If you experience persistent bad breath, the cause may come from deep in the digestive system. However, bad breath caused by the digestive system can have many causes.
Let’s look at conditions of the gut microbiome and its associated causes of bad breath.
The Digestive System and Bad Breath
Most people who have bad breath from the digestive system describe a rotten egg smell. This is due to gut microbiota that break down sulfur, releasing an eggy-smelling gas. For some people. However, the smell is a more rotten, putrid smell.
Sulphur Burp Microbes
Sulfur-reducing bacteria and other micro-organisms utilize sulfur compounds within food, producing hydrogen sulfide as an end product. This can make your burps smell like rotten eggs. These bacteria include H. Pylori.
H. Pylori Symptoms
H. Pylori is one of the most common causes of bad breath from the digestive system. It’s a type of bacteria that exists within your normal gut microbiota, but when things get out of balance, it can wreak havoc.
It can cause duodenal ulcers and about two-thirds of stomach ulcers. It’s also often detected in the stomach lining of patients with stomach cancer.
H. pylori are the most common chronic bacterial pathogen in humans. It’s present in over 50% of the world population and is more common in older people and in less sanitary, more crowded places. With increasing standards of hygiene and less overcrowding, the infection rate is decreasing.
H. pylori symptoms can be spread by mouth-to-mouth contact, contaminated water, sharing food or utensils or through body fluids like vomit or feces.While many people with H. pylori infection don’t have any symptoms, if symptoms occur alongside bad breath, it’s a good sign that you may have it.
H. pylori symptoms include:
- abdominal pain
- loss of appetite
- weight loss
- peptic ulcers
But if you don’t have symptoms, how can you discover if you have H. pylori and if it is the cause of your bad breath?
Testing H. pylori symptoms
- Breath tests
A urea breath test may detect if H. pylori is the cause of your bad breath
- Blood tests
Laboratory analysis can detect H. pylori in a blood sample.
- Stool tests
Your feces can also be tested for H. pylori. Your doctor will give you a container to take home so that you can provide them with a stool sample to send to a laboratory for analysis.
Treatment of H. pylori symptoms
In some cases, a 1 or 2-week course of antibiotics may be required to cure H. pylori symptoms. This may resolve bad breath. Common antibiotics prescribed by doctors for H. pylori include amoxicillin, tetracycline (not to be used for children <12 yrs.), metronidazole, or clarithromycin.
Antibiotics should be taken with extreme caution due to the impact on your microbiome. But in some cases are necessary.
Before taking antibiotics you should look for general dietary causes of digestive imbalance.
GERD symptoms as a cause of bad breath
GERD symptoms are a very common digestive system disorder that can cause bad breath.
The most common GERD symptoms are chronic heartburn (a burning pain in the lower chest), caused by acid reflux.
Other less common GERD symptoms include:
- Reflux (stomach acid or contents building up or splashing up into the esophagus or even the mouth)
- Belching or burping
- Pain or discomfort when swallowing
- Waterbrash (a sudden excess of saliva)
- Dysphagia (the sensation of food sticking in the esophagus)
- A chronic sore throat
- Throat infections
- Inflammation of the gums or gum disease
- Erosion of the enamel of the teeth (your dentist may notice this)
- Chronic irritation in the throat
- Croaky voice in the morning
- A sour taste in the mouth
What causes GERD Symptoms?
H. pylori infection can be a significant factor in GERD symptoms and other digestive disorders.
GERD symptoms occur due to a 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 or LES.
The LES normally opens wide to permit swallowed food and liquids to pass easily into the stomach. When this valves relaxes too much or becomes weak, it can allow stomach acid and contents up into your esophagus, causing your GERD symptoms and sometimes, bad breath.
Often, people are treated for GERD symptoms with proton pump inhibitors, which reduce stomach acid production, or medicines to neutralize stomach acid.
In the book Heartburn Cured, Dr. Robillard discusses how heartburn is caused by bacterial ‘overgrowth’ and poor digestion of carbohydrates.
Tips For Reducing Acid Reflux and GERD Symptoms:
- Breath properly, through your nose and deep into your diaphragm (belly breathing). This provides good oxygen perfusion in the body.
- Reduce simple carbohydrates such as sugar and wheat from the diet
- Eat foods rich in pre- and probiotics. To balance your microbiome, you need to eat prebiotics (food for bacteria) and probiotic foods (fermented foods).
SIBO (Small Intestinal Bacterial Overgrowth) and Bad Breath
If you’re experiencing gas, burping and bloating then SIBO may be causing your bad breath.
In your digestive system, trillions of bacteria live in the large intestine where digestion takes place. The small intestine is designed for nutrient absorption and has far less microbiota, but sometimes bacterial overgrowth occurs here.
80% of people with irritable bowel syndrome (IBS) also have Small Intestinal Bacterial Overgrowth SIBO.
Symptoms of SIBO include:
- Bloating within an hour of meals
- Joint pain
- Skin rashes
Some patients may develop SIBO after a gastric infection. Patients who have fructose malabsorption or lactose intolerance may also experience problems with gut bacteria. Symptoms tend to be worse after eating fiber.
Gasses produced in SIBO are the major cause of complaint and may cause bad breath.
Testing for SIBO
If you, your doctor or your dentist suspect that SIBO may be the cause of your bad breath, a breath test for hydrogen sulfide may be recommended.
