Bad breath: symptoms, causes and treatment

An unpleasant smell from the mouth was felt, probably, by everyone at least once in his life. Taste and dry mouth are less common, with more serious pathologies.

By what kind of smell or taste in the mouth a person feels, it is possible to determine a specific disease.

In this book, we will figure out why such symptoms may appear, what tests need to be passed and how to treat this or that disease.

Bad breath

Breath odor can be sour, liver, metallic, fecal, fetid, acetone. Consider the immediate cause of each odor.

Sour smell

What can cause sour breath? The reasons for such an unpleasant symptom can be gastritis, stomach or duodenal ulcer, gastroesophageal reflux disease, impaired relaxation of the lower esophageal sphincter (achalasia cardia).

Gastritis

Gastritis is a group of diseases characterized by similar symptoms, but which are based on different causes.

The disease is characterized by sour breath, heaviness in the stomach, belching, and sometimes regurgitation.

Often the patient complains of a feeling of fullness in the stomach, burning and pain in the epigastric (in the navel and 2-3 cm above it) region.

Moreover, soreness and heaviness appear after eating fried, spicy, smoked, rough food. Sometimes diarrhea or constipation may occur.

Also, patients with gastritis complain of weakness, low blood pressure, heart pain, drowsiness, increased sweating.

With some forms of gastritis, there is a feeling of "creeping" in the arms and legs, burning and pain in the tongue, loss of interest in life.

Gastritis occurs for a variety of reasons. In most cases, the symptoms of this pathology appear due to the presence of the bacteria Helicobacter pylori in the body.

Also, smoking, alcohol, prolonged use of non-steroidal anti-inflammatory drugs, and excessive consumption of spicy and hot foods lead to the onset of symptoms of gastritis.

In addition, gastritis can be caused by the throwing of intestinal contents into the stomach, metabolic disorders, heart and lung diseases.

Stomach or duodenal ulcer

A peptic ulcer is a deep tissue defect in the stomach or intestines. The disease proceeds with periods of exacerbation and remission.

During an exacerbation, the patient complains of sour breath, heaviness in the stomach or in the epigastrium, weight loss, heartburn, belching.

The latter can be acidic (with hypersecretion of gastric juice), together with belching, food can come back out.

Also, peptic ulcer disease is characterized by vomiting, after which the condition improves significantly.

But the main complaint of patients with peptic ulcer disease is epigastric pain. It can be cutting, aching, burning. Soreness can occur either immediately after eating or some time after eating.

"Hungry" and "night" pains are also characteristic. Moreover, the intake of food or antacids helps to relieve the pain syndrome.

Peptic ulcer and duodenal ulcer occurs as a result of an imbalance between protective factors (mucus, bicarbonates, tight connection of cells with each other, good blood supply to the stomach) and factors of aggression (Helicobacter pylori, gastrin, histamine, salt acid).

Alcohol consumption, heredity, smoking, stress can lead to such changes.

Also, peptic ulcer disease appears against the background of frequent drinking of coffee, taking NSAIDs or hormonal drugs, intermittent sleep or lack of sleep, excessive consumption of spicy, salty, smoked food, non-compliance with the regimen nutrition.

Gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is a chronic disease with episodes of exacerbation and remission.

The pathological process occurs due to the throwing of gastric contents into the esophagus. Sometimes the contents of the duodenum are also thrown into the esophagus.

The disease is characterized by the presence of symptoms such as:

• heartburn. This term refers to a burning sensation behind the breastbone that extends to the neck and pharynx. Heartburn occurs when stomach contents come into contact with the lining of the esophagus. It appears after taking alcohol, spicy, fried, hot dishes, bending the torso down, after intense physical exertion;
• belching. Occurs in half of patients with GERD. This symptom is more pronounced after eating or drinking soda. In this case, the patient smells sour from the mouth. With prolonged physical exertion, regurgitation may appear;
• dysphagia is impaired swallowing, and odonophagia is pain when swallowing. These symptoms occur due to a violation of the motor function of the esophagus. Pain when swallowing is a consequence of inflammation of the lining of the esophagus. Moreover, if signs of impaired swallowing are strongly expressed, and at the same time heartburn has disappeared, this may indicate a narrowing of the lumen of the esophagus;
• soreness along the esophagus. At the same time, it seems to patients that their heart hurts. But pain in heart disease occurs after physical exertion, and the discomfort with GERD is not associated with exercise;
• increased salivation.
• otorhinolaryngological syndromes (from the ENT organs). The patient complains of a sore throat or feeling of a lump in the throat, hoarseness of the voice.
• dental syndrome is characterized by the appearance of caries due to damage to the enamel by acid, the appearance of ulcers in the oral cavity;
• bronchopulmonary syndrome - cough, bronchial asthma, shortness of breath.
• bloating;
• feeling of "quick satiety" while eating;
• nausea;
• epigastric pain.

