Halitosis, or bad breath, seems to be a part of the human condition. Nearly everyone has bad breath at one time or another. According to the "Journal of the Canadian Dental Association," at least 50 percent of the population suffer from chronic halitosis, and half of these people have problems that are severe enough to interfere with their social function. A number of reasons can be behind the causes of malodorous breath; in some cases, a digestive problem may well be the culprit.
Halitosis at a Glance
The most common cause for halitosis is inadequate oral hygiene. Food particles and cellular debris that get trapped between the teeth, on the surface of the tongue and in the gum recesses become the substrate for bacterial activity. As microorganisms decompose this material, they produce gases that create an unpleasant aroma. "Morning breath" is a temporary example of this phenomenon. Untreated cavities, dental abscesses and sinus infections are less common causes of halitosis. Until recently, digestive problems were often overlooked as causes of halitosis.
Hiatal Hernia
Once you swallow your food, it is sequestered within your stomach by the esophageal sphincter, which is a muscular narrowing at the lower end of your esophagus. Normally, the esophageal sphincter opens to allow the downward passage of food or fluids, then retightens to prevent the swallowed material from backwashing into the esophagus. If you have a hiatal hernia, which occurs when a portion of your stomach slips through the sphincter and remains in the chest cavity, your esophageal sphincter becomes ineffective. Food collects in the upper, herniated portion of your stomach, and odors then rise through the esophagus.
GERD
Gastrointestinal reflux disease, or GERD, occurs when acidic stomach contents repeatedly regurgitate into the esophagus. A hiatal hernia can contribute to GERD, but GERD can occur in the absence of a hiatal hernia. The reflux of partially digested food material into the esophagus, along with its accompanying odors, is believed to be the basis of GERD-related halitosis. A 2007 study from "Oral Diseases" suggests that halitosis associated with GERD may be more common than was once believed.
Helicobacter Pylori
Infection with Helicobacter pylori, the bacterial agent that causes the majority of peptic ulcers in the United States, may cause halitosis. Although some investigators have found no association between H. pylori infection and bad breath, the authors of a 2007 article in "Medical Principles and Practice" reported that eradication of H. pylori resulted in sustained improvement of halitosis.
Other Conditions
Pancreatic insufficiency, which leads to a deficit of digestive enzymes; peptic ulcer disease, which may delay stomach emptying; and other digestive conditions can contribute to halitosis. If you are suffering from halitosis, and poor dental hygiene has been ruled out as a cause, you should see your physician for further advice. A 2010 "Canadian Journal of Gastroenterology" review shows that gastrointestinal causes of halitosis are relatively common, and most people's breath improves when the underlying problem is addressed.
References
- "Journal of the Canadian Dental Association"; Oral malodor: philosophical and practical aspects; Bosy A; 1997
- "Oral Diseases"; Halitosis and gastroesophageal reflux disease: a possible association; Moshkowitz M, et al.; 2007
- "Medical Principles and Practice"; Eradication therapy in Helicobacter pylori-positive patients with halitosis: long-term outcome; Katsinelos P, et al.; 2007
- "Canadian Journal of Gastroenterology"; The gastrointestinal aspects of halitosis; Kinberg, S, et al.; 2010
