What causes bad breath even after brushing?

While everyone has experienced bad breath at some point in their lives, some people have chronic halitosis that brushing and mouthwash won’t help. In some cases, these people have breath that smells like feces, which can be indicative of a more serious underlying medical condition that may require prompt medical attention. While poor oral hygiene can cause a person’s breath to smell like poop because of excessive bacterial growth and gum disease, sometimes it’s a symptom of a more significant health issue.

One significant health issue that can cause the breath to smell like poop is an intestinal obstruction. This occurs when your small or large intestine is blocked, trapping feces and fermenting food in your body. This is a dangerous medical emergency that prevents newly ingested food from moving through the intestinal tract and prevents feces from leaving the body, leading to breath that smells like fermenting food and poop. Other symptoms of an intestinal blockage are decreased appetite, bloating, swelling of the abdomen, constipation, nausea, vomiting, diarrhea, severe abdominal pain or cramps, and the inability to pass gas. Depending on the severity and extent of the obstruction, your doctor may prescribe intravenous fluids, or you may require surgery. You will also be medically treated for pain and nausea and instructed to take an antibiotic, to ward off infection.

While an intestinal blockage clearly necessitates immediate medical attention, bad breath may also be a sign of other issues that would best be addressed by a general practitioner. Prolonged vomiting leads to dehydration, and both of these things can cause bad breath. If you’re vomiting because of a bowel obstruction, your breath will smell like feces, but you may be vomiting for other reasons, which will also cause bad breath. If you vomit excessively for any reason, talk to your general medical practitioner. Treatment for vomiting will depend on the cause. Sometimes, as with a virus or food poisoning, the symptom must simply be given time to pass. Depending on duration, treatment may consist of anti-nausea medication and IV fluids, and if you vomit excessively for more than a few days, continue to seek consistent medical attention.

Sinus and respiratory infections may also cause a person’s breath to smell like feces. Infections like bronchitis, colds, viruses, and strep throat generate bacteria that move from your nose to your throat, causing pungently offensive breath. Sinus infections may have other symptoms, like thick, darkly colored nasal mucus, a fever, irritability and fatigue, swollen eyes, headache, and postnasal drip that may cause nausea or vomiting. Severe sinus infections are more prevalent in children than in adults. Most sinus infections can be effectively treated with prescription antibiotics and over-the-counter medication to treat pain and other uncomfortable symptoms that may accompany a sinus infection, like coughing and congestion.

GERD, or gastroesophageal reflux disease, can cause a person’s breath to smell like feces because the stomach acid backs up into the esophagus. This acidic wash irritates the esophagus, which can cause extreme discomfort as well as foul breath. GERD is usually manifested by mild acid reflux once or twice a week, a severe reflux episode at least once a week, heartburn after eating, difficulty swallowing, regurgitation of sour food or liquid, laryngitis, cough, worsened or newly developing asthma, and insomnia. Depending on severity and frequency of symptoms, people with GERD choose a variety of treatments. Some use prescription or over-the-counter medications like antacids or proton pump inhibitors, both of which reduce the production of acid, or medications that help stabilize the lower sphincter of the esophagus. Most people with GERD know what foods aggravate their symptoms; if you do, avoid them when possible. In extreme cases of GERD, doctors may recommend surgery to tighten the lower esophageal sphincter, which prevents stomach acid from splashing into the esophagus.

Another severe medical complication that can cause the breath to smell like poop is ketoacidosis, a serious complication of diabetes. When the body produces excessively high levels of ketones, which are acids in the blood, this is called ketoacidosis; this is most commonly seen in people with type 1 diabetes and requires immediate medical attention and hospitalization. Ketoacidosis causes profound dehydration and dry mouth, as well as prolonged vomiting, all of which can lead to breath that smells like feces. Symptoms of ketoacidosis are extreme thirst, frequent urination, nausea, vomiting, confusion, pain in the abdomen, a flushed face, rapid breathing, fruity-smelling breath, and fatigue; when tested, patients experiencing ketoacidosis have excessively high blood sugar levels and a high levels of ketones in the urine. While hospitalized, a person in a state of ketoacidosis will have their insulin and blood sugar levels medically stabilized, using treatments like insulin therapy and the replacement of fluids and electrolytes. If your ketoacidosis arose as a result of an infection or other illness, you may also receive antibiotics or other medication.

Liver failure is another serious condition that may accompany breath that smells like feces. Acute liver failure requires immediate medical attention and often happens quite suddenly. Again, this leads to profound dehydration, which can cause the breath to smell like feces. Liver failure can lead to weight loss, jaundice, fatigue, loss of appetite, nausea, easy bruising or bleeding, and the buildup of fluid in the abdomen or in the legs. In cases of acute liver failure, you may be given medications that reverse the effects of poisoning, or you may be recommended for a liver transplant if your condition is deemed irreversible by medical specialists. If you have chronic liver failure, which is caused by a condition like cirrhosis, you may be treated for alcohol dependence, medicated for hepatitis, advised to reduce your weight, or treated for other causes of cirrhosis.

If your halitosis is caused by plaque buildup because of your own lapses in oral hygiene, visit the dentist for a cleaning. It will help heal the halitosis and may also allow the dentist insight into a possible underlying medical condition. Try to establish and maintain proper home hygiene, including brushing your teeth, gums, and tongue twice daily with fluoride toothpaste, using an antibacterial toothpaste or mouth rinse if recommended by your dentist, and flossing daily. If you have developed gum disease which is causing bad breath, your dentist can treat that, too, so make an appointment promptly. Treatment for the less-serious causes of halitosis is usually successfully within a short time period. If your dentist suspects a more serious cause for your halitosis, like intestinal obstruction, ketoacidosis, or liver failure, prompt emergency medical care is imperative. When intercepted early enough, these serious conditions can have a positive outcome, and you may be able to recover fully. In all cases, if you have foul breath, especially breath that smells like feces, see your dentist as soon as you can. If you have other symptoms, including those enumerated above, see your doctor immediately.

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