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Old 10-14-2009, 08:49 AM   #1
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Bad breath - trying to find cause (GI/sinuses/etc.)

Hi all,

I'm a 25 year old male, and I've had bad breath of some type for my whole life. I grew up not having very good oral hygiene, and I decided to fix that six or seven years ago. But that didn't fix my breath issues; according to my wife, doing a full brush/floss/scrape/rinse turns the worst of it from "poop" to "mint-flavored poop." I'm desperately searching for something to pursue, because all of my attempts thus far have turned up empty (with one semi-exception, an antibiotic, see below). To that end, I'll write out as much as I can think of, and I hope it rings a bell for someone.

I've done some stuff medically for about the past year in an attempt to find the cause. Nothing conclusive, but here are the steps I've taken.

- Just to rule it out, I went for full dental cleanings every few months for a year, and asked three different dentists about my issue. Didn't help.

- Went to a GI specialist. I was tested for a variety of allergies & diseases (celiac, gluten sensitivity, lactose intolerance, pollen/dander/food allergies, to name a few). I also had an abdominal sonogram and a chest x-ray, both of which turned up nothing except for a slightly enlarged liver (within tolerances). When the next line of inquiry involved an endoscopy, I decided to try a different route.

- Went to a nutritionist next. I did the deal with the halimeter (measures hydrogen gas levels in breath) and tested for fructose and sucrose sensitivity. The baseline for a "problem" is 5 ppm hydrogen in a released deep breath. With nothing in my stomach, I was getting readings in the 3-5 range.

The fructose test (1 can of soda after 12 hours of fasting, test 3 hours later) gave a reading of 1. The sucrose test (2 teaspoons of sugar in 8 oz. of water after 12 hours of fasting, test 3 hours later) turned up a much higher reading, a 10. From this, the nutritionist concluded that it was a sucrose intolerance, either joined with or caused by a case of bacterial overgrowth in my intestines, and put me on a 40 billion per dose probiotic, along with cutting out any major sources of sucrose. As a result, I've cut my sucrose intake to just about nothing, substituting Splenda and fruit flavoring when I need to.

Frankly, I'm not sure how well calibrated the test is, as the readings seem very arbitrary, and in return visits I've gotten wildly different readings (2 to 8) on an empty stomach). It could be that my bowels backing up during 2-3 days without a bowel movement could be causing the issue, but that's pretty much just conjecture. Even though I understand that the sugar test could have been completely wrong, I've forged ahead anyway.

During six months of living sugar-free, eating better (more greens, complex fats, etc.) my breath hasn't changed a bit. I've tried eating smaller meals many times a day, I've tried adding a lot of fruits and vegetables, cutting out saturated fats. I've been taking probiotics, 40 billion a day, for that entire period. I've tried fiber for periods of time, on and off.

- Finally, I just had a bad sinus infection for which I needed 10 days of antibiotics (biaxin/clarithromycin). During those 10 days, and for a couple of days after, the breath problem was gone, so I do strongly suspect it's bacterial in nature. For the record, this was the first time in 10 years that I'd taken antibiotics. What sucks to me is that after I finished the antibiotics, I started taking the potent probiotic supplements again in hopes that the good bacteria would replace the bad, but the breath has started coming back already after only a few days. So it makes me wonder exactly where the problem lies; it could be anywhere in my body, not just my intestines.

Medically, that's where I stand. Physically, here's some stuff about the applicable systems:

- I've always had a long period of time between bowel movements, usually 2-3 days, but on that third day I tend to go a couple of times. I was hoping the fiber would help this, but I haven't noticed much change.

- I never really noticed it until my recent sinus infection, but one of my nostrils tends to be clogged at any given time. It'll fix itself when I stand up, typically, but when I'm sitting there's a noticeable lack of air passing through one nostril compared to the other. The right nostril tends to get the short end of the stick. A few years back, for a span of probably two or three years, I had chronic nosebleeds out of the right nostril. Not sure if any of this relates to the breath, but I figure I may as well mention it.

