Teeth Bleaching Planet

Q.For five months, I have been having problems with bad breath. I’ve been to the dentist twice, and that’s not the problem. I also had an MRI that ruled out any sinus problem. One doctor suggested that I have a “slow” stomach/digestive system — that the food sits in my stomach too long and some of the gases creep back up. He thinks this is also because I do not have frequent bowel movements — I can go two or three days without one, and when I do have one, it is not big. He had me try a drug called Propulsid. After a few weeks on that, the problem went away. Now I have been off Propulsid for about three weeks, and the problem is starting up again. What can I do to get my digestive system working normally again without taking medication? I am 35, white, female, and in good health.

Terry

A. Symptoms like bad breath, chronic sore throat, laryngitis, and other ear, nose and throat problems may be due to gastroesophageal reflux disease (GERD) — the reflux of stomach contents into the esophagus or perhaps as high as the throat. Your bad breath may be due to GERD even if you do not have heartburn.

It’s certainly possible, as your doctor suggested, that you also have a problem with delayed stomach emptying. This is sometimes seen in GERD patients, and it may also occur in patients with irritable bowel syndrome — which, in turn, may be the cause of your constipation. The improvement on Propulsid is likely due to improvement of stomach emptying. This can happen independent of any change in your bowel movements. An occasional patient will have improvement in constipation on Propulsid, but a more effective way to improve constipation is to add fiber (Metamucil or bran), fruits and vegetables to your diet; for details, see my earlier column on Stopping Long-term Laxative Use.

You might keep a diet diary to see which foods cause you to fill up fast or bloat; these are signs of slowed stomach emptying. Also, eat smaller, more frequent meals and exercise regularly to improve stomach or bowel function. You may wish to see your doctor to be evaluated with a nuclear X-ray (in which you eat a meal containing a substance visible on X-rays so that the doctor can track how fast the stomach empties over the next hour or two). This can show whether your stomach empties slowly.

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