Association Between Halitosis Diagnosed by a Questionnaire and Halimeter and Symptoms of Gastroesophageal Reflux Disease

Abstract

Background/Aims The relationship between halitosis and gastroesophageal reflux disease (GERD) remains controversial. The aim of this study was to investigate an association between subjective and objective halitosis and GERD. Methods The subjects were enrolled from participants who visited a health promotion center at Seoul National University Bundang Hospital. For diagnosis of halitosis, a questionnaire was requested, and volatile sulfur compounds (VSCs) were measured by Halimeter. Self-conscious halitosis was defined as halitosis perceived by himself or herself. Informed halitosis was defined as halitosis perceived by others. Objective halitosis was defined when mean VSCs values were > 100 parts per billion. GERD was defined based on a questionnaire and endoscopy, including erosive esophagitis and non-erosive reflux disease (NERD). Results A total of 54 subjects (male:female = 33:21) with mean age of 46.0 ± 11.4 years were analyzed. The mean VSCs values were not significantly different between presence and absence of self-conscious halitosis ( P = 0.322), but significantly different between presence and absence of informed halitosis ( P = 0.021). Informed halitosis was associated with objective halitosis ( P = 0.039). GERD, erosive esophagitis and NERD did not correlate with objective halitosis ( P = 0.556, 0.206 and 0.902, respectively). In multivariable analysis, the relationship between objective halitosis and GERD symptoms including chest pain, heart burn, acid regurgitation, epigastric pain, hoarseness, globus sensation and coughing was not significant. Besides, GERD was not associated with self-conscious halitosis, informed halitosis and objective halitosis, respectively. Conclusions GERD might not be associated with self-conscious, informed halitosis and objective halitosis indicated by Halimeter results. Informed halitosis could be correlated with objective halitosis determined by the Halimeter.

Influence of tobacco smoking on the development of halitosis

“…The prevalence of halitosis varies according to the study population, because the perception of halitosis differs among culturally diverse populations [4] . In Japan, population-based studies have reported the prevalence of halitosis to be 6–23% [5] , [6] .…”

Sex and Gender Differences in Gastroesophageal Reflux Disease

“…1,8,16,[93][94][95] Whether extra-esophageal reflux symptoms are truly related to esophageal reflux remains controversial. A recent study has shown that the presence of reflux symptoms is related to significantly higher levels of TRPV1, PAR2, and IL-8.…”

Halitose: approches diagnostiques et thérapeutiques pluridisciplinaires

“…Bien que la recherche de H. pylori n’a pas été faite chez tous nos patients (absence de moyens financiers), nos résultats ont montré une forte fréquence de l’infection au cours de l’halitose (sur 10 patients atteints d’halitose dépistés pour l’infection à H. pylori , 90% étaient porteurs de la bactérie), confortant ainsi le lien supposé entre H. pylori et l’halitose retrouvé dans la littérature [10, 21-23]. Mais les études existantes montrent des résultats contradictoires; pour d´autres études l´halitose serait liée aux maladies du TGI autres que l´infection à H. pylori [20,24]. Moshkowitz et al ont en effet rapporté une forte association entre la survenue et la sévérité de l’halitose avec le reflux gastro-œsophagien (RGO) [20] et l’absence de lien entre d’autres facteurs de troubles dyspeptiques tels l’ulcère peptique ou l’infection à H. pylori et l’halitose [20, 25].…”