Lower esophageal spasm

Esophageal spasm is manifested by chest pain, heartburn, sour breath, and dysphagia.

Pain in the chest with esophagospasm appears due to the contraction of the muscles of the esophagus. The spasm appears on its own or after swallowing food or saliva.

Soreness can go away and come back. Also, the pain syndrome can become stronger against the background of stress. Patients note that the pain extends to the area of ​​the sternum or between the shoulder blades.

Soreness "gives" to the back, lower jaw, arms, shoulders, neck or ears. Pain cider can last either a few seconds or a few minutes.

The pain goes away on its own. Rarely, soreness can bother the patient for an hour. Patients describe the pain as dull or sharp.

They sometimes describe it as a "lump" behind the breastbone. Soreness can be stopped by taking antispasmodics.

Dysphagia (impaired swallowing) with esophageal spasm occurs after consuming liquid or solid food.

In some cases, swallowing is impaired only when liquid food is ingested. Dysphagia does not occur on its own. She accompanies pain syndrome.

Heartburn with esophagospasm occurs in 1/5 of patients. Sometimes there is a reverse reflux of gastric contents into the esophagus.

Symptoms of narrowing of the esophagus: dysphagia, asthma attacks, cough; frequent pneumonia, rupture of the esophagus.

Metallic smell

Causes of metallic odor from the mouth:

• long-term use of anthelmintic and antibacterial agents;
• dehydration;
• taking a large amount of mineral water with iron;
• poisoning;
• diabetes;
• dysbiosis;
• bleeding in the mouth;
• the presence of inserted dentures;
• stomach cancer.

Dysbacteriosis

Dysbacteriosis is a condition characterized by an increase in the number of pathogenic microflora and a decrease in the number of beneficial bacteria in the intestine.

The consequence of such changes is metabolic disorders and indigestion.

With dysbiosis, the patient is worried about:

• belching;
• nausea and vomiting;
• cramping abdominal pain;
• bloating;
• frequent urge to defecate. In this case, a small amount of feces is excreted. A sensation of incomplete emptying of the intestines is characteristic;
• metallic taste in the mouth;
• rumbling in the stomach;
• constipation or diarrhea, or their alternation. Feces can be either hard at the beginning and mushy at the end of emptying, or "sheep" for constipation;
• admixture of mucus in feces;
• "Seizures" in the corners of the mouth;
• allergic reactions on the skin;
• dry skin;
• sleep disturbance;
• weakness and fatigue;
• headache;
• itchy skin.

Diabetes

This is a group of metabolic diseases characterized by a constant increase in blood glucose levels. The disease develops as a result of a violation of insulin secretion or its action.

The patient may complain of metallic odor from the mouth, weakness, thirst, malaise, blurred vision, increased urine output, cramps in the limbs, apathy, itching of the skin, and leg ulcers.

Stomach cancer

Stomach cancer is a malignant growth in the stomach. How does stomach cancer manifest? What symptoms should you look out for first?

