Why do I have bad breath?

What is bad breath?

Bad breath can come in many forms, levels of severity and can even be triggered by many a wide range of factors.

Simply speaking, it is an unpleasant odour eminating from the breath of a person. Chronic bad breath is referred to as halitosis. Less commonly, it is also called fetor oris, ozostomia or stomatodysodia.

What causes bad breath?

Often identifying the cause of bad breath is the first step towards treating this entirely preventable condition. As mentioned above, it can be caused by a wide variety of things. For example, smoking, dry mouth, a medical condition (such as diabetes) or diet (for example, a diet high in protein or other acid-forming foods, eating garlic and onions or drinking too much coffee or alcohol).

The most common causes of bad breath are preventable and easily treated. However, in some cases, chronic halitosis may indicate an underlying problem in the stomach or digestive system. It is this potential cause that will be considered below.

The digestive system

The digestive tract extends all the way from the mouth right through to the anus. It therefore makes sense that any problems in the digestive tract (such as Irritable Bowel Syndrome, for example – see below), can result in bad breath. As such, it is possible for anyone to suffer from halitosis (including both vegetarians and those who eat meat).

Stomach, intestinal and bowel problems may all be a contributing factor to bad breath. Digestion begins in the mouth. Saliva has digestive enzymes which begin the digestion process, and the type of food eaten can affect the food chemistry of the mouth. Saliva will also pick up odours from food within several hours after it has been eaten. Odours are strongest from carbohydrates (sugars, starches and cellulose), less strong from proteins and non-existent from fats. Bacteria in the mouth react with the decaying food and drink residue and can be the source of foul odour.

Digestive enzymes and nutrition

Digestive enzymes become more important as we get older, because their production by the body decreases as we age. A high level of the naturally-occurring digestive enzymes in foods is also destroyed when they are cooked.

If our bodies are enzyme deficient, they must divert nutrients to manufacture those digestive enzymes, which would otherwise be used to make intracellular enzymes such as catylase and SOD, which protect cells as antioxidants. Lower levels of digestive enzymes can also potentially lead to excess gas formation and putrefaction in the intestines. For some, this can contribute to bad breath gases travelling through the bloodstream and to the lungs, where they are exhaled.

Dairy allergy, lactose intolerance and gluten sensitivity

A dairy allergy or lactose intolerance could also be the cause of bad breath. If you think that this could be the case, you could try eliminating all dairy products from the diet temporarily to see if they are the culprit.

Even if you do not suffer from a dairy allergy or intolerance, some people find that the elimination of dairy products can nonetheless help with the control of bad breath odours. This is because dairy products can thicken mucous in the mouth and contribute to the anaerobic environment bacteria thrive in, leading to the production of volatile sulfur compounds (VSCs). It also supplies lots of protein used in the breakdown by bacteria to form VSCs.

For those individuals who are intolerant to gluten (a protein composite found in foods processed from wheat and related cereals) and are also suffering from halitosis, it is important to ensure that you are drinking a great deal of water to wash away thick mucous and bacteria and to keep the mouth flowing freely with saliva. This decreases mouth pH and increases oxygen, both of which help control halitosis.

Candida albicans

Candida is an overgrowth of yeast (referred to as candidiasis), which usually starts in the gastrointestinal tract and then gradually spreads to other parts of the body. It is a resilient and invasive parasite, which usually attaches itself to the intestinal wall and can (if left untreated) become a permanent resident of the internal organs. One of the known symptoms of candida is bad breath. This is because an abnormally high level of fungal organisms in the intestines may result in increased fermentation of the carbohydrates you eat. This produces a variety of toxins and gases.  

Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, which results in unusual sensitivity and muscle activity. It is sometimes referred to as spastic colon, spastic colitis, mucous colitis or nervous stomach and is a functional disorder, where the function of the bowels may be abnormal, but no structural abnormalities exist.

It is widely accepted amongst naturopathic practitioners and other complimentary and alternative health therapists that bad breath can be a sign of long-term problems in the colon. They believe the health of the gastrointestinal system is integral to overall well-being, and support for IBS (and bad breath symptoms) often involves seeking to restore gut health (including a healthy balance of bacteria).

