Bad Breath from Stomach Ulcers – Symptoms and Treatment

Bad Breath from Stomach Ulcers – Symptoms and Treatment
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Bad Breath from Stomach Ulcers – Symptoms and TreatmentClinical Content Reviewed by Dr. Jay Khorsandi, DDS
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Table of Contents

  1. What Are Stomach Ulcers
  2. Why Ulcers Affect Your Breath
  3. Signs and Symptoms of Bad Breath from Ulcers
  4. Treatment Options
  5. Preventing Ulcers and Bad Breath
  6. References

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.

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.

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.

Doctors test for the presence of H. pylori by using a simple test known as a urea breath test. Patients first breathe into a special medical bag which can measure the presence of carbon dioxide. They are then given a solution containing a chemical called urea, which 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.

Better breath can start with a healthier gut, and probiotics can restore the balance of acid in your digestive system, so you’re less likely to suffer some adverse effects.

Signs and 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

When stomach ulcers are the cause of your bad breath, tending to your oral health will not be enough to improve the problem.

If H. pylori is determined to be the cause, you will need to see a doctor for a prescription of antibiotics to clear the bacteria out of your system. Be sure to take the entire dose prescribed to you by your physician, even if you are feeling better before you run out of pills. Stopping too early could cause the infection to resurface, forcing you to start the treatment process all over again.

If something else is responsible for your ulcers or if your case is particularly severe, your doctor may also prescribe proton pump inhibitors (PPIs), cytoprotective agents or acid blockers to reduce your stomach's acid content. They may also recommend that you take an antacid in the future to relieve the discomfort of your symptoms.

After you treat your stomach ulcer, you should continue practicing good oral hygiene and see your dentist regularly. This will help to control any periodontal disease in your mouth and freshen your breath.

How Do You Prevent Ulcers and Bad Breath?

There is no way to eliminate all of your chances of contracting stomach ulcers, but you can make them less likely by doing the following.

  • Avoid trigger foods. Everyone is different, but most people find that their body responds poorly to spicy, fatty or acidic foods. If this is the case, consuming these items anyway may produce a surge of acid and increase your chances of developing ulcers.
  • Limit your intake of over-the-counter medications. If you must take NSAIDS, take them after you eat. This lessens the impact they have on your body and keeps your stomach’s natural defenses in good working order.
  • Control your vices. Quit smoking if you can and try to limit your alcohol consumption as much as possible. These things can raise your acid levels if you are exposed to too much of them over long periods of time.
  • Reduce your stress. Although stress does not contribute as much to ulcer formation as previously thought, it can promote excess acid production which does play a role in this process.


Stomach ulcer. (September 2018). National Health Service (NHS). Date fetched: July 30, 2021.

Peptic ulcer. (August 2020). Mayo Clinic. Date fetched: July 30, 2021.

Understanding Ulcers - Prevention. (May 2021). WebMD. Date fetched: July 31, 2021.

Helicobacter Pylori. (2021). John Hopkins Medicine. Date fetched: July 30, 2021.

H. Pylori (Helicobacter Pylori) Breath Test / Urea Breath Test. (2021). Cleveland Clinic. Date fetched: July 29, 2021.

Relationship of Halitosis with Gastric Helicobacter Pylori Infection. (March 2015). Journal of Dentistry of Tehran University of Medical Sciences. Date fetched: July 30, 2021.

Cancer, Stomach Ulcer Bacteria May Cause Halitosis. (January 2009). American Dental Association. Date fetched: July 29, 2021.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.