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Abstract
It was recently suggested that the favourable effect of proton pump inhibitors on gastric reflux could threaten the homeostasis of the inner ear in several different ways. Moreover, when it is considered that a gastric type proton pump has been found in the inner ear, it could be hypothesized that this treatment has a direct effect. As ischaemia threatens gastric mucosa even by acid secretion, thus implying resistance of the proton pump to damaging factors, a similar kind of mechanism could be imagined in the inner ear, where it could even cause the osmotic changes possibly involved in Ménière's disease hydrops. This hypothesis, if proved, could open new perspectives on some not fully understood phenomena and lead to finding more satisfactory therapeutic options.