When You Have Fluid in the Ear

The symptoms, causes, and treatment of otitis media with effusion

Fluid in the ear occurs when the eustachian (auditory) tube, the channel that normally drains fluid from the ear into the back of the throat, gets blocked. This causes the fluid to get trapped in the middle ear space behind the eardrum.

Having fluid in your ear is called serous otitis media (SOM) or otitis media with effusion (OME). Ear infections, colds, and allergies can all cause inflammation or mucous that blocks the eustachian tube.

This article goes over what causes fluid buildup in the ear, how otitis media with effusion is diagnosed and treated, and how you can prevent fluid from collecting in your ears.

causes of fluid accumulation in the ear

Verywell / Emily Roberts

Symptoms of Fluid Buildup

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

  • Ears that feel "plugged up" or fullness in the ears
  • Increasing ear pain when changing altitude; not being able to "pop" the ears
  • Ringing in the ears (tinnitus)
  • Hearing loss or muffled hearing
  • Behavior problems and poor school performance
  • Rarely, balance problems that cause you to feel dizzy or experience vertigo (the feeling like everything around you is spinning)

If you've had fluid in your ear before, you might be able to tell that it's built backup again and know that you'll need treatment.

Is Otitis Media With Effusion an Ear Infection?

Fluid buildup with OME is not infected. Middle ear infections occur when ear fluid has been infiltrated by a bacterium or virus. That said, having OME can increase the chances of developing an ear infection.

Fluid in the Ears of Babies and Toddlers

Small children may not have symptoms of fluid in the ear at all. If they do, they may not be able to tell an adult what's wrong.

If the child's ear pain is not severe, caretakers may not even realize there's a problem.

Fluid in the ear may not be suspected until a small child exhibits issues like balance problems, speech delays, or difficulty hearing/passing a hearing exam.

Causes of Fluid in the Ear

Fluid in the ears is caused by some form of auditory tube dysfunction. Common causes include:

Anyone can get fluid in their ears. However, it's much more likely to occur in children because their auditory tubes are smaller than adults' are.

Children's tubes also run in a more horizontal direction than adults, which can encourage fluid to pool in the ear.

There are about 2.2 million cases of OME in the United States each year. About 90 out of 100 children will get fluid in their ears at some point before they are 5 or 6 years old.

Diagnosis

Fluid in the ear often goes undiagnosed because it may not cause any symptoms. If your child has symptoms of otitis media with effusion, they'll need to see their pediatrician or an ear, nose, and throat specialist (otolaryngologist).

A specialist may have better diagnostic equipment to figure out what's causing the fluid buildup in a child's ear. More importantly, a specialist's experience helps them recognize subtle clues that could mean there's fluid trapped in the ear.

Otoscope Exam

The best method for diagnosing otitis media with effusion is an ear exam with a handheld tool called an otoscope or otomicroscope. Otoscopes are more common because they're less expensive, but otomicroscopes allow for a more accurate diagnosis.

Checking the ear with an otoscope is very simple. The healthcare provider pulls back the ear and gently inserts the tip of the otoscope. The scope brings the eardrum into view.

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.

Sometimes, the only indication that there's fluid in the ear is a slight retraction of the eardrum or slightly abnormal color. That's why it takes a skilled provider to diagnose otitis media with effusion.

Tympanometry Exam

Fluid in the ear can be confirmed by another test called tympanometry. This test is similar to an otoscope exam, but the provider uses a tool called a speculum.

For the test, the speculum is placed in the outer ear canal. It's important to hold very still during this test. If possible, you should not talk or swallow during the exam.

The instrument measures the pressure inside the ear and then generates a tone. The eardrum (tympanic membrane) reflects some of that sound back into the tympanometer.

If there is fluid in the ear, the eardrum will stiffen and an abnormal amount of sound will be reflected.

How Is Fluid in the Ear Treated?

You may not need any treatment for otitis media with effusion. The fluid usually drains on its own within a few weeks. However, if it does not, the treatment will depend on several factors.

  • If the fluid is present for six weeks, treatment may include a hearing test, a round of antibiotics (if you have an active infection), or further observation.
  • If the fluid is present after 12 weeks, you will need a hearing test. If there is significant hearing loss, a provider may consider antibiotics or placing tubes in your ears.
  • If the fluid is still present after four to six months, you may need to have tubes placed in your ears surgically even if you don't have much hearing loss.
  • If your adenoids are so large that they block your auditory tubes, they may need to be removed.