Dysbiosis

In adults, bad breath is often one of the first signs that normal bacteria levels in the gut are imbalanced. Dysbiosis (also sometimes called dysbacteriosis) refers to a microbial imbalance on or within the body; in other words, an imbalance of “good” versus “bad” bacteria. When levels of friendly bacteria in the digestive system are low, partially digested food decays, producing foul gas and toxemia.

Certain health foods, organic products and food-based supplements (such as herbal colon cleansers, high-strength multi-strain probiotics, digestive aids and cleanse and detox supplements) can offer support in resolving bad breath, particularly where this is linked to digestive health.

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What is coeliac disease?

Coeliac disease (pronounced see-liac and spelled celiac in other countries) is an autoimmune disease, not an intolerance as is often assumed.

This means that the body’s immune system attacks its own tissues, through the production of antibodies. In the case of coeliac disease, this reaction is triggered by gluten.

Gluten is a protein composite found in wheat and related cereals, including barley and rye. If eaten by coeliacs, it inflames and damages the lining of the small intestine.

The primary functions of the small intestine are to breakdown and absorb the nutrients in food. In untreated coeliac disease, the cells lining the small intestine become flat and inflamed and their surface area significantly reduced. This results in a reduction in the absorption of nutrients from food and can lead to malnutrition and deficiencies in vitamins, iron, folic acid and calcium. Sugars, proteins and fats are often poorly absorbed as well.

Coeliac disease is closely related to dermatitis herpetiformis, which is an autoimmune blistering disorder associated with a gluten-sensitive enteropathy.

What causes coeliac disease?

The precise cause, or causes, of coeliac disease are not yet known. However, it is believed that there are three primary factors that underlie its development. These include:

  • an environmental trigger (in this case gluten)
  • a genetic susceptibility
  • an unusually permeable gut.

Occasionally, the stress of an operation, accident, intestinal infection or pregnancy can trigger the onset of the condition.

How is coeliac disease diagnosed?

Research shows that coeliac disease affects around 1 in 100 people in the UK, making it much more common than previously thought. Under-diagnosis is also significant problem, with it being estimated that around 500,000 people have not yet been diagnosed.

Coeliac disease can be diagnosed at any age. For example, even babies can be diagnosed – after weaning, when cereals containing gluten are first introduced into their diet. However, the most common age of diagnosis is currently between 40 and 60 years old.

What are the symptoms of coeliac disease?

The physical signs of coeliac disease vary from person to person and can range from mild to severe – it affects people differently.

Symptoms may present in the digestive tract, or in other parts of the body. For example, one person might have diarrhoea and abdominal pain, while another person may be irritable or depressed. In fact, irritability is one of the more common symptoms in children.

Some of the most common symptoms generally include: tiredness, anaemia, diarrhoea, abdominal discomfort, weight loss, vomiting and mouth ulcers.

Unfortunately, some people present no symptoms at all. While this may sound like a good thing, such people are still at risk of the complications associated with the disease. The longer a person goes undiagnosed and untreated, the greater the chance of developing malnutrition and other complications. Anaemia, delayed growth and weight loss are signs of malnutrition, because the body is just not getting enough nutrients.

In addition, increased incidence of rheumatoid arthritis, diabetes mellitus, autoimmune thyroid disease, sarcoidosis, vasculitis, pulmonary fibrosis, osteoporosis, infertility and other diseases of the gut have been reported in coeliac patients.

How is coeliac disease treated?

Unfortunately, there is currently no known cure for coeliac disease. However, the primary treatment, which is usually very successful, is to remove all sources of gluten from the diet. This approach is also effective in cases of dermatitis herpetiformis.

Concern has surrounded oats containing gluten (as some people with coeliac disease are also sensitive to oats), but studies have shown that consumption of a moderate amount of oats does not worsen dermatitis herpetiformis or celiac disease.

A gluten-free diet is a lifelong commitment, and adherence to a strict diet is difficult to achieve; gluten is present in various foods that are consumed on an everyday basis. Improvement of symptoms can also take several months and requires patience and staying-power. Having said that, a well-planned diet can deliver excellent results.

Nutritional supplementation, in conjunction with a well-balanced diet, is also recommended for patients on a strict gluten-free diet. This will help to ensure that they are receiving the broad spectrum of nutrients (such as vitamins and minerals) that they need. In particular, nutrients-fortified gluten-free meal shakes can be a safe, easy and effective way to achieve this.

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