Signs that indicate stomach cancer are as follows:

• loss of appetite, feeling of quick satiety, metallic odor from the mouth. Such symptoms appear due to a tumor that takes place in the stomach. Therefore, even if a person has eaten little, it seems to him that he has already eaten. In addition, there is a feeling of aversion to certain foods. More often, the patient refuses to eat meat, since the stomach is not able to digest it due to a decrease in the release of pepsin;
• anemia - a decrease in the content of hemoglobin or red blood cells in the blood. This symptom of the disease can be either a consequence of an aversion to meat or food in general, or appear against a background of bleeding;
• nausea;
• vomit. It is important that with a malignant neoplasm of the stomach, blood may be present in the vomit. Then the vomit takes on the color of coffee grounds. This sign indicates ulceration of the tumor masses and bleeding;
• dysphagia - swallowing disorder. This symptom is detected when the tumor is localized in the cardiac part of the stomach. When swallowing food, a person feels discomfort, burning along the sternum;
• constant belching;
• weight loss - occurs both due to a decrease in appetite and directly due to a tumor. Since the patient does not consume enough food, the body has nothing to build new cells from. In addition, when a cancerous tumor decays, toxins are released that disrupt the metabolism of proteins, fats and carbohydrates. Sometimes weight loss is expressed in cachexia - complete exhaustion;
• asthenic syndrome (constant weakness, fatigue). It appears both due to anemia and due to the toxic effect of the tumor. In this case, the patient complains of constant fatigue, moodiness, mood swings, insomnia;
• soreness in the epigastrium (in the navel and 2-3 cm above it). With a malignant neoplasm of the cardiac part of the stomach, pain syndrome appears after eating. But more often the pain is not associated with food intake;
• the patient's appearance is also specific: the skin is dry, pale (with bleeding), an earthy shade (in the later stages). When the tumor decays, a fetid odor emanates from the patient's mouth;
• if the tumor closes the gatekeeper, then undulating movements (peristaltic waves) are visible on the patient's stomach;
• if there are metastases to distant lymph nodes, then they can be felt (above the collarbone on the left, armpits, in the neck).

Liver odor from the mouth

Liver odor from the mouth indicates liver dysfunction. The symptom may be caused by hepatitis or cirrhosis of the liver.

Hepatitis is an inflammatory process in the liver, the final outcome of which is cirrhosis.

With hepatitis, patients complain of hepatic odor from the mouth, pain in the hypochondrium on the right, flatulence due to a decrease in bile secretion, which disrupts the digestion of food. Yellowing of the skin, weakness, fatigue, and itching also occur.

With cirrhosis, the listed symptoms are accompanied by an increase in the anterior abdominal wall and the appearance of veins on the skin of the abdomen.

Fecal odor

The smell of feces from the mouth can appear due to gastritis, gastric ulcer and duodenal ulcer, irritable bowel syndrome, intestinal obstruction, the presence of helminths, dental diseases.

Irritable bowel syndrome

Irritable bowel syndrome is a disorder of bowel function that is accompanied by recurrences of abdominal pain that occurs at least 1 time per week.

In this case, the pain syndrome is associated either with defecation, or with an altered frequency or shape of stool.

The patient is worried about diarrhea or constipation. Diarrhea occurs in the morning after the first meal. Stool frequency is 2 to 4 times, sometimes more, in a short period of time.

A strong urge to defecate is characteristic, while the person feels that the intestines, as if, have not been emptied completely.

The patient notes that during the first bowel movement, the stool was denser than during the subsequent ones. Moreover, with the following bowel movements, the volume of the stool decreases. Symptoms are absent at night.

Also, with irritable bowel syndrome, the patient is worried about pain. The pain syndrome can be aching, burning, dull. Sometimes the patient describes the pain as dagger, twisting, constant.

Soreness is felt in the iliac region (limited to the lower ribs and pelvic bones), often on the left. A patient with irritable bowel syndrome notes that abdominal discomfort increases after eating.

The pain goes away after having a bowel movement, taking drugs that reduce the spasm (antispasmodics), or passing gas.

Another sign of irritable bowel syndrome is bloating (flatulence). Patients note that flatulence appears after eating, increases during the day. At the same time, abdominal distention is not observed in the morning hours.

In addition, patients with irritable bowel syndrome may be disturbed by: a feeling of heaviness and fullness in the stomach, nausea, fecal odor from mouth, heartburn, soreness in the lumbar region, pain in muscles and joints, symptoms from the genitourinary system (feeling of incomplete emptying bladder, frequent urge to urinate, frequent urination at night), soreness during intercourse in women, sleep disturbance.

Intestinal obstruction

In addition to fecal odor from the mouth, patients complain of abdominal pain, lack of stool and gas, bloating and vomiting. Sometimes there is blood in the stool.