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.

Children who are at a higher risk of complications from fluid in the ears, including those with developmental delays, may need earlier treatment.

If your child does not need treatment for otitis media with effusion, you might be told to manage their symptoms and wait for the fluid to clear up on its own. The condition usually goes away whether or not a child has surgery.

Can You Prevent Fluid in the Ear?

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).
  • Keep things clean. Wash your hands and your child’s toys frequently.
  • Avoid overusing antibiotics. Don't take antibiotics if you don't need to and don't take them for longer than is necessary. For example, If you have a viral infection, antibiotics won't help.
  • 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.
  • Stay up to date on vaccines. The pneumococcal vaccine (Prevnar) helps prevent the most common type of ear infection. Getting a yearly flu shot may help as well.

Summary

Otitis media with effusion is the medical term for fluid buildup behind the eardrum. It happens when inflammation, mucous, a growth, or a structural problem in the ear blocks the drainage of fluid from your auditory tube.

You may or may not have symptoms of otitis media with effusion. You might feel pain or notice changes in how things sound.

Many times, fluid in the ear gradually goes away on its own. If you have an infection, you may need antibiotics. If the fluid buildup in your does not get better or gets worse, you might need surgery to help drain it.

Simple strategies may help prevent fluid buildup, like avoiding irritants and allergens; washing your hands, keeping your child's toys and play areas clean, and staying up-to-date on vaccines.

A Word From Verywell

Fluid in the ear is a common problem, especially for young children. Whether you are an adult or a child, the fluid in your ear will likely resolve without treatment.

That said, if you have fluid in your ear and your symptoms have lasted for more than six weeks or are getting worse, call your healthcare provider. The condition can get better but it needs to be treated properly.

Frequently Asked Questions

  • How long does it take for fluid in the ear to go away in adults?

    It can take up to three months for fluid in your ear to clear up on its own. If you continue to have problems, your provider may prescribe antibiotics and look for an underlying problem that could need specific treatment.

  • How do you remove water stuck in your outer ear?

    Tugging on the earlobe and shaking your head should help water flow out of the ear canal. You can also try to create a vacuum with the palm of your hand.

    Using a solution that's 50% rubbing alcohol and 50% white vinegar after swimming can also dry the ear canal and may prevent infections caused by swimmer’s ear.

  • Is it normal to have fluid drain from your ear?

    White, yellow, or brown earwax that drains from your ear is normal. It can be runny and should only be a small amount. If discharge continues or has blood or pus in it, seek emergency care. You may have a ruptured eardrum.

  • How do you treat fluid in the ear naturally?

    You may hear about eustachian tube rehabilitation, chiropractic, and herbal remedies being helpful for fluid in the ear. However, research on the safety and effectiveness of complementary/alternative treatments for otitis media with effusion is limited.

  • What medicine dries up fluid in ears?

    Your provider may want you to take an antihistamine or decongestant if you have fluid buildup in your ears. You may also need an antibiotic, depending on what is causing the fluid buildup.

  • Does swimming cause fluid in the ear?

    Contrary to popular belief, getting water in a baby's or young child’s ears will not cause serous otitis media. However, children who swim frequently and do not dry their ears enough may get swimmer's ear—a completely different condition.

11 Sources
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. Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M. Update on otitis media - prevention and treatment. Infect Drug Resist. 2014;7:15-24. doi:10.2147/IDR.S39637

  2. Centers for Disease Control and Prevention. Antibiotic Prescribing and Use: Ear Infection.

  3. Fruhner M. What is middle ear fluid and how can this impact my child? Children's Hospital Los Angeles.

  4. Kwon C, Lee HY, Kim MG, Boo SH, Yeo SG. Allergic diseases in children with otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2013;77(2):158-61. doi:10.1016/j.ijporl.2012.09.039

  5. Agency for Healthcare Research and Quality. Otitis Media With Effusion: Comparative Effectiveness of Treatments.

  6. 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

  7. Tufts Medical Center. Ear: Swimmer’s (otitis externa).

  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. American Academy of Otolaryngology–Head and Neck Surgery. Treating and Managing Ear Fluid.

  10. D'Alatri L, Picciotti PM, Marchese MR, Fiorita A. Alternative treatment for otitis media with effusion: eustachian tube rehabilitationActa Otorhinolaryngol Ital. 2012;32(1):26-30.

  11. UTHealth Houston McGovern Medical School. Fluid in the Ear.

Additional Reading