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PubMed2001

Spontaneous fluctuations in the concentrations of oral sulfur-containing gases.

Breath hydrogen sulfide (H2S) and methyl-mercaptan (CH3SH) concentrations are used as quantitative indicators of halitosis. However, measurements of these gases in duplicate oral samplings often show poor reproducibility. To determine if this poor reproducibility is an artifact of the collection/analytical procedure or a true biological phenomenon, we used a standardized technique to collect from 20 to 30 oral gas samples at two-minute intervals from 11 healthy subjects. The samples were analyzed for sulfur gases and CO2. Sizable variations in H2S and CH3SH concentrations were not associated with alterations in CO2, indicating that the variations did not reflect variable contamination with atmospheric or pulmonary gas. In addition, fluctuations in H2S and CH3SH were not identical and often were not random. We conclude that minute-to-minute variability in oral sulfur gas concentrations is a true biological phenomenon. This fluctuation complicates experimental studies designed to show that interventions alter halitosis.

Adult↗
PubMed2001

Clinical and microbiological effects of oral zinc ascorbate gel in cats.

The clinical and microbiological effects of zinc ascorbate gel applied orally in cats were evaluated during a 42-day study period. Cats were divided randomly into two equal groups, with the treatment group (18 cats) receiving zinc ascorbate gel and the control group (18 cats) receiving a placebo (0.9% sterile saline). Clinical parameters evaluated biweekly included halitosis, plaque, calculus, and gingivitis. Aerobic and anaerobic bacterial cultures were obtained from cats in the treatment group at Days 0 and 42. There was a significant decrease in plaque, gingivitis, and anaerobic periodontal pathogens in treatment group cats. Halitosis and calculus scores were not significantly different in treatment group compared with control group cats. The results of this study suggest that zinc ascorbate gel used as an oral antiseptic improves feline oral health, and may be most effective in decreasing bacterial growth, plaque formation, and gingivitis when applied following a professional teeth cleaning procedure.

Administration, Topical↗
PubMed2003

Reliability of clinical parameters for predicting the outcome of oral malodor treatment.

We conducted the present study to determine which clinical parameters for diagnosing halitosis are most reliable in the development of an accurate prognosis for oral malodor treatment. Clinical evaluation included a questionnaire, oral examination and volatile sulfur compounds (VSC) measurement, and organoleptic test (OLT) at baseline. Ninety-two patients classified with oral pathologic halitosis were treated in a similar manner. Improved treatment outcome was defined as < 0.25 ppm of total VSC, < or = 2 OLT score, and < 30 on the "sad feeling" scale as subjective stress level by oral malodor 6 months after baseline. Thirty-four patients demonstrated improvement due to the treatment. In a multiple logistic model, pocket depth, OLT score, intra-oral discomfort, and self-perception of oral malodor at baseline displayed significant association with "not improved outcome". These results suggest that malodor- and periodontal-disease-related parameters and self-estimation of malodor at baseline are effective for prediction of outcome.

Adolescent↗
PubMed1995

Assessing the contribution of anaerobic microflora of the tongue to oral malodor.

Research suggests that the tongue plays an important role in the production of oral malodor. To investigate the role of tongue surface characteristics and oral bacteria in halitosis development, the authors tested associations between odor measurements, volatile sulfur compound levels, periodontal parameters, tongue surface characteristics, presence of trypsinlike activity of organisms on the tongue and teeth and bacteriological parameters in 16 participants with complaints of oral malodor. The data indicate that the proteolytic, anaerobic flora residing on the tongue plays an essential role in the development of halitosis.

Adolescent↗
PubMed2001

Effect of different mouthrinses on morning breath.