In some cases, fever appears. When feeling the abdomen, there is a sharp pain.

The disease develops gradually. Characterized by episodes of abdominal pain, flatulence.

Helminthiasis

Helminthiasis is an infectious pathology caused by parasitic worms. Helminths can enter the body in different ways.

In the acute period, symptoms appear, which are characteristic of all varieties of worms.

The body temperature rises, there is pain in the abdomen and its swelling, aches and soreness in the muscles, swelling, pain in the joints, rashes on the skin.

There is an increase in lymph nodes, diarrhea or constipation, cough, fecal odor from the mouth. The liver and spleen are enlarged.

If helminthiasis is difficult, complications may develop in the form of inflammation of the heart muscle, inflammatory process in the brain, inflammation of the liver tissue, pneumonia, disorders in the coagulation the blood system.

After the transition to the chronic stage, symptoms of damage to the organ where the worm parasitizes appear. If the helminth colonizes the intestines, then the patient complains of soreness and bloating, diarrhea, and constipation.

In addition, a person begins to get very tired, apathy appears, and a lack of interest in life. With enterobiasis, the patient is worried about itching in the anus in the evening and at night.

With trichocephalosis, blood may appear in the patient's feces, and the rectum may fall out. With ascariasis, constipation occurs, up to intestinal obstruction, the skin turns yellow, and inflammation of the pancreas develops.

Putrid odor from the mouth

Putrid breath (or halitosis) occurs due to the presence of putrefaction products or toxins in the body.

The symptom may indicate:

• peptic ulcer of the stomach or duodenum;
• gastritis;
• dysbiosis;
• gallstone disease;
• diabetes mellitus;
• kidney failure;
• diseases of the oral cavity.

The smell of acetone

The smell of acetone from the mouth may indicate serious illnesses:

• chronic renal failure;
• diabetes mellitus type 1 or 2;
• hyperthyroidism;
• gastroenteritis (infections of the gastrointestinal tract).

Also, the smell of acetone from the mouth appears with prolonged fasting and dehydration.

Taste in the mouth

An unpleasant taste in the mouth also indicates a disease of the organs of the gastrointestinal tract.

So, bitterness occurs with gallstone disease, stomach cancer, gastroesophageal reflux disease.

A salty taste is characteristic of dehydration, chronic diseases of the heart and blood vessels, and the brain.

An unpleasant taste in the mouth after eating appears with gallstone disease, esophagitis, gastritis, neoplasms of the oral cavity, infections of the gastrointestinal tract.

A sweet and sour taste is characteristic of pancreatitis.

Cholelithiasis

Gallstone disease is a hereditary chronic disease characterized by the formation of stones in the biliary tract.

A “classic patient” with gallstones is a woman over 40 years old, with overweight and postponed childbirth.

Sometimes gallstones are asymptomatic. Symptoms of the disease occur only with an inflammatory process or "clogging" of the outlet duct of the bladder with a stone.

In this case, biliary colic occurs. Basically, the latter appears an hour and a half after eating fatty foods, fried or after overeating. The pain builds up rapidly.

It begins in the hypochondrium on the right or in the epigastric region (near the navel and 2-3 cm above it). Soreness "gives" to the right shoulder blade, spine, right shoulder and neck.

Also, an attack of biliary colic is characterized by nausea and vomiting. They don't bring relief.

In addition to these signs, patients complain of a bitter taste in the mouth after eating, a change in pressure, an increase or decrease in pulse rate, constipation or urge to defecate, and an increase in body temperature.

Often, such an attack begins at night, which is typical for diseases of the gallbladder.

If colic lasts more than 6 hours, then gallbladder inflammation may have developed. In case of high fever, one can think of inflammation of the pancreas or bile ducts.

Inflammation of the gallbladder (cholecystitis) develops when stones "clog" the bile duct, which leads to increased pressure in it and a lack of blood supply to its walls.

Infection also contributes to the appearance of cholecystitis. In this case, when feeling the abdomen, the patient notes soreness in the right hypochondrium. When pressing on the stomach and abruptly releasing it, the patient may cry out in pain.

Esophagitis

Esophagitis is an inflammation of the lining of the esophagus due to various reasons.