I may try the ear/nose/throat approach next. As it stands, by cutting out sugar my weight has dropped from 195 to 165 in a matter of six months. A metabolism test clocked me at around 3000 calories per day from normal daily activities. Bottom line, it now takes serious effort for me to keep my weight constant, because if I were to eat only when I'm hungry I'd only eat one or two times per day.


I don't even know which path to pursue at this point, much less what to look at specifically. Any random thoughts that anyone may have would be greatly appreciated, and I'll be happy to provide more specific info upon request.

Thanks

Last edited by jj284; 10-14-2009 at 11:23 PM.

 
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Old 10-14-2009, 05:07 PM   #2
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

Wow- you sure have been thru the ringer.

The fact that the antibiotic for your sinus infection seemed to clear the halitosis temporarily may indicate that you have a low grade chronic
sinus infection. I would go back to the Ear, Nose Throat physician for another thorough work-up.

Also have any one of these doctors given you a blood work up? Diabetes can cause bad breath, although I would assume the GI doc and nutritionist would have found this.

Really baffling.

The antibiotic reaction might be key.
Let us know what direction you go in!

zuzu

 
Old 10-14-2009, 06:04 PM   #3
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

Seriously- try taking chlorophyll. Mint chlorophyll is also made. It works wonders. You can get it quite easily at most health food stores.
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Old 10-14-2009, 11:41 PM   #4
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

Quote:
Originally Posted by zuzu8 View Post
Wow- you sure have been thru the ringer.

The fact that the antibiotic for your sinus infection seemed to clear the halitosis temporarily may indicate that you have a low grade chronic
sinus infection. I would go back to the Ear, Nose Throat physician for another thorough work-up.

Also have any one of these doctors given you a blood work up? Diabetes can cause bad breath, although I would assume the GI doc and nutritionist would have found this.

Really baffling.

The antibiotic reaction might be key.
Let us know what direction you go in!

zuzu
Thanks for the reply. I'll try to give you some more details.

I received two blood work-ups in response to this issue. The first was my general doc almost a year ago, with the usual workup of cholesterol/cell counts/general health/etc. The second was a couple of months later from the gastroenterologist, and included an allergy screening for a boatload of common allergens, along with several chronic GI problems such as the aforementioned celiac and gluten intolerance. All came up negative. I would assume that this would have caught diabetes at some point.

The sinus idea first popped into my head (lol?) during the recent experience with the antibiotics. After doing some more reading, a low-grade chronic sinus infection does not seem too far-fetched, as I had a lot of sinus issues when I was younger and my mom still struggles with them regularly. Ironically enough, I never went to an ear/nose/throat specialist. As soon as I felt the waterfall effect in my sinuses during a coughing fit, I knew what I had and I went in as soon as I could to see my general doctor. Though he wasn't available, another doctor did see me and pretty much confirmed it on the spot. I had wheezing with it too, so he gave me an inhaler to make sure the preceding chest cold couldn't set up shop indefinitely.

Throughout all of this, I've honestly questioned whether I really have a problem with sucrose. It hasn't helped the breath, and there's never been any physical discomfort from it, except for that one morning that I had two big spoonfuls on an empty stomach for the test.

Anyway, I haven't been to an E/N/T doc at all for this issue, but it's an angle I may pursue now. If anyone has any more insight or telltale signs to look for, I'd be happy to hear them. I don't plan to abandon any of these paths, but I need to focus my energy on one route at a time.

Thanks again!

 
Old 10-27-2009, 11:42 AM   #5
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

Bumping to see if anyone has any more opinions. Breath has indeed come back, and I'm planning to go to my general doc for a physical soon.

 
Old 10-31-2009, 07:40 PM   #6
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

Have you ruled out tonsil stones?

They're not always easy to see, but they're VERY easy to smell.

 
Old 02-26-2010, 05:43 AM   #7
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

I am 40 YEAR OLD MALE WITH THE SAME PROBLEM, IT IS A MYSTERY? IF YOU GET ANY ANSWERS LRT ME KNOW!

 
Old 04-23-2010, 01:42 AM   #8
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

I would suggest tonsil stones. In fact, I think these little disgusting things are the cause of almost all bad breath.