BACKGROUND: Morning breath odor is an often-encountered complaint. This double-blind, crossover, randomized study aimed to examine the bad breath-inhibiting effect of 3 commercially available mouthrinses on morning halitosis during an experimental period of 12 days without mechanical plaque control. METHODS: Twelve medical students with a healthy periodontium refrained from all means of mechanical plaque control during 3 experimental periods of 12 days (with intervening washout periods of at least 3 weeks). A professional oral cleaning preceded each period. During each experimental period, as the only oral hygiene measure allowed, the students rinsed twice a day with one of the following formulations in a randomized order: CHX-Alc (a 0.2% chlorhexidine [CHX] solution); CHX-NaF (CHX 0.12% plus sodium fluoride 0.05%); or CHX-CPC-Zn (CHX 0.05% plus cetylpyridinium chloride 0.05% plus zinc lactate 0.14%). After 12 days, morning breath was scored via volatile sulfur compound (VSC) level measurements of the mouth air and organoleptic ratings of the mouth air, the expired air, and a scraping of the tongue coating. At the 12-day visit, a questionnaire (subjective ratings) was completed and samples taken from both the tongue coating and the saliva for anaerobic and aerobic culturing and vitality staining. The de novo supragingival plaque formation was also recorded. All parameters were correlated with the baseline registrations. RESULTS: Although oral hygiene during the 3 experimental periods was limited to oral rinses, bad breath parameters systematically improved, with the exception of a slight increase in VSC levels while using CHX-Alc, a finding which was associated with the direct influence of the CHX on the sulfide monitor. The oral microbial load after the use of CHX-NaF remained unchanged, while for the CHX-Alc and CHX-CPC-Zn, significant reductions in both aerobic and anaerobic colony forming units (CFU)/ml were noticed in comparison with baseline data for both tongue coating and saliva samples. The composition of microflora, on the other hand, did not reveal significant changes. The supragingival plaque formation was inhibited, in descending order, by CHX-Alc, CHX-CPC-Zn, and CHX-NaF. The subjective scores for the rinses indicated a higher appreciation for CHX-CPC-Alc and CHX-NaF because of a better taste and fewer side effects. CONCLUSIONS: The results of this study demonstrate that morning halitosis can be successfully reduced via daily use of mouthrinses. CHX-Alc and CHX-CPC-Zn mouthrinses result in a significant reduction of the microbial load of tongue and saliva.

Adult↗
PubMed1999

An inventory of patients' response to treatment at a multidisciplinary breath odor clinic.

OBJECTIVE: This study was undertaken to assess patients' response to their treatment at a multidisciplinary oral malodor clinic. METHOD AND MATERIALS: In 4 years, a multidisciplinary breath odor clinic in Belgium examined 406 patients. The team consisted of an ear, nose, and throat specialist, a periodontologist, occasionally a specialist in internal medicine, and, more recently, a psychiatrist. After the initial visit, each patient was scheduled for a follow-up appointment 2 to 6 months later; however, only 143 patients (35%) showed up for this control visit. The remaining 65% of the patients answered a mailed questionnaire. RESULTS: About half of the patients who returned no longer had complaints, while 17% reported no improvement. This group was characterized by imaginary bad breath and manifest psychologic problems. There was also disbelief of their cure, although clinical examination (organoleptic evaluation and volatile sulfide measurement by means of a portable monitor) did not reveal any oral malodor. Some also insufficiently performed the recommended oral hygiene measures (tongue brushing and interdental cleaning). Most of the patients who returned the questionnaire were disappointed by the suggestion that their halitosis was the result of insufficient oral hygiene. CONCLUSION: Better education of both the public and dental professionals as to the most frequent cause of halitosis, insufficient oral hygiene, might elevate the level of compliance by patients.

Adolescent↗
PubMed2002

[Origin and treatment of bad breath].

Halitosis affects more than 60% of the population. In about 8% of the cases, halitosis is related to an ENT pathology, and in less than 1% to gastric dysfunction. Ninety percent of these problems are associated to an oral disease. Gram-bacteria are often responsible of bad breath. They transform some amino-acids in volatile sulphur compounds. These bacteria are, also, directly associated with periodontal diseases which affect a major part of the adult population. These diseases are the most important cause of tooth loss after the age of thirty-five, with progressive destruction of supporting tissues of the teeth.

Adult↗
PubMed2003

[Effect of spirochetes and porphyromonus gingivalis on oral malodor].

OBJECTIVE: To assess the effect of Spirochetes and Porphyromonus gingivalis (Pg) on the production of volatile sulfur compounds (VSCs) and oral malodor, respectively. METHODS: 117 systemically healthy periodontitis patients were divided into two groups according to organoleptic rating (OR) by organoleptic method: 85 subjects with oral malodor (halitosis group, HG) and 32 cases without oral malodor (no-halitosis group, NHG). VSCs measurements were made with halimeter. Subgingival plaques and tongue coating were taken to calculate the proportion of Spirochetes (with 2% Congo Red Smears, S%) and the amounts of Pg (with indirect immunofluorescence method). The examination will be repeated in 46 HG cases after periodontal therapy. RESULTS: S% in PD < 4 mm sites of HG was significantly higher than that in NHG (P < 0.01). S% in PD >or= 4 mm sites and tongue coating, Pg in all three sites were not different between two groups. In HG, OR and VSCs levels were correlated with S% in tongue coating (P < 0.01, P < 0.05) and PD < 4 mm sites (P < 0.05), and not correlated with S% in PD >or= 4 mm sites. OR was related to Pg in PD >or= 4 mm sites (P < 0.05) and there was no relationship between OR and Pg in tongue coating and PD < 4 mm sites. VSCs levels was not correlated with Pg in all three sites. S% in tongue coating and subgingival plaque, Pg in subgingival plaque, OR and VSCs levels were significantly reduced after periodontal therapy (P < 0.01). CONCLUSIONS: The direct relationship of Spirochetes and Pg respectively to bad breath was not found obviously. But Spirochetes is one of the microorganism on oral malodor. Periodontal therapy can improve oral malodor.