The main signs of inflammation of the mucous membrane of the esophagus are difficulty in swallowing, a bitter taste in the mouth after eating, vomiting, nausea, a feeling of a foreign body in the throat, pain in the mouth.

Often, patients complain of soreness in the chest and in the epigastrium (in the navel and 2-3 cm above it) after swallowing food. The same symptoms can occur with physical exertion, wearing tight straps.

Often, soreness appears when lying down. In this case, the pain is paroxysmal and "radiates" to the heart, neck or back. Pain syndrome is accompanied by belching of air.

Sometimes stomach contents may be released when belching. Also, patients complain of heartburn in the evening and at night. In addition, hiccups, excessive salivation, vomiting, nausea, and difficulty breathing are troubling.

Moreover, patients note that hiccups continue for a long time, and its occurrence is associated with belching.

Pancreatitis

Pancreatitis is an inflammation of the pancreas that causes irreversible changes in the organ.

With pancreatitis, pain can spread to the lower abdomen. Soreness "gives" to the back and becomes worse after eating. The pain syndrome subsides after adopting a sitting position or when the trunk is tilted forward.

The disease is characterized by recurrence of pain, with short attacks lasting up to 10 days. In some cases, the pain is permanent.

Also, with an exacerbation of the pathology, patients may complain of fatty, fetid feces, which are secreted in large quantities and poorly flushed from the toilet.

Characterized by weight loss, bloating, nausea, vomiting that does not bring relief, a sweet taste in the mouth. Often worried about diarrhea, alternating with constipation.

In some cases, there is yellowness of the sclera and skin, dryness of the skin. Red rashes are found on the body, which do not disappear when pressed.

With significant damage to the gland, signs of diabetes mellitus develop (dry mouth, frequent and profuse urination, blurred vision, slow healing of skin lesions, weakness and fatigue, "creeping creeps" in limbs).

Dry mouth

Dry mouth can indicate diseases such as:

• diabetes;
• dehydration;
• excessive consumption of salty foods;
• respiratory or gastrointestinal tract infections;
• diseases of the salivary glands;
• smoking;
• nasal congestion;
• taking certain medications;
• low pressure;
• pregnancy;
• lack of potassium.

Dryness and burning of the tongue can cause burns of the oral mucosa, hormonal disorders, vitamin A deficiency, pathology of the endocrine system, stress, anemia, and neoplasms of the oral cavity.

A white coating on the tongue and dry mouth may indicate:

• chronic pancreatitis;
• gastritis;
• peptic ulcer;
• stomach cancer;
• dysbiosis;
• infectious disease of the oropharynx;
• candidiasis;
• sore throat;
• dental diseases;
• syphilis;
• scarlet fever;
• HIV infection.

Which doctor should I go to?

If you experience bad breath, taste, or dry mouth, you should consult a therapist or gastroenterologist.

After the examination, the doctor will prescribe the necessary treatment or advise the consultation of a specialist of the appropriate profile.

Diagnostics

What tests do you need to take to determine the cause of bad breath, taste, or dry mouth? The patient should undergo laboratory and instrumental studies.

Laboratory research:

• general blood analysis;
• general urine analysis;
• biochemical blood test (with the detection of the level of ALT, AST, bilirubin, total protein, creatinine, alkaline phosphatase, cholesterol, glucose, GGT, C-reactive protein, amylase);
• urine analysis for diastasis (with pancreatitis);
• analysis of feces for occult blood;
• analysis of feces for worm eggs;
• definition of H. pylory (Helicobacter pylori) - breath test, urease test, strip test, polymerase chain reaction, serological methods;
• determination of the level of glucose and glycated hemoglobin in the blood;
• study of the level of alkaline phosphatase and enterokinase in the contents of the duodenum;
• determination of fat content in feces;
• study of the acid-forming function of the stomach (pH-metry);
• blood test for HIV;
• blood test for syphilis;
• a blood test for viral hepatitis.

