Bad Breath and Proton Pump Inhibitors

Many people are confused about the relationship between bad breath and proton pump inhibitors: do these drugs for gastroesophageal reflux disease (GERD) cause halitosis? The confusion arises from the fact that GERD itself is thought to be a cause of halitosis.

GERD is often cited as a cause for halitosis and proton pump inhibitors are a standard treatment for GERD-the idea that these drugs may cause the bad breath, or make it worse is a relatively new development. Some medical professionals, in fact, will assume halitosis in a patient with acid reflux is caused by the condition and use GERD drugs to treat it. We need more research to investigate proton pump inhibitors and bad breath to clarify these issues.

In 2006, Brazilian researchers reported on a study that suggested a link between bad breath and proton pump inhibitors. They reported that a large percentage of patients taking these drugs have halitosis. Furthermore, their research showed a relationship between halitosis and proton pump inhibitors regardless of whether the breath odor originated in the mouth or from a non-oral source. They suggested that the underlying cause was an overgrowth of bacteria, in either the mouth or the intestine, caused by the drug.

Interestingly, many experts feel that relatively few cases of halitosis are caused by acid reflux and odors traveling up the throat from the stomach. This lends more support to the suggestion that halitosis and proton pump inhibitors may be linked: it is possible some cases of bad breath associated with GERD in the past were actually caused by the drugs instead. In addition, it suggests that treating halitosis in GERD patients with these drugs may actually make the problem worse. The answers remain far from clear: more research on bad breath and proton pump inhibitors is required.

For the present, when patients suffer from bad breath and proton pump inhibitors are necessary for the treatment of GERD, the best recourse is still a good breath product that targets the bacteria that produce bad odors in the mouth. At least for those whose halitosis originates in the mouth, this approach should offer some relief.

Patients suffering from either halitosis or GERD should consult a qualified medical professional to determine the best course of treatment.