Bad Breath/reflux? pnd? infection? Something else?

Oral and dental care
1

Hi,

I wasn't sure where to put this duscussion.

I've had bad breath (especially horrendous morning breath) for as long as I can remember. Probably for a good 10 years or so? (I'm 29)

I've also experience what I think is possible post nasal drip (tongue is always coated. Often feel mucus on back of throat and need to clear my thoat)

and some sort of acid reflux in my throat (occasional burning sensation below my adams apple)

Both the possible PND and reflux seemed to come on after already having bad breath for a numbe of years though, so i'm not sure if they're even related? The reflux feeling is fairly infrequent.

I also occasionally get tonsil stones.

I have good oral health. Brush twice per day, floss, moutwash. Dentist confirmed gums are healthy.

Yet I can taste bad breath coming on again shortly after my morning routine.

NOW, I recently took metronidazole for something completely unrelated, and to my utter amazement, my breath became as fresh as a babies! Reflief after a decade! Even my morning breath smelt of nothing.

I was so happy until I read online that other people had experienced this phenomenen, but that the bad breath returns when you stop taking the antibiotic.

I stopped taking it 4 days ago, and I think that my breath may finally be reverting back This morning wasn't quite as fresh as yesterdays. I'm depressed now that my bad breath is likely to return in full force within a few days.

I'm wondering if anyone can shed any light?

Anyone been in the same boat and found a cure?

Can any knowledge be gained from the fact that the antibiotic temporaily cured me or not?

 

2

As a first step you could try probiotics. After reading about Metronidazole and what it was doing for you ie. keeping bad bacteria in check, maybe that is the issue. I use a full spectrum probiotic or acidophilus and bifidus. When I buy it from the health food store it comes refrigerated. I keep mine in the fridge because I usually have it for a long time. It helps with a lot of stuff and I have recently started taking them again to see if I can cure the halitosis I get that comes from my stomach. If it doesn't, I will go back to apple cider vinegar (which I have been avoiding because I despise the taste). That being said, you could also try apple cider vinegar (organic, Bragg's, with the could in it if you can find it, if not get at grocery store). You can drink that every day if you want. Couple tablespoons. Hope this helps good luck!

3

And by 'with the could in it" I mean 'cloud'.

4

Hi.

At the moment (4 days since taking my last pill) my breath is actually still very nice (although my morning breath seemed to begin to return somewhat when I awoke this morning).

I'm expecting it to completely revert back within a few days.

I tried probiotics a few years ago and it didn't help at all, unfortunately.

At the moment my plans are to possibly do another course of Metronidazole at some point, simply because from the hundreds of cases i've read, there were 2 people who were cured for very a very long time (possibly permanantly??) after taking the second course.

I also plan to try probiotics again, also breaking up the tablets and using it a saline rinse and almost like a mouth wash (again, from my reasearch of cases similar to mine)

Also another few ideas (Apple cider vinegar, Grapefruit seed extract among others) 

After that, i'll be pretty low on ideas and any hope of a cure!

5

Regarding ruling out things with the antibiotic experience in mind.

My breath is still fresh and i've been off the pills for 5 days now.

If the cause of my breath was my tonsils and tonsil stones (which I used to be certain of, but recently, not to sure) wouldn't my breath have had reverted back straight away?

What is taking so long?

Is ny body just slowly bulding up bacteria again somewhere which when it gets to a certain point will make my bb symptoms return?

I did get the occasional tonsil stone when I was on the antibiotic and they still had that awful smell to them, yet my breath was nice.

One of my best friends introduced me to tonsil stones as he sometimes gets them, and his breath(including morning breath!) is odorless! (lucky guy)

I feel as though I should be able to play detective and rule out certain causes after experienceing nice breath for teh first time in forever since taking the antibiotic, but I guess it's not as easy as that?

I've always asumed it's either:

tonsils/tonsils stones (Often feel like something is in my throat and cough them up occasionally. It's also how i'd describe my 'morning breath'wink

To do with acid reflux? (I get it but infrequently)

Some sort of infection? 

PND (I *think* I have this)

Anyway, from googling, the longest example i've seen of someone enjoy fresh breath for after taking the metronidazole is 4 weeks. I'm only on day 5 so have a while to wait. 

