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NEWCASTLE, UNITED KINGDOM. Acute otitis media is an inflammation of the middle ear often involving
the exudation of pus from a pierced or broken eardrum. It is widely believed that otitis media is caused by a
viral or bacterial infection. Researchers at the University of Newcastle now provide convincing evidence that
otitis media with effusion (glue ear) may actually be caused, or at least exacerbated, by acid reflux from the
stomach. They point out that reflux of gastric juice to the middle ear is quite possible in resting (supine)
children because of the angle and immaturity of the eustachian tube in infants and children. The gastric
juice would cause inflammation in the middle ear and provide an ideal breeding ground for bacteria.
To test their hypothesis the Newcastle researchers analyzed pus from 54 children aged 2 to 8 years who
were suffering from otitis media. They found that 83 per cent of them had high concentrations of pepsin (a
major component of gastric juice) in the pus. The average concentration was about 1000 times higher than
the concentration found in blood serum. The researchers conclude that the pepsin came from reflux of
gastric juice and suggest that glue ear could be prevented by antireflux treatment.
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