Fluid in ear: inside and behind eardrum

Understanding fluid in ear: Otitis media with effusion, causes and treatments

Have you ever felt like your ear was full, or sounds were suddenly muffled like you were underwater? You might be experiencing fluid in the ear—a common condition that can affect people of all ages, from toddlers to seniors.

At Amplifon Canada, we care about your hearing health. In this article, we explain what fluid in the ear is, why it happens, and what you can do about it.

What is fluid in ear?

Fluid in the ear, medically known as otitis media with effusion, occurs when fluid builds up behind the eardrum in the middle ear. Unlike an ear infection, this fluid isn’t necessarily infected, but it can still cause discomfort, hearing difficulties, or a sensation of fullness. It often develops after a cold, sinus infection, or allergies and is especially common in children, though adults can experience it too. In most cases, the condition is temporary, but if fluid lingers, it can impact hearing and overall ear health.

Otitis media with effusion

Otitis media with effusion (OME) is a condition where fluid accumulates in the middle ear—the space behind the eardrum—without signs of an acute ear infection (like pain or fever).

In OME:

The fluid can be thin and watery or thick and sticky.
There is no active infection, so symptoms like ear pain or fever are usually absent.
It often causes muffled hearing, a feeling of fullness in the ear, or popping sensations.

OME is particularly common in children, but adults can experience it too—especially after a cold or with chronic sinus issues. While it usually resolves on its own, prolonged fluid can interfere with hearing and may require treatment if it persists.

Fluid inside eardrum

Although it’s often referred to as “fluid inside the eardrum,” what’s actually happening is that fluid has built up in the middle ear, the air-filled space located just behind the eardrum. This condition is known as otitis media with effusion. It usually occurs when the Eustachian tube—which helps drain fluid and equalize pressure between the ear and the throat—becomes blocked due to a cold, allergies, or sinus congestion.

When fluid collects in this space, the eardrum may not vibrate properly, leading to symptoms like muffled hearing, a feeling of fullness, or popping sounds. The fluid is usually not infected, but if it stays trapped for too long, it can increase the risk of a middle ear infection.

This condition is most common in children but can affect adults too—especially after a respiratory illness. In many cases, the fluid clears on its own, but if it lingers for weeks or affects hearing, it’s best to consult a healthcare provider or hearing specialist for treatment options.

Fluid behind the eardrum

Fluid behind the eardrum—also known as a middle ear effusion—occurs when fluid collects in the middle ear space, just behind the eardrum. This fluid is usually the result of a blocked or swollen Eustachian tube, which normally helps drain the middle ear and equalize pressure.

This condition can happen after a cold, sinus infection, or allergic reaction, and while it often goes away on its own, it may cause symptoms like muffled hearing, a feeling of fullness or pressure, or occasional popping or crackling sounds. In most cases, the fluid is not infected—but if it becomes trapped for too long, it may lead to an ear infection.

Doctors can identify fluid behind the eardrum during an ear exam. If it doesn’t resolve naturally within a few weeks, treatment may include decongestants, nasal sprays, or in persistent cases, ear tubes to help drain the fluid and prevent hearing loss.

Fluid on the eardrum

There’s an important distinction between fluid behind the eardrum and fluid on the outside of the eardrum.

Fluid behind the eardrum refers to fluid trapped in the middle ear, the space located just behind the eardrum. This is the most common type and usually results from Eustachian tube dysfunction, often following a cold, allergies, or sinus infection. It's known medically as otitis media with effusion. It can cause muffled hearing, pressure, popping sensations, and—in some cases—infection.

Fluid on the eardrum (or outside the eardrum) typically means water or moisture trapped in the outer ear canal, such as after swimming or bathing. This can lead to a condition called swimmer’s ear (otitis externa), especially if bacteria grow in the moist environment. Symptoms may include itching, redness, drainage, and pain, especially when touching the outer ear.

Middle ear effusion

Middle ear effusion is the presence of fluid in the middle ear — the air-filled space located just behind the eardrum — without signs of acute infection (such as pain or fever).

It often happens when the Eustachian tube, which normally helps drain fluid from the middle ear into the back of the throat, becomes blocked or doesn't function properly. This can be caused by:

A recent cold or upper respiratory infection
Allergies
Sinus congestion
Changes in pressure (like during air travel)

The fluid may be thin or thick (sometimes called "glue ear" when it's sticky), and it can cause:

Muffled hearing
A feeling of fullness in the ear
Occasional popping or crackling sounds

While middle ear effusion often clears up on its own, if it lasts for weeks or affects hearing—especially in children—it may require medical attention.

What does fluid in the ear look like?

Fluid in the ear isn't usually visible from the outside, but it can be seen during a medical exam using a tool called an otoscope. When fluid is present in the middle ear, the eardrum may appear dull or slightly discoloured—often taking on a yellow, grey, or amber hue instead of its normal pearly tone. In some cases, tiny air bubbles may be visible behind the eardrum, or the fluid may give the ear a cloudy or milky appearance, especially if it's thick, as seen in cases of "glue ear." Depending on the pressure in the middle ear, the eardrum may also look slightly retracted or bulging. However, these changes can only be confirmed by a healthcare provider during an ear examination.