6

breath has pretty much reverted back, now sad

I'm a bit gutted. It was so nice having fresh breath.

I'm kind of out of ideas.

I'm gonna try probiotics again, although I tried them some time ago and they didn't help at all.

Might try another course of Metronidazole (one person I read about had a long term relief after taking a second course) 

Apple cider vinegar as suggested doesn't seem to be helping.

The antibiotic is the only thing that has ever worked and it was like a God send (whilst I was on it)

Damn.

7

I have recently been diagnosed with SIBO.  Small intestinal Bacterial overgrowth.  The diagnosis was discovered by me having a Hydrogene Breath test.  And the treatment is short sharp courses of antibiotics followed by high dose good quality probiotics.  I have so have completed one course of antibiotics and nearly three weeks of probiotics.  So far this has been working reasonably well.  But not completely.  I have been told that w no single antibiotic will deal,with all the bacterial overgrowth as easy type of antibiotic will be effective of different Bactria. I am also having advise on my diet, the Fodmap diet is mainly for people with IBS but as I understand it many people with IBS also have SIBO.   It's has taken me 20 years to find out what is wrong with me.  20 frustrating years of misdiagnosis,  and I had reached a point that I thought I was "managing" my problem, best I could.  It was a rapid deteriation 3 months ago that made me persevere to find someone who,could properly diagnose me.   NOT easy, I have had gastro specialist who,wanted to,send me to an oral  hygienist and doctors tell me it's all in my head and that there is nothing wrong you can have no idea how relieved I was to finally get a diagnosis because until you find put what is wrong you can't do anything to,remedy it. I have had 20 wasted years of guess work to,what was causing my bad breath to suddenly flair.  It was devastating to many an intimate moment and nealy cost me my marrage. Don't let any doctor, specialist etc try to belittle the impact of this issue on your life. 

8

Yes, it's very frustrating.

I'm glad you appear to be on route to finding your cure.

Intersing that your treatment is along the lines of what I planned to do with my self-medication.

(I plan to buy some more Metronidazole and also a good probiotic to take lots of, after finishing the antibiotic)

I was so happy when the metronidazole worked. Not only because it was nice having fresh breath even wbefore brushing my teeth!, but because I assumed that teh fact that it helped had given me a huge clue as to the underlying cause. However, that assumptiong appears to have been wrong (?) The case is still unknown.

I guess The metro killed all anerobic bacteria which has since come back, but I don't know where that bacteria is coming from.

But if it was an infection causing bad breath, wouldn't the metro have killed it off meaning that my breath shouldn't have reverted back?

It's all very confusing.

I'm not surprised it took you 20 years. I've had about 12 years so far  and am none-the-wiser

9

Hi Mike,  please go back over my information in my last message.  If you have SIBO the antibiotics you took will have only removed some of the bacterial overgrowth, is is why I was advised that there are 5 different families of antibiotics but NONE of them will deal with all the Bactria that are causing the problem. Which is why after youa stop taking the tablets the symptoms return quiet quickly.  Self medicating is doggy you really need advice.  And the over use of antibiotics can cause these problems in the first time,  it seems that it was an overuse of antibiotics ( for acne) is what made me ill in the first place, so if you keep taking those tablets you will be setting yourself up to be much worse.  I know no two peoples situation is the same but from what you are telling us, it does sound very similar to the diaognisis I have. 

10

When I was a teenager, my Dr prescribed me various antibiotics for years for my acne! I hated taking them because It didn't feel right, and they also only gve me limited help.  lymecycline for about 8 months. Doxycycline for a year or so. flucloxacillin too (only one that gave me some success until it suddenly stopped working).

Eventually I took accutane which was a God-send!

I do wonder if the antibiotics messed me up. (but then why were the Doctors so happy to prescribe me antibiotics for years and years??)

I took pro-biotics for a long time a year or so back to help combat my breath in the hope that it was maybe the antibiotics that had caused it and in an attempt to reverse the effects, but they didn't help me at all. No change.

