Changes in halitosis value before and after Helicobacter pylori eradication: A single‐institutional prospective study

Abstract

Background and Aim Although patients report either improved or worsened halitosis after Helicobacter pylori eradication therapy, such complaints are subjective. Only a few studies have objectively evaluated reports of changes in halitosis after H. pylori eradication; thus, this study aimed to investigate these changes after a successful H. pylori eradication. Methods Between February 2015 and October 2018, 56 347 patients visited the clinic. Informed consent for participation in this study was obtained from 164 patients scheduled to undergo upper gastrointestinal endoscopy due to halitosis. Of the 91 patients with H. pylori infection, the halitosis values were evaluated as Refres breath (RB) values using a Total Gas Detector™ System and compared before and after successful H. pylori eradication, as confirmed with urea breath testing. Results Among the 91 patients treated, 77 patients were successfully eradicated of H. pylori and had their Refres values measured (21 men and 56 women; mean age, 64.2 ± 11.5 years, including 10 smokers); among these 77 patients, 27 showed RB values of > 60. Their RB values significantly improved from 73.5 Â (95% confidence interval [CI], 64.1–82.9) to 59.4 Â (95% CI, 50.0–68.8) (P = 0.038). Of the 30 patients who could be followed up for > 2 years after successful H. pylori eradication, 8 with an RB value ≥ 60 showed significant RB value improvements from 77.9 Â (95% CI, 59.4–96.4) to 30.1 Â (95% CI, 11.6–48.6) (P = 0.0016). Conclusions Helicobacter pylori eradication therapy could improve halitosis, and such improvement could be maintained even 2 years after successful eradication.

Preliminary investigation of a combined herbal extract of Aruncus dioicus, Cirsium nipponicum, and Ocimum basilicum for halitosis

“…[63] Most patients with malodor experience an improvement in halitosis after eradicating H pylori. [35,[64][65][66] H pylori contributes to halitosis by generating hydrogen sulfide and methyl mercaptan. [67] The alterations in the mucosa of the gastric region, characterized by erosive changes, are strongly linked to elevated levels of VSC, indicating that halitosis might stem from damage to the GI mucosa caused by H pylori.…”

Gastric Helicobacter pylori infection does not contribute to extraoral halitosis and its eradication cannot achieve substantial reduction of halitosis

“…19,21 The relationship between H. pylori and halitosis was first proposed by Marshall et al 15 Since then, a growing number of studies support this theory by proving that halitosis is reduced after H. pylori eradication. 18 A meta-analysis with the highest level of evidencebased medicine published in 2016 provided clear evidence that H. pylori infection correlated with halitosis, and H. pylori eradication therapy might be helpful in those patients with refractory halitosis. 20 Based on this theory and successful experience in literature, a large number of patients with extraoral halitosis and good oral hygiene status have been referred to our gastrointestinal clinic by dentists.…”

“…A possible link between H. pylori and halitosis was noted about three decades ago 15,16 . Since then, a number of studies have demonstrated the relationship between halitosis and H. pylori by demonstrating improvement of halitosis after successful eradication therapy 17,18 . Lee et al 19 .…”

“…15,16 Since then, a number of studies have demonstrated the relationship between halitosis and H. pylori by demonstrating improvement of halitosis after successful eradication therapy. 17,18 Lee et al 19 even proved that H. pylori was able to produce VSCs including H 2 S and MM, which suggests that H. pylori can contribute to the development of halitosis.…”

Microbial functional pathways based on metatranscriptomic profiling enable effective saliva-based health assessments for precision wellness

“…For example, left unchecked, chronic oral inflammation may advance to gum disease, and is linked to several conditions beyond the oral cavity, including diabetes, cardiovascular diseases, and Alzheimer’s disease [28] , [29] , [30] , [31] , [32] . Similarly, chronic halitosis is associated with Helicobacter pylori infections, liver disease, and gastroesophageal reflux disease [33] , [34] , [35] . Bi-directional associations like these are opportunities for health professionals to act on findings from early risk assessments and encourage proactive healthcare measures [36] .…”