Symptoms of fluid in ear

The symptoms of fluid in the ear can vary depending on the amount of fluid and whether there's an infection, but the most common signs are subtle and often mistaken for other issues.

The most common symptom of fluid in the ear is a feeling of fullness or pressure, almost like having water trapped after swimming. People often describe it as a sensation of being “plugged” or like hearing through a tunnel. Muffled hearing is also very typical, as the fluid prevents sound from passing through the middle ear properly.

Some individuals notice popping or crackling sounds, especially when yawning or swallowing. In some cases, there may be issues with balance or dizziness, since the middle ear also plays a role in maintaining equilibrium. While fluid in the ear usually isn’t painful, if it becomes infected, it may lead to discomfort, earache, or even fever.

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What causes fluid in the ear in adults?

In adults, fluid in the ear is most often caused by Eustachian tube dysfunction, where the tube that connects the middle ear to the back of the nose fails to open and close properly. This can happen after a cold, sinus infection, or allergy flare-up, all of which can lead to swelling and congestion in the nasal passages and throat.

Seasonal allergies, which are common across Canada, can cause inflammation that blocks fluid drainage.

Other potential triggers include air pressure changes during flying or diving, smoking (which irritates the lining of the Eustachian tube), and in some cases, acid reflux, which can cause inflammation near the opening of the tube.

While less common, tumours or structural issues in the nasal cavity or throat can also contribute to chronic fluid buildup in adults.

How to remove fluid from ear? Treatment

In many cases, fluid in the ear will clear up on its own within a few days or weeks, especially if it's caused by a cold or minor sinus congestion.

However, if the fluid lingers, causes discomfort, or affects hearing, treatment may be needed. Here are some common approaches:

Watchful waiting: Often, no immediate treatment is required. Doctors may recommend monitoring the condition for a few weeks to see if the fluid drains naturally.
Nasal decongestants or antihistamines: If allergies or sinus congestion are contributing factors, medications such as antihistamines (like cetirizine or loratadine) or nasal sprays may help reduce swelling and allow the Eustachian tube to function properly.
Valsalva maneuver: This is a gentle technique where you close your mouth, pinch your nose, and try to blow gently through your nose to equalize pressure. It may help open the Eustachian tube and release trapped fluid.
Warm compresses: Applying a warm cloth to the affected ear can help relieve pressure and encourage fluid drainage, especially if there is mild discomfort.
Ear tubes (tympanostomy tubes): For adults or children with chronic or recurring fluid buildup, a specialist may recommend placing small tubes in the eardrum to help drain fluid and ventilate the middle ear.
Treating underlying conditions: Managing allergies, sinusitis, or acid reflux can prevent future episodes of fluid buildup.
Surgery (rare cases): If fluid persists and causes significant hearing loss or discomfort, and other treatments have not worked, minor surgical procedures may be considered.

Fluid in ear & other conditions

Fluid in ears from a cold

It’s very common to develop fluid in the ears after a cold. When you catch a cold, your nose, throat, and sinuses become congested and inflamed. This inflammation can extend to the Eustachian tubes—the small passages that connect your middle ear to the back of your throat. Their job is to equalize pressure and allow fluid to drain from the middle ear. But when they become blocked or swollen due to a cold, fluid can build up behind the eardrum.

You might not feel pain, but you may notice muffled hearing, a sensation of fullness or pressure, or a popping sound when you yawn or swallow. This is the result of fluid that hasn’t yet drained properly.

In most cases, the fluid will clear up on its own within a couple of weeks after your cold improves. However, if the fluid lingers longer than three weeks, or you begin to notice significant hearing loss, it’s a good idea to consult a healthcare provider or hearing specialist.

Ear infection and fluid in ear

Fluid in the ear is often linked to ear infections, especially in children, but adults can be affected too. When the middle ear becomes infected—typically following a cold, sinus infection, or allergy flare-up—it’s known as acute otitis media. This condition causes inflammation and fluid buildup behind the eardrum. In some cases, the fluid is non-infected at first (a condition called otitis media with effusion) but can become infected if bacteria or viruses multiply in the trapped fluid.

Common symptoms of an ear infection with fluid include ear pain, pressure, reduced hearing, and sometimes fever. You may also notice fluid or pus draining from the ear if the eardrum ruptures due to pressure.

Even after the infection clears, fluid can remain in the middle ear for weeks, continuing to cause muffled hearing or a feeling of fullness. If the fluid doesn’t drain on its own, medical treatment—such as antibiotics, decongestants, or even ear tubes—may be necessary.

Prompt treatment of ear infections can prevent complications and reduce the risk of long-term hearing problems. If you're experiencing persistent symptoms or recurring infections, it's important to seek advice from a hearing care provider.

Cold head and fluid in ears

When you have a cold or head congestion, it’s common to feel pressure in your ears or experience muffled hearing. That’s because the cold can cause inflammation and mucus buildup in the nasal passages and sinuses, which affects the function of the Eustachian tubes—the small channels that help drain fluid from the middle ear and balance ear pressure.