If I go to my Dr and tell him I have bad breath and I want help, I know he'll just tell me to chew gum or something! They don't seem to think it's a real issue. Would I be better off telling him something else in the hope that he'll run tests? (like the breath test you mentioned)

YOu mentioned that ''here are 5 different families of antibiotics but NONE of them will deal with all the Bactria that are causing the problem'', so then how DO you deal with all of the bacteria causing the problem? 

11

Hi mike, I really sympathises with you, and I know what you mean about the doctor not taking your seriously . Been there.  I had a follow-up,appointment with my gastro man this evening.  I have been lucky with the first course of antibiotics they gave me, in so,far it has made a serious improvement for me and now imam taking top( and i'm sad to say very expensive probiotics.). Unfortunately I am having to,pay for them myself because my local,health authority have banned GP's for prescribing them.  They class them as food not medicine !!

There is no,way of knowing which antibiotic will work for you and some people get a result from one while somepeople will have to work through all 5.  And there is no guarentee that it won't come back.  Hence the importance of the probiotics. 

I have decided to,take a second course because all though I am much improved I am aware that I need my system more robust to allow me to have a less restricted diet.  But I have been warned that the next course may do very little to help my condition there is now way of knowing. 

Meanwhile I mentioned that I have also been advised to work with the fodmap diet.  This won't prevent me from getting CIBO but will minimise the foods that cause the biological process that causes the bad breath, by removing foods that produce cause fermentation in breaking down.  The diet is complex and I have been advised to,have professional help,with it, but the things that must be removed from the diet are gluten grains, any type of onions/leeks and garlic.  

12

If it sheds any light, I don't think that my diet plays much of a role. 

I used to experiment, and even if I live on water, fresh vegetables and fruit, my breath doesn't really change. 

I also still can't shake the idea that my tonsils are playing at least a part in my misery. It's difficult to be sure.

My tonsils are cryptic. Likely the result of being over-prescribed anti-biotics as mentioned before.

However, when I inspect them in the mirror with a light and dig around, I rarely see any tonsil stones. However, if I 'suck' on my tonsils (so that you make a noise like a pig) I often feel my breath is instantly worse. Could it be that they're hiding extremely deep and that they are my cause (or at least a part)?

Can the fact that the metronidazole 'cured' me temporarily prove or disprove the theory?

I asked my Dr if he would refer me to an ENT to have them removed, but he said that nobody would touch them, because they are small and are apparently doing a good job (as i've not had too many bad throats!) and so wouldn't consider my request.

Nobody seems to want to help me!

 

13

Also have had a slightly coated tongue for years. Don't think it's candida as Fluconazole didn't improve it. Tongue doesn't *seem* to smell at all, though.

Also, when I was on metronidazole and had baby fresh breath, my tongue was still coated. Not sure if any of that can give any clue or not,,.,,

14

Hi.

Still here. No change sad

i've tried everyone's suggestions: Oil pulling, grapefruit seed extract/saline solutions to clean sinuses. Boat loads of pro-biotics.

All it's done is put a dent in my bank balance.

I'm going away with friends in a few days and we're gonna be spending alot of time in a car together. Really wanted fresh breath for that. Was gonna buy some more metronoadozole (only thing that's ever worked for me), but apparently you can't mix it with alcohol, and we'll be drinking.

Spent the last of my wages on CB12 mouthwash this morning (never tried it)

I keep coming back to my tonsils. Possibly also a post nasal drip/sinus issue. 

I do this thing where I kind of breath in and out through my nose, but they're not real breaths. I don't know how to describe what im doing. Sort of flexing my sinuses? I can feel a kind of 'sticky' sensation and hear a little noise when I do it. 

Do everyone's tonsil stones smell the same? 

When my breath is bad, it smells like a milder version of tonsil stones. 

------------------------------------------------------------------------------------- 

I think there's enough evidence to warrant a tonsilectomy. 

I've spoke to my GP once who didn't even entertain the idea of referring me to have my tonsils cut out. 

He said they were nice and small tonsils and have been doing a good job for me based on the fact that I'd not had recurring throat infections according to my medical records.

I'm not sure whether to keep seeing him pretending to have a bad throat so he gets bored of me and refers me for a tonsilectomy?

Or whether to take a loan out to pay for a private tonsilectomy?

Obviously It could be a waste of money (and pain) but I'm starting to get desperate.