The test measures the hydrogen and methane gas produced by bacteria in the small intestine that has diffused into the blood, then lungs, for expiration.
After a 1 or 2-day preparatory diet, which removes much of the food that would feed the bacteria, you drink a sugar solution of glucose or lactulose.
Treatment for SIBO
If SIBO is identified as the cause of your bad breath, a course of antibiotics may be recommended. However, it often recurs.
A low-FODMAP (Fermentable, Oligo-, Di-, Mono-saccharides, and Polyols) diet can also help short term. You should aim to reduce or eliminate simple carbohydrates, such as sugar or wheat, from your diet.
Irritable bowel syndrome and bad breath
While SIBO more commonly causes bad breath, irritable bowel syndrome can cause bad breath too.
Irritable bowel syndrome (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.
Other IBS symptoms include:
- Sensation of incomplete evacuation after defecation
- Mucus in your stool
- Weight loss
If you suffer from bad breath that can be described as sulfur burping, and also have diarrhea or vomiting, you should see a doctor immediately. These may be the first signs of irritable bowel syndrome.
Crohn’s Disease and Celiac Disease
Malabsorption of food is a major cause of bad breath. 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, causing smelly burps and sometimes bad breath.
Digestive System Infection
If you’ve experienced diarrhea and digestive system problems alongside bad breath, it may be caused by infection.
A specific digestive system infection can cause bad breath. Giardiasis is a diarrheal disease caused by the microscopic parasite Giardia lamblia, a one-cell parasite that can infect humans via food or water. Symptoms of Giardiasis include bloating, diarrhea, farting, unpleasant-smelling burps and bad breath.
If your bad breath is caused by Giardiasis, you have contracted the infection by:
- Swallowing Giardia picked up from surfaces that contain feces from an infected person or animal
- Drinking or accidentally swallowing infected water or using ice made from infected water sources
- Giardia may live (for example, untreated or improperly treated water from lakes, streams, or wells)
- Eating unprepared food containing Giardia organisms
- Having contact with someone who is ill with Giardiasis
The incubation period after exposure is generally 1 to 3 weeks. A Giardiasis diagnosis is generally made by testing stool samples.
For persistent infections, your doctor may prescribe antibiotics.
- Metronidazole (Flagyl) is the most commonly used antibiotic for giardia infection, but you may be prescribed
- Tinidazole (Tindamax) or Nitazoxanide (Alinia).
Gallbladder problems and bad breath
Gall bladder dysfunction, gallstones or gall bladder removal can lead to unpleasant burping that can cause bad breath.
Your gall bladder produces digestive juices used for fat absorption.
When the gall bladder builds up mineral stones, the bile ducts can become blocked. This can cause infection and also pain, nausea or even vomiting, especially after eating a fatty meal.
Symptoms of gall bladder disease include:
- Agonizing pain in the upper right abdomen — especially after a heavy meal. This may last minutes or hours.
- Sudden fever
- Nausea and/or vomiting after meals
- Light clay color stools (caused by insufficient bile, this indicates blocked gall bladder ducts)
- Itchy skin rashes
- A white-coated tongue
- Pungent body odor and yellowish skin
- Yellow, discolored eyes, and dark circles beneath the eyes
Gall bladder problems can a serious health issue, so if you are experiencing these symptoms along with bad breath, ensure you see a doctor.
Constipation that causes bad breath
If your bad breath smells like feces, the cause of your bad breath may be constipation.
Constipation causes an accumulation of undigested food in the bowels. It’s thought to often be caused by a passive lifestyle and a lack of exercise.
Sitting all day, which many of our jobs now require, isn’t good for our digestion. If you also have a diet low in fiber and a lack of exercise, you may suffer from constipation. Unfortunately, constipation can be the cause of bad breath.
If you suffer from bad breath and constipation, try to take regular exercise, increase your intake of fiber, drink water every hour and reduce your intake of fats.
Gastroparesis is a condition where there is damage to the nerves or muscles of the stomach, causing it to empty very slowly. Sometimes this nerve damage occurs due to long-term diabetes (diabetic gastroparesis).
The vagus nerve may also be injured or severed during surgery, which can affect the pumping of food from the stomach. However, sometimes gastroparesis occurs for no known reason (idiopathic gastroparesis).
This slow emptying of the stomach can cause bad breath.
Bad breath may be a symptom of pyloric stenosis. This is a condition where the last part of the stomach is abnormally narrowed. It is mainly seen in infants and may be linked to genetic and environmental factors. The main symptom and it can lead to dehydration, which in turn can cause bad breath. If left untreated, the dehydration can cause fatal complications.
Supplements to heal bad breath naturally
For a quick natural remedy to heal digestive bad breath I suggest these supplements may help to:
1) Kick-start digestion
2) Rebalance the gut microbiome
3) Recalibrate the immune system
If you have digestive system symptoms as well as bad breath, visit your doctor. Don’t be embarrassed – they’ve seen it all before! Their advice may cure both your digestive problems and your bad breath.
Do you know someone with bad breath? Leave your questions in the comments below.
Want to know more? Dr Steven Lin’s book, The Dental Diet, is available to order today. An exploration of ancestral medicine, the human microbiome and epigenetics it’s a complete guide to the mouth-body connection. Take the journey and the 40-day delicious food program for life-changing oral and whole health.
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