Adolescent↗
PubMed1997

[Bad breath from the oral cavity].

Halitosis, or bad breath, is a clinical problem for many people. In the majority of cases the problem has been shown to originate in the oral cavity. All conditions that favour the retention of anaerobic, mainly gram-negative, bacteria will predispose for the development of bad breath. In addition to periodontal pockets, the most important retention site is the dorsum of the tongue with its numerous papillae. The bacteria metabolize sulphur-containing amino acids to yield the volatile sulphur-containing compounds hydrogen sulphide and methylmercaptane. These substances have an offensive odour in very low concentrations. The sulphur compounds may also damage the surrounding tissue directly, and thereby contribute to the initiation and development of periodontal disease. During the night and between meals the conditions are optimal for odour production. The importance of regular meals is therefore emphasized. To supplement conventional oral hygienic measures the patients are advised to brush their tongue. The use of oral care products which contain metal ions, especially zinc, will inhibit odour formation because of the affinity of the metal ion to sulphur. It is also possible to measure the level of volatile sulphur-containing compounds in the air in the mouth directly by means of a portable sulphide monitor. Dentists and physicians are both advised to discuss the problem of halitosis with their patients, since this should be regarded as an important aspect of the patient's health.

Halitosis↗
PubMed1998

Oral malodor measurements on a tooth surface of dogs with gingivitis.

OBJECTIVE: To measure production of volatile sulfur compounds (VSC) responsible for halitosis on the crown surface of the maxillary fourth premolar of dogs with gingivitis. ANIMALS: 28 dogs owned by veterinary students who complained that their dogs had halitosis. PROCEDURE: Clinical dental indices (plaque index, calculus index, and gingival index) were measured on the most diseased maxillary fourth premolar tooth. Production of VSC from the crown surface of the tooth was recorded by use of a portable sulfide monitor. Measurements were performed several times on each dog over a 2-month period, resulting in 98 series of measurements. RESULTS: Dogs with heavy amounts of plaque or calculus (plaque and calculus indices of 2 or 3) had significantly higher VSC readings than did dogs with no visible plaque and calculus accumulation. Significant (P = 0.0008) correlation was found between VSC measurements and plaque index, and significant correlations were found between VSC measurements and calculus index (P = 0.00118) and gingival index (P = 0.00475). CONCLUSION: VSC production recorded on the crown of maxillary fourth premolar teeth of dogs with gingivitis is significantly correlated with the amount of plaque and calculus accumulation and with severity of gingivitis. CLINICAL RELEVANCE: VSC measurements on tooth surfaces could be used as a site-specific method to assess, in conjunction with clinical dental variables, effectiveness of dental hygiene products.

Animals↗
PubMed1995

Use of intraoperative corticosteroids in pediatric tonsillectomy.

OBJECTIVE: To determine the effects of a single dose of dexamethasone sodium phosphate on postoperative morbidity in children undergoing tonsillectomy. DESIGN: Randomized, double-blind, placebo-control clinical trial. SETTING: Academic, tertiary care children's hospital. PATIENTS: Sixty-nine children (35 boys, 34 girls), aged 3 to 18 years, undergoing tonsillectomy with or without adenoidectomy. INTERVENTION: Patients were randomized to receive a single dose of intravenous dexamethasone or saline. MAIN OUTCOME MEASURES: Pain scores, determined by a Faces Scale, were obtained at 4-hour intervals during the first postoperative day and daily for 7 days thereafter. Total use of an analgesic; type of diet; level of activity; presence of halitosis, nausea, emesis, or fever; and incidence of postoperative bleeding were also compared between the two groups. RESULTS: The two groups of children were similar in age, gender, diagnosis, and surgical time. Pain scores in the postoperative period were identical while the patients were in the hospital and for the first 7 days after discharge. No statistically significant differences were noted in pain scores, nausea, emesis, halitosis, analgesic medications required, diet, or activity levels between the two groups of patients. CONCLUSION: A single intraoperative dose of dexamethasone did not appreciably affect postoperative morbidity in children undergoing tonsillectomy.

