Aydinmur - please advise, I believe I am in type 3 category

[thissux]

Hi Aydinmur,

I am a 41 year old woman that once had occassional bad breath. November or December of 2011 something took a bad turn for me. I had previously stopped drinking alcohol for a long time as it had been a problem for me in years past. I was under stress, some good some bad and had started drinking again and then this breath started. Room filling, office filling, perhaps theater filling. Enough to make people's eyes water at times. I have smelled it only rarely. Sometimes I can taste it in the back of my throat. I have been to an Ear, Nose and Throat doctor, tube down my nose, told LPR reflux (silent reflux I guess), was given Prilosec. Had classic symptoms. Lump in throat, constriction in throat and the horrible smell. I am not sure if I am low acid or high. The medication might have helped lump in throat. I have foul stools and they are not the normal color most times, green or yellow. Went to Gastroenterologist - he confirmed the odor, as I did not have money he did not run H Pylori test but gave me a metro combination for days. Had no effect. He also put Gastritis as a possibility. From what I have read, this type 3 is very hard to diagnose and more so to cure. Am I correct? Could it just be the gastritis and if I stay alcohol and cigarette free, could this heal? Could there be other causes that may be treatable? Is LPR halitosis really treatable? It is causing a lonely and painful life for me. I have always been outgoing, very athletic and loveable. I am a pretty woman, yet people from several yards/meters away smell it.
I thank you for attending this site and could you please give your best thoughts on what I might be able to do? Can I ever be the way I was or even better? All the best, this sux

[HigherThoughts]

thissux I have been doing more research on systemic bad breath problems. I came across something I haven't seen anyone mention before.

It could be due to some liver problems, which can cause something called fetor hepaticus. Also called breath of the dead. You mentioned it was bad after a night of drinking alcohol. If you had a big history of alcohol abuse you may have damaged your liver.

I may also have damaged my liver because of certain drugs.

Background
Liver diseases can cause a sweet, musty aroma of the breath, called fetor hepaticus. Even in a stage of cirrhosis, the disease can be asymptomatic for many years. Breath analysis might be helpful to detect occult liver pathology.

Source: http://www.sciencedirect.com/science/ar ... 3208006466

Of course we need to have tests run to see if our liver has problems. For me it always comes back to the money. If I had a great amount of money I could go and get tested for many things and try many treatments.

Well this is just 1 potential cause so its worth a look.

[ruch]

I have a question for aydinmur too.

i notice that my bb (which i am pretty sure originates in the mouth.. and i also have some post nasal drip) is worse as the day progresses. you would think that it would be worse upon awaking, but i find that after i wake up and brush my teeth and use grapefruit seed extract and a zinc-based rinse or chlorhexidine (or sometimes even with just brushing alone!), i cannot really detect bb on myself. as the day progresses though, it gets worse.. even after i brush and rinse again later with the same things.

just wondering why this might be the case. i am wondering if it holds any clues on how to deal with my bb, if i seem to have less(?) odor-causing bacteria in my mouth in the morning.

my routine at night before bed is:
-brush, floss, scrape tongue
-rinse with grapefruit seed extract (GSE - about 8 drops in 5 oz water) and sometimes i swallow but sometimes i don't
-if i am not too tired, i will use my neti pot to rinse my sinuses (with saline solution + 2 drops of GSE), and also irrigate my gums using my Hydrofloss machine with about 30 drops of GSE in 600mL of water.

i have to use a dental guard because i clench or grind my teeth at night, so i sleep with my mouth open. because of open mouth and no food for hours, you would think my bb would be worse in the morning (even after brushing since as we all know, brushing doesn't help that much for those of us with chronic bb).. so this just doesn't make sense to me.

i also have a lot of mercury amalgam fillings on my molars from when i was a young child 4 of them!) but i am hoping to get them removed and replaced with tooth coloured filling soon (actually, my dentist says the teeth all need to be capped since they are chipping and cracking over time). my dentist recently told me one of my molars was definitely cracking (apparently, the mercury expands over time and can cause this?). do you think this might be a source of bb as well (bacteria breeding in crevices in my teeth?). i notice my tongue is more white at the end of the day too, and also when my bb is worse (and it doesn't go away with scraping.. i always scrape whenever i brush).

[NOTANYMORE]

LPR reflux is complicated. First you would need a gastric emptying study to determine if you have any motility problems, i.e. food moving too slowly through your stomach. If that test comes back normal, you would then need a ph monitoring study to determine if you are producing too much or too little gas, both of which can trigger LPR. If you are ambitious, however, you could simply try the paleo diet (very few carbs) for a month and if your reflux gets better, than you have low stomach acid. If you reflux is off the charts, which I suspect it will be, than you know that you need to try and keep your body in an alkiline state by eating plenty of vegetables and restricting acidic foods and beverages. Also, you would need to keep taking the ppi's as well, making sure take them at least 30 minutes prior to eating.

If you take ppi's, depending on the strength, you can actually negate their effects by consuming a high acid diet....this is very important. Also, at night, if you aren't elevating your head than your esophagus cannot heal, because the acid is just washing back up your esophagus during your sleep and undoing all the healing the ppi's have been achieving during the day!

This is a mechanical problem which WILL NOT GO AWAY without surgery. You have a weak LES and drugs WILL NOT fix your problem. Only your choices and actions can help. The drugs will reduce the acid and work to heal erroded tissue, but if you decide to sleep laying flat or binge drink, smoke, drink lots of caffeine, etc. than you are creating your own problems.

One last thing.....stress. I will always preach about the destructive power of stress with regards to reflux. You can take all the reflux meds in the world but any stress will quickly reverse their actions. Stressing about your breath will be the hardest thing to overcome but once you do, you WILL rid yourself of the halitosis. This may sound extreme, but i believe you should get yourself some low dose (20mg citalopram) anti-anxiety meds and take them for a couple months so you can start to heal the stress. Keep taking you reflux meds and watch everything fall in to place! I'm sure there will be people replying with all kinds of negative comments but trust me this will work. I am cured, educated, and trying to help and you my friend, have nothing to lose by trying.

Stay strong.

[noway]

I have foul stools and they are not the normal color most times, green or yellow.

Hi thissux,
Your problem maybe excess bile secretion which burn your lining mucosa of the GI tract.. try to take a cytoprotection drugs with the PPI to make a barrier between the tissues and the harmful bile secretion. Go to the pharmacy and buy any drug contains an active ingredients called "Sucralfate" and take one tablet a hour before each male (3 times per day).

[thissux]

NOTANYMORE - thank you so much for your response. Did or do you have bad breath caused by LPR reflux? If so, sounds like you got it under control. It is a bear to deal with. It's been a year with this. My whole digestive system seems to be off. Noway, Ruch and Higherthoughts thank you for your help too.
I have some people that I consider trustworthy that are telling me that I have no bad breath what-so-ever, however I get so many nose rubs. Many people are telling me I do not have it. Why the nose rubs? Ugh!