As a result, fluid can become trapped behind the eardrum, leading to a sensation of fullness, popping, or even mild hearing loss. This is especially common during or just after a cold, when your head feels stuffy or “blocked.” In most cases, the fluid will drain naturally within a week or two as the cold resolves. However, if symptoms linger or worsen, it could be a sign of ear infection or ongoing Eustachian tube dysfunction.

Staying hydrated, using saline nasal sprays, or inhaling steam can sometimes help relieve pressure and support drainage. If the feeling doesn’t go away or starts to affect your hearing more seriously, it’s a good idea to see a hearing care professional.

Pneumonia and fluid in ears

While pneumonia primarily affects the lungs, it can also indirectly lead to fluid buildup in the ears. This is because pneumonia, like many respiratory infections, can cause widespread inflammation and sinus or nasal congestion, which affects how well the Eustachian tubes function. These small tubes connect the middle ear to the back of the throat and are responsible for draining fluid and equalizing pressure.

During a case of pneumonia—especially if it’s accompanied by severe congestion or frequent coughing—the Eustachian tubes can become blocked. This prevents fluid from draining properly, leading to a sensation of fullness in the ears, muffled hearing, or popping sounds. In some cases, the trapped fluid may also become infected, resulting in a secondary ear infection.

Though fluid in the ears isn’t a direct symptom of pneumonia, it’s a possible side effect of respiratory illness. If you're recovering from pneumonia and notice ear-related symptoms that don't improve—such as pressure, hearing changes, or discomfort—it’s a good idea to consult a healthcare provider or hearing care professional to check for fluid or infection in the ears.

FAQs about fluid in ear

How to get rid of fluid in ear?

Fluid in the ear, especially behind the eardrum, can be uncomfortable and affect hearing. In many cases, it clears up on its own within a few days or weeks.

But if the fluid lingers or causes symptoms like muffled hearing, pressure, or dizziness, certain treatments can help.

Self-Care and Home Remedies:

Wait and monitor: Often, no treatment is needed. Fluid caused by a cold or allergies may drain naturally once inflammation subsides.
Yawning, swallowing, or chewing gum: These actions can help open the Eustachian tubes and release pressure, encouraging fluid to drain.
Valsalva maneuver: Gently blow while pinching your nose and keeping your mouth closed. This can help equalize pressure in the ears.
Stay upright: Avoid lying flat, especially right after waking up. Gravity helps promote drainage.
Warm compress: Applying a warm cloth to the affected ear may help ease pressure and improve circulation.

Medical Treatment:

Decongestants or nasal sprays: If nasal congestion is blocking the Eustachian tubes, over-the-counter or prescription sprays can help reduce inflammation.
Antihistamines: If allergies are the cause, allergy medications may relieve symptoms and allow fluid to clear.
Ear tubes: For people with chronic or recurring fluid in the ear, a specialist may recommend placing small tubes in the eardrum to ventilate the middle ear and prevent buildup.
Treat underlying conditions: Addressing sinus infections, allergies, or acid reflux can prevent future episodes.

How to get rid of dizziness from fluid in ear?

Dizziness caused by fluid in the ear is often the result of pressure or imbalance in the inner or middle ear, where the body’s sense of balance is regulated. When fluid builds up—usually behind the eardrum—it can disrupt how the ear sends signals to the brain, leading to feelings of lightheadedness, unsteadiness, or even vertigo.

Here are some ways to help relieve dizziness related to ear fluid:

Treat the underlying cause: If the fluid is due to a recent cold, sinus infection, or allergies, addressing that condition with decongestants, antihistamines, or nasal sprays can reduce swelling and help the fluid drain.
Use the Valsalva maneuver: Gently pinch your nose, close your mouth, and try to blow out (without letting air escape). This may help open the Eustachian tubes and balance ear pressure, which can ease dizziness.
Stay upright and hydrated: Avoid lying flat for long periods. Sitting or standing upright can encourage fluid to drain naturally. Drinking plenty of fluids can also help thin mucus and reduce pressure.
Warm compress: Applying a warm cloth over the affected ear can increase circulation and promote drainage, which may help reduce dizziness.
Vestibular support: In persistent cases, balance therapy or vestibular exercises may be recommended by a healthcare provider.

Can fluid in the ear cause nausea?

Absolutely. When fluid builds up behind the eardrum—commonly due to a cold, allergies, or an ear infection—it can disrupt the normal function of the inner ear, which plays a key role in maintaining balance and spatial orientation.

This disturbance can lead to symptoms such as:

Dizziness or lightheadedness
A sensation of imbalance or unsteadiness
Vertigo (a spinning feeling)
Nausea or even vomiting

The inner ear contains the vestibular system, which communicates with the brain to help you stay balanced. When pressure from fluid interferes with this system, your brain may receive mixed signals about your body’s position, leading to nausea.

This kind of nausea is often temporary and improves as the fluid drains. However, if nausea is persistent or accompanied by hearing loss, pain, or severe dizziness, it's a good idea to consult a healthcare provider. In some cases, treatment for inner ear inflammation or ear infections may be needed.

Prevention is key

Find out, with the help of our experts, how to prevent ear problems like fluid in ear.

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