Adolescent↗
PubMed1993

The results of functional endoscopic sinus (FES) surgery on the symptoms of patients with cystic fibrosis.

The relationship between cystic fibrosis (CF) and sinus disease has been appreciated since at least 1959. Unfortunately the standard methods used to treat sinus disease have been very unrewarding in the CF patients. We evaluated the long-term results achieved on 17 patients with CF that underwent FES surgery between July 1988 and January 1991. This group consisted of 16 pediatric and 1 adult patients with previously diagnosed CF, documented chronic sinus disease and nasal polyposis that had failed long-term maximal medical management. The patients, or their parents, were contacted and asked to rate the severity and frequency of their symptoms associated with chronic sinus disease, pre- and postoperatively. The specific symptoms evaluated were nasal obstruction, nasal discharge, postnasal drip, halitosis and cough. In addition, we attempted to measure the number of hospitalizations and the presence and frequency of headaches. We were able to show that, while there was no change in the relative health of patients as measured by the number of hospitalizations, there was a significant improvement in the quality of life. There was a marked decline in the frequency of nasal obstruction, nasal discharge and postnasal drip and a high level of patient satisfaction with the procedure. No changes were seen in the frequency or nature of the cough, halitosis or headache.

Adolescent↗
PubMedDate not supplied

Oral findings and health status among hospitalized patients with physical disabilities, aged 60 or above.

The purpose of the study was to determine oral health status and the prevalence of oral mucosal lesions among hospitalized elderly patients with physical disabilities. The study group consisted of 111 (43 male and 68 female) elderly patients with physical disabilities. Clinical examination and interview methods were employed. Clinical examination revealed that 45.9% of the elderly patients had one or more oral mucosal lesions. Xerostomia (58.6%), coated-hairy tongue (54.1%) and halitosis (46.8%) were the most frequently encountered oral findings and mucosal lesions. As the most interesting finding discovered in elderly patients, macroglossia (30.6%) seems to depend on physical disability. Coated or hairy tongue was commonly related to poor oral hygiene, with both crude odds ratio (OR) of 3.25 (95% CI: 1.26-8.36) (P=0.021) and the logistic regression OR of 3.36 (95% CI: 1.21-9.33) (P=0.020). Halitosis and bruxism were commonly related to dentate patients [logistic regression OR of 0.29 (95% CI: 1.12-0.74) (P=0.009) and 0.21 (95% CI: 0.06-0.74) (P=0.016); respectively]. Increase in dental problems may have negative impacts on chewing, nutrition, aesthetics and phonation in elderly patients. It is particularly noteworthy that physical disability in elderly patients limits their ability to effectively follow oral hygiene procedures.

Aged↗
PubMed2004

Medium-term follow-up after deployment of ultraflex expandable metallic stents to manage endobronchial pathology.

BACKGROUND: Between March 1997 and March 2004 we deployed 80 Ultraflex metallic expandable stents (Boston Scientific, Waterson, MA) in 69 patients under direct vision using rigid bronchoscopy. We report our medium- to long-term experience in patients for whom these stents were deployed. METHODS: To date 15 patients have been followed for more than 1 year (median 41 months, range 12 to 83 months) after stent deployment. Indications for stenting in these patients were neoplasia (5), stricture (5), airway malacia (1), iatrogenic tracheal tear (1), and compression from an aortic aneurysm (1), a right interrupted aortic arch (1), and a right brachiocephalic artery aneurysm with tracheomalacia (1). Ten tracheal stents (9 covered, 1 uncovered) and 10 bronchial stents (8 uncovered, 2 covered) were inserted, and 5 patients received two stents. RESULTS: Five of these patients experienced no long-term problems. Complications included troublesome halitosis (5), which was difficult to treat despite various antibiotic regimes; granulation tissue formation above and below the stent that was successfully treated with low-power Nd:YAG laser therapy (7); and metal fatigue (1). We did not encounter stent migration. CONCLUSIONS: We conclude that Ultraflex expandable metallic stents have an important role in the management of selected patients with diverse endobronchial pathologies and are well tolerated in the long-term. Although associated granulation tissue can be successfully treated with Nd:YAG laser, halitosis can be a difficult problem to address.

