Causes of Bad Breath: Stomach Issues

When we think of bad breath, we don’t usually think of stomach issues. That is because we all tend to believe that poor oral hygiene is the cause of bad breath, not something happening in the stomach.

Sometimes, however, treating a stomach problem is what is really need to get bad breath under control. Stomach problems are not as common as gum infections or sinusitis as causes of bad breath, but a particular strain of “stomach bug” known as Helicobacter pylori is often responsible for both bad breath and stomach ulcers.

Bacteria and Bad Breath

It’s not hard to understand how bacteria in the mouth can cause bad breath. There are between 500 and 1000 different species of bacteria living in your mouth. A milliliter of saliva can contain more than 100,000,000 individual microorganisms, and many billions of bacteria live in the tiny cracks and groves on the surface of your teeth, on your gums, and on your tongue. About a dozen strains of these bacteria feed on food particles and dead human cells and release stinky sulfur compounds that cause bad breath.

Not as many bacteria live in your stomach. The acid environment of your stomach digests both food and bacteria. Helicobacter pylori keeps from being dissolved by stomach acid by swimming away from the acid released by the stomach as food as ingested and burrowing deep into the protective mucus in the stomach lining. This species of bacteria can form colonies that create films that form tiny spirals in the stomach lining to protect their members from destruction. The bacteria can use stomach acid itself as a source of food, and they rely on the air swallowed with food for their oxygen supply.

The immune system releases hormones that try to force the stomach to destroy the bacteria by producing more acid. It usually does not work. Typically the lining of the stomach is damaged by the extra acid but the bacteria, which are capable of feeding on stomach acid, continue to thrive. The lining of the stomach becomes ulcerated.

But how does this process cause bad breath?

The valve between the esophagus and stomach tends to leak. Especially after eating a large meal, most people can sense the release of a tiny amount of stomach acid that is quickly neutralized. There can be a moment of pain that quickly goes away.

When the stomach is colonized by Helicobacter pylori, however, the stomach is so full of acid that the normal process of gastroesophageal reflux releases more acid than the throat can neutralize. Even when the release of acid itself is not particularly painful, the acid can wear away tissue in the larynx and pharynx that is attacked by some of the same kinds of bacteria that cause bad breath in the mouth. Mouthwash, brushing, and flossing won’t work. Only getting rid of the infection will get rid of the bad breath it causes.

How to Tell Whether Stomach Problems Are Causing Bad Breath

The bad breath caused by stomach infections tends to come and go. After a heavy meal, more acid comes up and more tissue in the throat is damaged. The result may be more bad breath about a day later.

Other times, however, the burping up of stomach acid is not as severe, and the breath will be fresher. People may not even know that they have a stomach infection that can cause both ulcers and bad breath. But there are some hints of the problem:

  • Men are about 3 times as likely to experience bad breath caused by stomach infections as women, due to eating more and producing more stomach acid.
  • Wearing away of tooth enamel is an important sign of gastroesophageal reflux disease.
  • Bad breath that occurs with stomach pains may be a sign of Helicobacter pylori infection.
  • Bad breath that started after taking a trip to a country that has contaminated water may be a sign of Helicobacter pylori infection. Many people develop this problem after trips to Nicaragua.
  • Stomach pain after eating may be a sign of Helicobacter pylori infection.

But it is also possible to have gastroesophageal disease, with reflux of stomach acid, and a combination of unpleasant symptoms including bad breath, even without stomach infection. Smoking, many kinds of blood pressure medications (beta-blockers and calcium channel blockers), eating fatty meals, eating large volumes of food, and drinking coffee can relax the sphincter that keeps the contents of the stomach from flowing upward. Acid can come up, damage the throat, and cause bad breath.

About 7% of the population has some form of gastroesophageal reflux disease. And about 3% of the population has bad breath caused by some form of gastroesophageal reflux disease.

What Can Be Done to Treat This Kind of Bad Breath?

If you have bad breath that is caused by a stomach problem, the most important thing you can do is probably something you never thought about doing: Eat less. Simply putting less stress on the stomach to produce stomach acid will do more to prevent stomach acid problems than anything else you can do.

It also helps to take a form of licorice called DGL. That’s an abbreviation for deglycyrrhizinated licorice, licorice that has the glycyrrhizin, a compound that can cause fluid retention and high blood pressure, removed in processing. You can’t just chug down DGL and expect it to work. The DGL in the product has to be released by mixing with saliva. In the stomach, DGL kills Helicobacter pylori bacteria and has other actions that also help reduce the production of stomach acid.

Other surprising ways to fight bad breath?

  • Lose weight. Less pressure on your stomach will reduce acid reflux.
  • Avoid tomatoes, citrus fruit and citrus juices, chocolate, peppermint, and coffee, which can relax the valve that keeps stomach acid down.
  • Avoid lying down until 3 hours have passed after eating a meal.

And don’t hesitate to get medical treatment for acid reflux disease. Your doctor may take care of many more problems than just bad breath.


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