 
Old 05-05-2010, 04:55 AM   #9
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

Have you tried SmartMouth Mouthwash? I really believe it will help!! I don't know if you are still on this site anymore but I'd love to hear if you try it and how it helps you!

 
Old 05-08-2010, 01:46 PM   #10
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

Hi guys.

My Life:
Im 24-year old male undergraduate. I think I started having bad breath when I was about 18-19. But during the last two to three years, it got relatively worse. I suspect this is due to the increased drinking and smoking when I joined college. I used to be a really popular guy, getting along with everyone, easily making friends, constantly dating different women in high school. When I go out, I do still get opportunities from women to talk to them, which in the past I would have easily aced, but now due to bad breath, my life is changing for much worse than I could ever imagine. It comes to the point that my working colleagues (i work in an office in sales part-time) think Im weird and a freak, as I avoid contact to people, I am just too embarassed to speak nowadays. My friends mentioned several times that i stink, or called me smelly boy. My mother mentioned i should try cleaning my tongue harder when i brush my teeth. My dad always carried mints when he meets me, not for himself, but to offer to me. I am currently at the stage where I am willing to give up my whole life savings to cure this problem. It has affected my confidence, I no longer try to make new friends, I avoid speaking at all times, and I cant even concentrate on the topic that i am speaking about with someone as the constant concern whether the other person thinks im disgusting is bothering me.

The problem:
When I look into the mirror and stick out my tongue, i see white bulges at the back of my tongue, and i dont even remember ever having a clean pink tongue. The tip in front is alright, but the further back it goes, the whiter it becomes. I read many reports, forums, etc. etc. online. And I am currently very very sceptical on online products. I bought the mouthwash from therabreath and the toothgel from terabreath. They only help me for at most an hour. And as I am still in uni, I dont really have large amounts to spend on expensive products, though if there is a guaranteed cure, I would be willing to spend all i have and even take a loan if necessary. Anyway, i suspect i have yeast infection on the tongue.

Dentist:
The last time i was at the dentist, i was planning to talk to her about my problem. I scheduled a cleaning of the teeth, and decided to ask her advice on bad breath after she cleaned my teeth, at least i would be more confident to speak. Then during the cleaning I actually saw one of her nurses mouthing the word "HALITOSIS" to her, while i was lying there with my mouth open. The dentist suppressed a giggle. And that was it. I didnt dare to bring up the topic anymore.

How I try to reduce it:
I reduced smoking extremely, maybe 2 or 3 a day. And I am planning to completely quit, i just got myself nicotine gum.
I brush my teeth and scrape my tongue, and floss. And rinse with mouth wash. I am not lacking in any oral hygiene.
I always carry a bag with me, so i can bring my toothbrush and toothpaste, and always brush directly after every meal or after a cigarette.
I am planning to put in all my concentration on finding a cure for this, once i completed my degree (final exams in 2 months). I cant possibly start a proper career in this manner. So I was planning to go to an ENT specialist and start trying every possible product. or do anything at all that i can find. I am going to put a pause in my life to clear this, once and for all i hope. So any advice from anyone would be so so much appreciated.

Questions:
1. Does everyone with bad breath also have a white coated tongue?

2. I just ordered some PROPOLIS mouthwash and PROPOLIS drops, as i read that some people were cured through the use of this, and it is relatively cheap. Does anyone have any experience with this?

3. I was thinking of ordering probiotic powder or maybe supplements, so i can get a healthier balance of bacteria. But these cost abit more, so i was hoping to get some feedback here first.


Lastly, id like to say to anyone who is reading this: writing here actually made me feel better. It gave me a sense of hope, something to look forward to (a life without bad breath) and i just want my normal life back. The life that everyone else around me has. To those who are fighting this problem, i know how depressing it gets. how you want to lock yourself in your home and never leave. And how someone who doesnt have this problem will never understand it. May this forum, not only be a way to find a cure, but a source of hope and strength during this battle...

 
Old 05-08-2010, 11:21 PM   #11
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

Dear BlackMan -

I would strongly urge you to consider tonsil stones.I feel like I am on a one-(wo)man-crusade against these horible things! Anyway - I had a very similar situation to you, and eventually decided to attack the problem very agrressively - I had my tonsils removed. I also had issues with recurrent tonsilitis so I figured it would kill 2 birds with 1 stone, so to speak.

