Halitosis and Helicobacter pylori: A possible relationship

Enzo Ierardi, Annacinzia Amoruso, Teresa La Notte, Ruggiero Francavilla, Stefania Castellaneta, Elisa Marrazza, Rosa Anna Monno, Antonio Francavilla

Research output: Contribution to journalArticlepeer-review


With the aim of investigating a possible relationship between 'objective' halitosis (established by sulfide levels in the breath) and Helicobacter pylori, we performed a study in 58 dyspeptic patients reported to suffer from 'bad breath.' Furthermore, we evaluated the effects on halitosis of eradication therapy (only for H. pylori-positive patients) and chlorhexidine antiseptic mouth rinses (in all patients). Sulfide compound assay indicated objective halitosis in 52/58 patients, 30 of whom were positive and 22 negative for H. pylori. In 19/30 eradication by double therapy provoked a decrease to below the cutoff value of sulfide levels in 15. In the other 11 of the 30 subjects, in whom H. pylori positivity persisted, halitosis parameters did not change. Chlorexidine reduced sulfides to below the cutoff value in 16/22 H. pylori-negative patients, but did not provoke any change in the 11 unsuccessfully treated H. pylori-positive subjects. In these, objective halitosis disappeared only after a successful eradication by triple therapy (9/11). Our results show a possible association between halitosis and H. pylori since bacterial eradication may resolve the symptom. Antiseptic mouthwashes may be effective only in absence of H. pylori, when halitosis may be due to oral putrefactive microbial activity. In a small number of subjects the cause and treatment of halitosis need to be clarified.

Original languageEnglish
Pages (from-to)2733-2737
Number of pages5
JournalDigestive Diseases and Sciences
Issue number12
Publication statusPublished - 1998


  • Bad breath
  • Dyspepsia
  • Halitosis
  • Helicobacter pylori

ASJC Scopus subject areas

  • Gastroenterology


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