Bad Breath from Stomach Ulcers – Symptoms and Treatment

If you experience bad breath regularly, stomach ulcers are a potential cause. These tummy aches stem from an infection of H. pylori, a common strain of bacteria linked to bad breath and periodontal disease.

Treating stomach ulcers requires a course of antibiotics and various measures to reduce the amount of acid inside the body. You can prevent this problem by eating well, taking time to relax, reducing your smoking and alcohol intake, and avoiding excessive use of common anti-inflammatory drugs.

What Are Stomach Ulcers?

Stomach ulcers are open sores that form in the inner lining of the stomach or small intestine. They are also sometimes called peptic ulcers. They develop gradually and can occur in isolated instances or in clusters.

Stomach ulcers are caused by a strain of bacteria known as Heliobacter pylori, or H. pylori. These bacteria secrete an enzyme known as urease, which attacks and weakens your stomach lining. When this happens, your stomach’s tissues become vulnerable to the acid in your system and ulcers start to form in response to this exposure.

Ulcers may also develop because of medications you take. Certain anti-inflammatory drugs (also known as NSAIDS) can inhibit the natural mechanisms your body uses to protect your stomach lining from the acid inside it, causing ulcers to form.

How are ulcers diagnosed?

If your doctor believes your bad breath is caused by H. pylori, you’ll need testing to confirm the diagnosis. Researchers say a urea breath test (UBT) is a useful first step, as it’s simple and not painful or invasive.

A typical UBT involves the following steps:

• Prepare. Medications like antibiotics and proton pump inhibitors can alter your results and make the test less accurate. Your doctor will ask you to stop these medications for several days (sometimes weeks) before the test.

• Provide a sample. You’ll breathe through a straw into a sample collection bag. This sample will be compared to another you’ll give later during the test.

• Take medication. Your doctor will give you a pill or liquid that contains urea.

• Provide a second sample. You’ll use a straw to breathe into a new sample collection bag.

The urea reacts to the presence of H. pylori by breaking it down into carbon dioxide. If there is significantly more carbon dioxide in the second bag compared to the first, doctors consider you infected with H. pylori and susceptible to ulcers.

Doctors may also try more invasive procedures, such as an endoscopy or a biopsy, to confirm the presence of ulcers when a urea test is inconclusive or when further certainty is required.

Why Do Ulcers Affect Your Breath?

Ulcers themselves do not cause bad breath, but the H. pylori bacteria is a contributing factor. Studies show that people suffering from halitosis (bad breath) are more likely to have H. pylori in their system than people in control groups. Since not all people with the infection also develop halitosis, the exact relationship between the two is still under investigation. These bacteria are also associated with the presence of periodontal disease, which may account for some of the foul smell.

Stomach ulcers also indicate that you may have excessive amounts of acid in your body. If so, you may experience additional medical conditions such as acid reflux, which further contributes to bad breath.

Treating your stomach ulcers will reduce your acid levels and may help to reduce the symptoms of these other conditions as well.

Do ulcers cause bad breath in everyone?

Most people already have H. pylori bacteria lying dormant inside them. For many, this is not a cause for concern. Only a small minority of people will go on to develop ulcers due to the impact of this infection, and the bacteria are harmless otherwise. In addition, not everyone who has H. pylori problems develops bad breath.

In 2015, researchers conducted a study of the connection between H. pylori and bad breath. They studied people with ulcers and bad breath, and they compared those results to people with no ulcers and no bad breath. They found H. pylori infection in 91% of people with bad breath, but 32% of those with no infection had bad breath too.

The scent of your breath can shift for all sorts of reasons. If your breath is bad, it doesn’t always mean that you have an ulcer. The American Dental Association says the following conditions can cause bad breath:

• Dry mouth

• Gum disease

• Foods like garlic or coffee

• Smoking or tobacco use

• Sinus conditions

• Diabetes

• Liver disease

• Kidney disease 

If you have bad breath that just won’t go away, talk with your doctor about testing and what to do next.

Signs & symptoms of bad breath from ulcers

The bad smell of your breath alone is not enough to know what caused it. If stomach ulcers are the culprit, you will also notice some of the following signs:

• Burning or gnawing pain in your abdomen

• Indigestion

• Heartburn

• A loss of appetite

• Unintentional weight loss

• Fatigue

• Generally feeling ill

There are also some symptoms of ulcers which indicate that you may be experiencing serious complications such as internal bleeding. Without prompt treatment, you could experience significant and irreversible damage to your internal organs or even die. Call your doctor or head to the emergency room immediately if you are:

• Vomiting blood (this may be ordinary red blood or dark and grainy-looking like coffee grounds

• Passing dark, sticky stools that resemble tar

• Feeling a sudden and sharp pain in your abdomen that worsens over time

Treatment options for bad breath

Addressing your bad breath starts with understanding the cause. When you know what’s wrong, you can work with your doctor on an appropriate solution. These are some of the methods your doctor might suggest: