Bad breath: Is it coming from the gut? (2024)

Background

Halitosis, also commonly known as “bad breath,” is a concern of many patients seeking help from the dentist, as bad breath is usually associated with oral conditions. Cavities, gum disease, dry mouth, tonsil stones, poor salivary flow, acidic oral environments, and the consumption of odorous foods can all be a cause of bad breath.

The oral care professional will typically tell a patient to brush, floss, rinse, and drink more water to combat this problem. But what if the problem isn’t coming from the patient’s mouth? In that case the dentist or hygienist may tell the patient there’s nothing wrong. In some cases, they may refer the patient to an ear, nose, and throat (ENT) physician or a gastroenterologist.

Although intraoral conditions can contribute to about 60%–70% of the etiology behind bad breath, the gut can play a major role (20%–30%) in the problem as well. Most people who have bad breath from the digestive system describe a rotten egg/fish/meat smell due to the bacteria in the digestive system that break down food products into sulfa gases. Sulfur-digesting bacteria and other microorganisms utilize sulfur compounds within food, producing hydrogen sulfide, dimethyl sulfide, and methyl mercaptan as an end product. This can make the breath smell bad and cause chronic halitosis. Here is a review of the top five digestive issues accounting for halitosis.

No. 1: Helicobacter pylori(H.pylori)

H. pylori is a type of bacteria that exists within the normal gut microbiota, but when it’s out of balance, it can cause duodenal and stomach ulcers.

Symptoms, tests, and treatment for H. pylori

No. 2: Gastroesophageal reflux disease (GERD)

GERD is a common digestive system disorder that can cause bad breath. GERD is caused by the failure of the muscular valve (sphincter) that separates the lower end of the esophagus from the stomach. This is known as the lower esophageal valve (LES). The LES normally opens to permit food and liquids to pass into the stomach. When this valve becomes weak, however, it can allow stomach acid and contents up into the esophagus, causing GERD and, sometimes, bad breath. H. pylori can also cause and/or exacerbate GERD.

Diagnosis, symptoms, and treatment for GERD

No. 3: Small intestinal bacterial overgrowth (SIBO)

Because the small intestine is designed for nutritional absorption and has fewer digestive enzymes than the stomach, bacterial overgrowth can occur in this organ. Eighty percent of people with irritable bowel syndrome (IBS) also have SIBO, which can develop after gastric infections. Patients who have fructose malabsorption, lactose intolerance, or eat a lot of fiber can develop SIBO. Gasses produced in SIBO are the major cause of complaint and may cause bad breath.

Symptoms, tests, and treatment for SIBO

No. 4. Irritable bowel syndrome (IBS), Crohn’s disease, and celiac disease

IBS is a common disorder of the digestive system. Most commonly, patients suffer recurrent abdominal pain and altered bowel habits, such as constipation, diarrhea, or both. Both Crohn’s and celiac disease may limit digestion, providing more undigested food for sulfur-reducing bacteria to break down. This generates more hydrogen sulfide and can cause halitosis.

Symptoms for IBS, Crohn’s, and celiac disease

No. 5: Digestive system infection (giardiasis, or giardia for short)

A specific digestive system infection can cause bad breath.Giardiasis is a diarrheal disease caused by the parasite Giardia lamblia, which can infect humans via food or water.

Symptoms, transmission sources, and treatment for giardiasis

Other gutproblems causing breath issues

These gut problems can also cause bad breath:

  • Gall bladder dysfunction, gallstones, or gall bladder removal
  • Constipation
  • Gastroparesis
  • Pyloric stenosis

Editor’s note: This article originally appeared in Perio-Implant Advisory, a chairside resource for dentists and hygienists that focuses on periodontal- and implant-related issues. Read more articles and subscribe to the newsletter.

Bad breath: Is it coming from the gut? (2024)

FAQs

Bad breath: Is it coming from the gut? ›

Sulfur-digesting bacteria and other organisms in your digestive system utilize sulfur compounds within food, producing hydrogen sulfide, dimethyl sulfide, and methyl mercaptan as an end product. This can make your breath smell bad and give you chronic halitosis.

How do you know if your gut is causing bad breath? ›

Your digestive tract may be the cause of your foul breath if you frequently get heartburn or reflux after eating particular meals, such as dairy and spicy cuisine. These acids may smell sour, which causes gaseous odors to impact your breath.

How to fix bad breath from your gut? ›

Try chewing sugar-free gum to stimulate saliva production and help banish bad breath. Keep a healthy mouth. Brush twice a day, clean in between your teeth with interdental brushes, floss, or water flossers daily, and use a mouthwash to ensure you don't have food particles or bacteria contributing to bad breath.

