Management of functional constipation-associated halitosis: a retrospective study

Abstract

The features of functional constipation (FC)-associated halitosis were identified in the author’s previous report. In this report, the author aimed to further investigate its treatment and efficacy. This retrospective study reviewed 100 FC patients, including 82 (82%) halitosis patients and 18 (18%) non-halitosis patients. They underwent the organoleptic test (OLT) to diagnose halitosis, and the organoleptic score (OLS) (0–5) was used to evaluated halitosis severity. The Cleveland Clinical Constipation Score (CCCS) (0–30) was used to evaluate FC severity. Patients were treated with the laxative polyethylene glycol electrolyte powder (PGEP) for four weeks. These tests were performed before and after treatment. The author found that, before treatment, the CCCS was 20.00 (18.00–23.00) for all patients, 21.00 (19.00–24.00) for halitosis patients, and 18.00 (17.00–18.25) for non-halitosis patients. A significant difference was observed between halitosis patients and non-halitosis patients (P < 0.001). The OLS for halitosis patients was 3.00 (3.00–4.00). A positive correlation (r = 0.814, 95% CI: 0.732–0.872, P < 0.001) was found between OLS and CCCS. A CCCS ≥18 predicted over 50% probability of halitosis. After treatment, the CCCS significantly decreased to 11.50 (6.00–14.75) (P < 0.001), and OLS significantly decreased to 1.00 (0.00–2.00) (P < 0.001). A positive correlation (r = 0.770, 95% CI: 0.673–0.841, P < 0.001) persisted between OLS and CCCS. A pre-treatment CCCS ≥21 predicted over 50% probability of post-treatment halitosis, while a post-treatment CCCS ≥12 predicted over 50% probability of post-treatment halitosis. The author concludes that the severity of FC parallels the severity of FC-associated halitosis, and can predict the probability of halitosis. Laxative treatment with PGEP is effective in improving FC-associated halitosis.