Bad breath or gallbladder disease?

Sometimes a particularly strong bad breath is not always related to oral hygiene problems. It may be a sign of another ailment and warrant further investigation. In this sense, could bad breath be a sign of gallbladder disease?

According to the gastroenterologist Jan Cubilla, the gallbladder produces strong digestive juices, which flow into the stomach. When mineral stones accumulate in the gallbladder, they can block the bile ducts and cause infection and a series of unpleasant or annoying symptoms, such as fleeting pain, nausea and vomiting - in some cases - especially after eating a greasy meal. But these are not the only ones. Another possible effect, a sign of gallbladder obstruction, is bad breath.

"If the patient is experiencing abdominal problems and suspects or has been told that he or she has bad breath, this may be a sign of problems later. Therefore, from then on you should compare the symptoms of gallbladder disease with the warning signs. If you experience any combination of these symptoms and signs, it's time to see your doctor," he says.

Internal symptoms of gallbladder disease are:

1. Intense pain in the right upper abdomen, especially after a heavy meal. The pain can last from minutes to hours.
2. Sudden fever.
3. Nausea or vomiting.
4. Clay color stools. The lighter color results from insufficient bile (i.e., blocking the gallbladder ducts).

External signs of gallbladder disease are:

1. Excessive bad breath.
2. Itchy rashes on the skin.
3. Tongue coated in white, even if it is brushed.
4. Offensive body odor and yellowish skin.
5. Yellow, discolored eyes and dark circles under the eyes.

"Bad breath alone does not mean that you have gallbladder disease, because it is very rare that bad breath that comes out of nowhere is not due to poor oral hygiene. However, if the bad breath is particularly offensive and is presents along with some of the most notable signs of gallbladder disease, especially unbearable abdominal pain, then there is sufficient evidence to go to a doctor in search of a more accurate diagnosis," Cubilla says.

Diagnosis and treatment
According to Cubilla, to diagnose gallbladder disease, a complete examination of the abdomen must be performed. This will involve checking for pain in the abdomen and one or more of the following tests and procedures may be performed. Some of them are:

Detailed medical history: It is important to have a list of your symptoms and any personal or family history of gallbladder disease. A general health evaluation may also be performed to determine if any other signs of long-term gallbladder disease are present.

Physical exploration: The doctor may try to generate Murphy's sign during the abdominal examination. This maneuver allows you to palpate (feel) the gallbladder and could indicate gallbladder disease.

X-ray of the chest and abdomen: With symptomatic cholecystitis, stones will appear on 20% of abdominal x-rays if they contain calcium. Chest x-ray may reveal pleurisy or pneumonia. A normal radiograph should not rule out further investigations.

Ultrasonography: This is the main diagnostic method and usually reveals the presence of gallstones, thickened walls or any other problem in the gallbladder. Ultrasonography produces images with an instrument that generates sound waves.

Other investigations: Blood tests are done to detect an increase in white blood cells and liver function.

Regarding treatment, in the first episode of gallbladder inflammation, when no stones are present, it is often treated with antibiotics. If the patient has multiple episodes again, surgery is recommended. This can be done either by opening the abdomen or by laparoscopy, which involves making three holes and inserting a camera. This type of surgery allows for easier and faster recovery, with virtually no scarring. If there are no urgent complications, most surgeons prefer this method.

"The gallbladder may at some point form an abnormal connection (fistula) to help process bile from the liver. This is the most serious problem associated with gallbladder diseases. Complications include: bowel obstruction, inflammation, perforation (a hole in the gallbladder), bacterial contamination and malignant transformation," says the doctor.

"Diet may play a role in gallstones. According to the University of Maryland Medical Center, studies have found that those who consume foods with monosaturated fats or omega-3 fatty acids (found in gallstone oil) fish) have a lower risk of gallstones. Fruits and vegetables, nuts, alcohol, and coffee appear to be associated with a lower risk of gallstones. Sugar consumption, however, is associated with a higher risk. of suffering from gallbladder diseases," says Cubilla.