Instrumental methods:

• fluoroscopy of the stomach with contrast - the patient is given a suspension of barium to drink before the examination. Then an X-ray examination is carried out, which shows how the evacuation function of the stomach (food advancement) works;
• plain radiography of the abdominal organs;
• fibroesophagogastroduodenoscopy (FGDS) with biopsy - allows you to see the gastric mucosa and the duodenum on the monitor, identify defects, assess their localization, depth and prevalence, take a biopsy;
• computed tomography of the abdominal organs;
• electrogastrography and ultrasound of the stomach - this test can also assess the motor function of the stomach. Before the ultrasound procedure, the patient drinks water to fill his stomach;
• morphological examination - a biopsy specimen is examined under a microscope. This technique allows you to confirm the inflammatory process, study the cells of the mucous membrane of the stomach and intestines and exclude cancerous degeneration of the inflamed areas.
• ultrasound echography (transabdominal ultrasound) - using this method you can detect free fluid in the abdominal cavity, assess the size and surface of the liver, bile duct, kidney;
• pH meter to determine the acidity of gastric juice;
• antroduodenal manometry - the study allows you to assess the motor function of the stomach and duodenum;
• endoscopic ultrasound examination;
• MRI of the spine;
• cholecystography;
• percutaneous transhepatic cholangiography;
• endoscopic retrograde cholangiography;
• magnetic resonance cholangiopancreatography;
• endoscopic ultrasound examination;
• bilioscintigraphy.

Treatment

To eliminate unpleasant symptoms such as bad breath, taste in the mouth, or dryness, it is necessary to treat the disease that caused these symptoms.

In each case, the treatment will be different, therefore, for the correct prescription of drugs, you must consult a doctor.

• with gastritis, antibiotics are prescribed (in the presence of Helicobacter pylori infection), proton pump inhibitors, glucocorticoids (with autoimmune type), gastric juice, acid-pepsin, hydrochloric acid, De-nol, prokinetics, Ursodeoxycholic acid;
• to eliminate unpleasant symptoms in gastric ulcer and duodenal ulcer will help proton pump inhibitors or H₂-blockers, antacids Also carry out eradication of Helicobacter pylori;
• treatment of sour odor in GERD is based on taking proton pump inhibitors, alginates, antacids, H-blockers;
• with intestinal obstruction, surgery is indicated;
• helminthiasis is treated with anthelmintic drugs;
• gallstone disease is eliminated with ursodeoxycholic acid, antispasmodics, defoamers, prokinetics. In some cases, surgical treatment is indicated
• pancreatitis is treated with analgesics or NSAIDs, enzyme preparations, insulin;
• in case of poisoning, gastric lavage, the appointment of laxatives, enterosorbents is necessary;
• with irritable bowel syndrome, antispasmodics, antidiarrheals, adsorbents, probiotics, laxatives, combined drugs (Trimedat), antidepressants and antipsychotics are prescribed;
• an unpleasant taste in the mouth with esophagitis is eliminated by antacids, proton pump inhibitors, H₂-blockers, prokinetics, antispasmodics, analgesics, antibiotics or antimycotics;
• probiotics, prebiotics, antibiotics, bacteriophages, antimycotics, immunomodulators, antispasmodics will help get rid of dysbiosis;
• in case of esophageal spasm, calcium channel blockers, antispasmodics, proton pump inhibitors, antacids, anti-anxiety, cytoprotectors are prescribed;
• an endocrinologist is engaged in the treatment of diabetes mellitus;
• for cancer of the stomach or oral cavity, the tactics of treatment are chosen by the oncologist.

Conclusion

An unpleasant smell, taste and dry mouth can indicate diseases of the gastrointestinal tract or other pathologies in the body.

So, bad breath occurs with gastritis, peptic ulcer, gastroesophageal reflux disease, spasm of the lower esophageal sphincter, dysbiosis, diabetes mellitus, stomach cancer, irritable bowel syndrome, intestinal obstruction, helminthiasis, renal failure, cholelithiasis illness, etc.

The taste in the mouth is characteristic of cholelithiasis, esophagitis, pancreatitis, chronic diseases of the heart and blood vessels.

Dry mouth occurs with smoking, dehydration, diabetes mellitus, excessive consumption of salty foods, nasal congestion, respiratory or gastrointestinal infections.

If you experience any discomfort, you should immediately consult a doctor. Only a specialist will be able to assume this or that disease and carry out the necessary examination and treatment.

Pathology therapy is individual in each case, therefore it is not recommended to self-medicate.