tinnitus.

Keywords: Gastroesophageal reflux disease; Nationwide cohort study; Tinnitus.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics approval: The retrospective cohort study was conducted under an informed consent waiver approved by the Institutional Review Board (IRB) at Ajou University Hospital (AJOUIRB-EX-2023–146).

Figures

Fig. 1
Fig. 1
A flowchart of the primary analysis. A flow chart illustrates the overall process of primary analysis before and after applying inclusion and exclusion criteria. GERD: Gastroesophageal reflux disease. National Health Insurance Service-National Sample Cohort (NHIS-NSC).
Fig. 2
Fig. 2
The cumulative incidence of tinnitus in patients with or without GERD. A Kaplan–Meier curve illustrates the cumulative incidence of tinnitus in patients with or without GERD. GERD: Gastroesophageal reflux disease.
Fig. 3
Fig. 3
Forest plots from primary analysis using multivariate Cox regression (model 2). CCB: calcium channel blocker; CCI: Charlson Comorbidity Index; CI: confidence interval; GERD: gastroesophageal reflux disease; H2RA: H2 receptor antagonist; PPI: proton pump inhibitor.
Fig. 4
Fig. 4
A flowchart of the secondary analysis. A flow chart illustrates the overall process of secondary analysis before and after applying inclusion and exclusion criteria. GERD: Gastroesophageal reflux disease; National Health Insurance Service-National Sample Cohort (NHIS-NSC); PPI: Proton pump inhibitor.
Fig. 5
Fig. 5
The cumulative incidence of tinnitus in patients with or without PPIs. A Kaplan–Meier curve illustrates the cumulative incidence of tinnitus in patients with or without PPIs. PPI: proton pump inhibitor.
Fig. 6
Fig. 6
Forest plots from secondary analysis using multivariate Cox regression (model 2). CCB: calcium channel blocker; CCI: Charlson Comorbidity Index; CI: confidence interval; H2RA: H2 receptor antagonist; PPI: proton pump inhibitor.
See this image and copyright information in PMC

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