How do I know where my bad breath is coming from? ›

Things to remember

Halitosis is caused by sulphur-producing bacteria in the tongue and throat. The major causes include a dry mouth caused by certain foods, smoking, poor oral hygiene and a coated tongue. The treatment of halitosis will depend on the underlying cause.

Does bad breath come from stomach or lungs? ›

Food. The breakdown of food particles in and around your teeth can lead to more bacteria and cause a foul odor. Eating certain foods, such as onions, garlic and spices, also can cause bad breath. After you digest these foods, they enter your bloodstream, are carried to your lungs and affect your breath.

What does leaky gut breath smell like? ›

Patients with gut problems have described multiple noticeable smells from the mouth. These include a: Rotten smell that resembles the scent of rotten eggs or sulphur. This is the most common smell people describe when experiencing chronic bad breath due to a gastrointestinal disorder.

How do you get rid of bad breath internally? ›

Say It Loud! 9 Easy Ways to Get Rid of Bad Breath
  1. Drink Water Often. Your mouth naturally has bacteria that protects the teeth from erosion. ...
  2. Use a Tongue Scraper. ...
  3. Consume More Probiotics. ...
  4. Rinse Your Mouth. ...
  5. Take Care of Your Gums. ...
  6. Eat More Apples. ...
  7. Give Oil Pulling a Try. ...
  8. Quit Smoking Cigarettes.
Aug 14, 2019

What does halitosis smell like? ›

When breathing, this overabundance of metabolites, foreign particles, and microbes can cause an unpleasant smell that is similar to fungus or mold.

Why do I have bad breath every day? ›

The most common cause of halitosis is poor oral hygiene. Without proper oral hygiene — like brushing, flossing and routine dental cleanings — harmful bacteria invade your mouth and multiply out of control. This can lead to several oral health issues like halitosis, cavities and gum disease.

What is the best probiotic for bad breath? ›

A new meta-analysis found that the ingestion of four probiotics can reduce the compounds that cause bad breath, at least in the short term. The four beneficial probiotics are Lactobacillus salivarius, Lactobacillus reuteri, Streptococcus salivarius, and Weissella cibaria, all of which may benefit gut health.

What drink kills bad breath? ›

Dry mouth contributes to bad breath, so be sure to drink a sufficient amount of water (six to eight 8-ounce glasses) daily. Drinking water will help keep odor under control because it helps wash away food particles and bacteria, the primary cause of bad breath.

Why does my breath stink even after brushing? ›

Bad breath that just won't go away or a constant bad taste in your mouth can be a warning sign of advanced gum disease, which is caused by a sticky, cavity-causing bacteria called plaque. Garlic, onions, coffee… The list of breath-offending foods is long, and what you eat affects the air you exhale.

How to treat bad breath that smells like poop? ›

Use proper dental hygiene, especially flossing. Remember that mouthwashes are not effective in treating the underlying problem. Fresh parsley or a strong mint is often an effective way to fight temporary bad breath. Avoid smoking.

How to clean your gut for bad breath? ›

Avoid trigger foods

And, as we know now, bad breath and gut health are linked to each other closely. It is essential to be mindful of what we put inside our bodies. Follow a healthy diet with enough fiber containing fruits and vegetables. Drink plenty of water to ease the digestion process.

Is my gut causing bad breath? ›

Sulfur-digesting bacteria and other organisms in your digestive system utilize sulfur compounds within food, producing hydrogen sulfide, dimethyl sulfide, and methyl mercaptan as an end product. This can make your breath smell bad and give you chronic halitosis.

How do I stop bad breath from my stomach? ›

Diet. To reduce GERD symptoms and bad breath, try changing your diet by avoiding or limiting foods that can trigger acid reflux and cause bad breath. These include foods and beverages such as alcohol, caffeine, onions, garlic, citrus fruits, tomatoes, peppermint, spicy foods, chocolate, and fried/fatty foods.

How to get rid of bad breath from stomach acid? ›

Drink enough water: drink at least 2 liters of water / day to help the salivary mechanism of the mouth work properly, limiting bad breath. Gargling with physiological saline is a simple and effective way to prevent plaque, kill bacteria in the mouth, and overcome bad breath caused by acid reflux.

Can probiotics help with bad breath? ›

Fight bad breath

One study had 23 people use an antimicrobial mouthwash and then take either a placebo or a supplement with the probiotic Streptococcus salivarius for three days. They found that 85 percent of the people who took the probiotic had major reductions in the amount of bacteria that caused the bad breath.

What does GERD breath smell like? ›

With gastroesophageal reflux disease (GERD), the muscle between your esophagus and stomach doesn't close properly. As a result, the contents of your stomach can back up into your esophagus, throat, or mouth. If you have GERD, your breath may sometimes smell sour, like partially digested food.

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