If that didn't work i'd have to investigate the effects of permanent use of metronidazole. 

I HAVE heard of some people using it long term for other illnesses, so I guess it's possible.

I also still suspect post nasal drip as a possibilty?Would explain the coated tongue. I also belivee that post nasal drip LEADS to tonsil stones. I think tonsil stones are just the mucus running from the sinuses, into the tonsils, and calcifying. Is there a way to eliminate post nasal drip (even though i'm not certain I have it) to eliminate that as a cause? I've tried various nasal irrigations etc, and nothing seems to change.

15

wat dose of metro did u take? 400mg? how many times per day? and for how long total?

How did u confirm that ur BB was "fresh"? did u ask a friend? Or did u just have a clean taste in ur mouth? The two are completely diff. I have clean taste in mouth but bad smell which I assume is SIBO or a digestion issue, most likely both. I take super high doses of probiotics (5 trillion per day) plus herbal antimicrobials (berberine and essential oils) which has no doubt made my bb smell way better, including that i wake up with fresh taste in mouth, however, the smell remains. so that means there is some infection going on, SIBO? I will have breath test done soon. I had stool analyses from genova and urine analyses, both indicating bacterial overgrowth. However, these tests do not indicate whether it is in the small bowel, just the colon.

Same for me, diet matters somewhat, but even if im doing elemental diet, protein shakes (vegan) and tons of water, my bb is better, but there remains a smell.

Also, do u get bb from nose? could u confirm it was gone during ur metro treatment?

How can u reorder metro? do u not need a prescription in UK? if not, i would do a lot to have u send me some, i can send u payment.

16

Hi. thanks for replying. Felt like I was talking to myself.

I took 250 mg of metro. Just 1 tablet per day, I can always smell my own breath, and I also realised there was no bad taste in my mouth, so I was confident my breath was nice.

But to be certain, I have avery young relative who lives with me who, like most kids, is brutally honest. He's told me my breath stinks lots of times, but when I was on the metro, I kept making a point of talking into his face close up, and he didn't say anything.

I didn't do the same test with my nose, but i'm still 99% sure that it was also odorless.

I'd read hundreds of threads about the drug before trying it.

It doesn't work at all for some people, and it temporarily cures some people.

That's why i'm sure that there's a clue there somewhere which is possibly being ignored by everyone?

When I took it the first time, I happened to find some in my drawer. Must have been prescribed for my brother for a gum infection and he never bothered to take it.

When I try it again, i'll either try to do an online consultation with a pharmacy to get a presription (would need to lie about my symptoms), or i'll be forced to pay way over the odds to an online pharmacy in another country (will obviously do my homework first to avoid getting scammed)

17

i am actually a physician scientist. My two cents on this issue is that the reason for relapse lies with the fact that the underlying issue is not being treated by antibiotics. So, metro is killing a lot of bad stuff, likely in ur small intestines (SIBO), probably in ur colon and perhaps somewhere else in your body (liver? sinuses?). Anyways, while on metro, the anaerobes are kept low, so you feel and smell better. However, the underlying issue is that, by this point, your immune system is weak (from chronic SIBO or infection) to the point where it cannot prevent this from reoccurring. Add to that the fact that you probably were eating a good amount of carbs while on metro, and werent taking probiotics, the result is that you were feeding those bad anaerobes, and not filling in the space they took up with good strains. So when u stop the metro, the bad anaerobes just repopulate the same spaces and boom, you smell again.

How to stop this? I think while on metro u must limit carbs and take probiotics (300billion+). And i dont mean taking primal defense or PB4 or watever crap they sell with less than 50billion CFU, cuz that stuff is worthless. your gut is populated with 100 trillion CFU minimum. do u really think 50 billion will make a difference... no not at all and clinical trials show that. Customprobiotics makes a cheap (cheapest probiotic out there PER CFU!) with 500 billion organisms per scoop, and will last 2-3 months if u use 1 scoop a day. it costs in the 170 range (US), but as i said, its the CHEAPEST on the market. u culd also do VSL#3, but thats pricey. I do both, i prefer custom and i can say that taking any high dose probiotic will benefit u, atleast give u a fresher taste in ur mouth (i have a fresh tasting mouth, but bad breath..., figure that out Dr. Katz, u crooked basterd).

