Heartburn drugs may cause bad breath

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It is believed that chronic heartburn or gastroesophageal reflux disease (GERD) causes bad breath or halitosis. Acid blocking medications have often been used for this purpose.

Now comes a study suggesting that the opposite is in fact true, i.e. the potent heartburn drugs of the proton pump inhibitor (PPI) class e.g. Aciphex, Prilosec, Prevacid, Nexium, Protonix etc. may actually cause bad breath.

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Dr. Camacho-Lobato and colleagues from Brazil recently presented their findings at the American College of Gastroenterology meeting in Las Vegas in October 2006 (Poster#8).

The researchers studied 23 consecutive adults with GERD. And compared them to 17 patients with dyspepsia or indigestion. Patients with oral or dental disease were excluded. Oral volatile sulfur compounds that cause bad odor in breath were measured.

These investigators found that bad breath occurred in 39 percent of the GERD as compared to only 18% in those with dyspepsia.

Because of their potent acid blocking activity, PPI have potential to cause small bowel bacterial overgrowth thus causing bad breath.

This study represents a classic chicken and egg story. Is it that GERD causes bad breath and patients were simply taking acid blocking PPIs to alleviate GERD. The reverse is also possible, i.e. the halitosis occurs due to acid blocking by these drugs in GERD, and contributes to the bad breath problem caused by GERD itself also.

Do you have chronic heartburn and/or bad breath? What measures do you take for these problems?

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