Anyway - I also could brush and floss and rinse, and within an hour my breath would be bad again. Since having my tonsils removed, I even wake up with fresh breath (Ok - a little "morning breath", but nothing too gross) and a good brush and rinse, and I am fine ALL DAY LONG. It has been a true miracle for me. I can't even express in words how fantastic it feels to be free of the wretched plight of stinky mouth. It is a whole new life for me!!!!!!!!! Seriously!

I think tonsils stones account for more bad breath than people realize! I feel like a new person, and even though the surgery was BRUTAL and the recovery was AWFUL - I do not regret it one bit!

 
Old 05-09-2010, 11:35 PM   #12
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

I'm still around, just figured this thread had gone to the bottom of the heap. Very happy it's gotten a few more responses. I was distracted from my own issues for some time because my wife's health took a dive for a bit, but I've refocused and I'm going to an ear-nose-throat doctor tomorrow morning to try to track this down. I will certainly bring up tonsil stones as a possibility, and report back if anything turns up.

 
Old 05-11-2010, 05:56 AM   #13
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

FYI jj284 - some ENT Docs are not familiar with tonsil stones because there was a time when everyone and his dog had their tonsils out, so the occurance of it dropped dramatically. Plus, from my expereince, not everyone knows what they are in general - just look at the amount of posts on this topic on this website alone; "what are these smelly white lumps?" and "why do I cough up gross chunks of white stuff" and so on. PLUS, some tonsil stones can be VERY well hidden, and hence get even stinkier, and harder to find. You'd almost have to dissect the tonsil to get to them, since the tonsils are usually not as smooth as you might imagine.

I'm not trying to sound like a zealot...hahaha.....I just know that I wouldn't have an ENT tell you "No" then rule them out straight away. This has been my issue, and the issue of many others, for years and years, and has gone un answered. My Mom first took me to the docs about this when I was about 7 or 8, and she even took in a tonsil stone......he had no idea what it was and told her to have me brush my teeth better. That answer led to 3 decades of suffering with bad breath, knowing these things were the cause, and yet unsure how to deal with it.

Good luck!

 
Old 05-14-2010, 10:33 AM   #14
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

Productive appointment. The doc listened to my problems and then scoped my right nostril to get a good look at my tonsils, throat, and nasal cavity. Weeeeeird feeling, lol. Anyway, she found a few things:
- A LOT of mucus buildup at the back of my throat/
- Deviated septum, shifted toward my right nostril. Helps explain why I've had nosebleeds only in that nostril, and why it stuffs up for no apparent reason.
- "Ratty-looking" tonsils. Not unhealthy or infected, just beaten up. She said they'd apparently taken a lot of abuse from infection, excessive throat clearing, and the many sore throats I've had for days or weeks at a time throughout my life.
- No visible tonsil stones. She was looking from right next to them, both from the front and through the scope from behind, and knew to look for stones without me even mentioning them. She said they can be sneaky buggers, and that they're nearly impossible to rule out from visual inspection alone. At my next appointment she's going to check again.

She suggested three possible causes for the breath, all related to the ratty tonsils: Post-nasal drip, acid reflux, and tonsil stones. She agreed that there was nothing dental that should be causing it.

I'm going back to see her in two weeks. In the meantime she's having me do sinus irrigation twice daily, and spraying Nasonex once daily. I've had a co-worker bugging me to try neti pot for quite some time, but having a doctor tell me sealed the deal, lol. Just like scoping my nostril, it's a weeeeeeird feeling. But I'm obviously poking at things that have never been touched before... I never even realized the two nostrils were connected like that.

Anyway, possible progress! Will keep you posted.

 
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Old 05-14-2010, 10:58 PM   #15
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Re: Bad breath - trying to find cause (GI/sinuses/etc.)

Thanks KatieMomma,
I finally made an appointment with an ENT for next friday, and i will definitely bring up tonsil stones. I hope something will be found to cure the problem!

 
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