I also think u shuld add in immune support, whether it be arabinogalactan (google) or astragalus, in addition to taking digestive enzymes AND betaine HCL AND 1 goldenseal capsule with EVERY meal. The point here is that many cases of SIBO are caused by poor digestion, pancreatic insufficiency and hypochloridia (low stomach acid). you need ur body to digest efficiently and quickly so the bad guys dont ferment it and proliferate.  Goldenseal just improves digestion bc its a tonic (google).

One last thing, i do think its important to stay on a natural antimicrobial (during?) atleast after or around the end of your antibiotics to kill off any remaining bad guys, or atleast to take for a longer period while u recover from antibiotics (metro still guys some good guys). Uva Ursi is a fantastic natural antimicrobial with activity against a wide range of bad guys. If u want u can also try taking floracol which is sacc. boulardii (friendly yeast) to guard against bad yeasts while ur small bowel is being cleaned up.

Id love to talk, this is the first forum ive ever posted on. Im in the process of getting metro for myself, im not sure if i shuld do 400mg 2x a day or 250 2x a day but im thinking 14-21 days. any suggestions?

Enough is enough, we all have great things to do in life, keep ur heads up. If nothing else, these experiences give us inner strength and an opportunity to discover resilience that we otherwise would never understand.

18

thanks MoneyGun. A fw more things to think about at least.

Yes, the metro was like a Godsend after a decade of false hope.

I always knew that it'd likely stop working when I stopped taking it, but I always had my fingers crossed that i'd be one of the lucky ones who it cures for good.

I still plan to take another course simply because I read of ONE case where the person was temporarily cured with it, then there bad breath came back after a few days of stopping, then they took another course and had nice breath permanently.

I have a new fear now of my system being resiliant to the metro, but I hope not.

I wonder about the possibilty of H pylori. I read the metro can be used on it's own to cure it, but i've also read that you need triple antibiotic to fight it.

I'm thinking of bying a home test kit for H pylori.

Does anyone know how accurate they are?

I don't really want to go straight to the Doctor as i'm sure he'd just fob me off as they always do. Blood tests etc cost them money, you see!

I've bought some expensive mouthwash to hopefull help in next week when i'm away on holiday with friends.

When I get back, I plan to either try to get some more metro and also follow your advice regarding carbs, probiotics etc to give it a better chance of working long term.

Or mayb testing for H pylor first, and then if positive, tell me Dr. that i'd tested positive on a home testing kit and I'd like him to confirm, and then go from there.

My main guesses as to what causes my bad breath are 'tonsil stones', 'acid reflux', 'Post nasal drip', 'infection like H pylor'.

It's SO difficult as they are all fairly 'linked'.

Regarding your question, When I took metro, I only took 1 250mg tab per day. I possibly took 2 tabs on my first day from memory. I took them for about 7 days.

Breath was baby fresh within a day or so. Stayed that way for about 4 days after, and then slowly came back.

I'd go with 2 x 250mg tabs If I was you.

Are you gonna see a Dr. to get a prescription?

19

im gonna ask a friend for a Rx.

So is ur problem strictly a mouth breath problem? like i said, i have fresh taste in mouth, but bad breath (digestive or SIBO). I'm Hpylori negative, and I suspect you will be too. I also suspect that u suffer from digestive issues. Are u constipated? How often do u do a bowel movement? per day/per week? are they smooth, solid pieces or small chunks? is there a smell?

20

strictly a mouth breath problem? I don't really know. I have a bad taste in my mouth. Coated tongue,too. I can smell my own mouth breath but not my own 'nasal breath'. However, I remember a long time ago, a friend told me he could smell a bad smell when I laughed out of my nose, so probably both.

I'm not particularly constipated. Usually 1 - 2 bowel movements a day. There is a smell (but then I think everyone's poop smells!)

Usually smooth and solid. Actually quite a healthy looking stool from what I gather.

My breath does change from day to day which is something that I really stuggle to work out!

Yesterday my breath was really bad all day.

Today, and at this moment in time (and I only have my own sense of smell to go by at the moment) it seems lots better.

My diet has been very similar both days! Confused about that