Adult↗
PubMed2004

Ethnoveterinary practices of owners of pneumatic-cart pulling camels in Faisalabad City (Pakistan).

The present study was planned to investigate the ethnoveterinary methods practiced by the owners of pneumatic-cart pulling camels in Faisalabad Metropolis (Pakistan). During a 7-year-period (November 1992-November 1999), 200 owners of draught camels working in the city were interviewed. Information concerning the ethnoveterinary practices for the treatment of common disorders of digestive tract (indigestion, colic and diarrhea), respiratory tract (cold/rhinitis, pneumonia), skin problems (mange, ulceration of nostrils with or without nasal myiasis, ticks and lice, harness sores), systemic states (fever, ze/rba/d, anhidrosis) and preventive therapy of indigestion and halitosis was collected through interviews and collated with those documented for the treatment of desert-dwelling camels. Familiarity of owners with two traditional methods of surra (trypanosomiasis) diagnosis ('Sand-ball test' and 'Hair-stick test') known to pastorilists was also probed. In addition, the dose and frequency of use of common salt was investigated. Traditional inputs utilized by the camel owners included various plant products, insecticides, sulphur, sump oil, common salt, aspirin, naphthalene balls and milk fat. Different owners used different combinations of traditional drugs for the treatment of disorders/conditions investigated. None of the camel owners was found familiar with the 'Sand-ball test' or 'Hair-stick test' of trypanosomiasis diagnosis. For the prevention of indigestion and halitosis all camel owners had practiced administration of 'massaulas' (physic drench/balls) along with common salt (average 250 g) on weekly basis. Firing had not been used by any owner. In general, the ethnoveterinary treatment practices used by the owners of city-dwelling camels appear to be different from those documented for the treatment of diseases of desert-dwelling camels.

Animal Diseases↗
PubMed2006

Antibiotics to improve recovery following tonsillectomy: a systematic review.

OBJECTIVE: To determine if antibiotics improve recovery following tonsillectomy. STUDY DESIGN DATA SOURCES: Electronic databases Medline, Embase, and Cochrane Controlled Trials Register were searched using relevant search terms. Additional trials, if any, were retrieved by searching the references from all identified trials, reviews, correspondences, editorials, and conference proceedings. No language restriction was applied. STUDY SELECTION: Systematic review of trials in which antibiotic was administered as a study medication intraoperatively and/or postoperatively, in children or adults undergoing tonsillectomy or adenotonsillectomy. Only randomized, placebo-controlled, double-blind trials attaining preset quality scores were included. Outcomes analyzed: 1) pain, need for analgesia, fever, halitosis, and return to normal diet and activities; 2) secondary hemorrhage using 2 parameters-significant hemorrhage (ie, warranting readmission, blood transfusion, or return to theatre for hemostasis) and total hemorrhage; and 3) adverse events. RESULTS: Five trials met the eligibility criteria. Antibiotics significantly reduced the number of subjects manifesting fever (relative risk [RR]: 0.62, 95% confidence interval [CI]: 0.45, 0.85) and duration of halitosis (-1.94 [-3.57, -0.30] days), and marginally reduced the time taken to resume normal activity (-0.63 [-1.12, -0.14] days), but had no significant effect in reducing pain scores (-0.01 [-0.60, 0.57]) or need for analgesia. Similarly, there was no significant difference in the time taken to resume normal diet or incidence of significant and total hemorrhage, although data was underpowered to detect differences for these outcomes. In the antibiotic group 4 patients developed an adverse reaction (3 cases of rash and 1 case of oropharyngeal candidiasis), while in the control group 1 patient had an adverse reaction (rash). The RR of antibiotic-related adverse events was 2.45 (0.45, 13.31). CONCLUSION: Antibiotics appear to be effective in reducing some, but not all, morbid outcomes following tonsillectomy, and may increase the risk of adverse events. Further trials are needed to better define the role of antibiotics in facilitating post-tonsillectomy recovery. EBM RATING: A-1a.

Adenoidectomy↗
PubMed1998

Helicobacter pylori infection in patients affected by insulin-dependent diabetes mellitus.

BACKGROUND/AIM: Insulin-dependent diabetes mellitus (IDDM) is the result of an autoimmune destruction of pancreatic Langerhans beta cells. Helicobacter pylori infection, the most common cause of gastritis and peptic ulcer, has been associated with some autoimmune diseases. The aim of this study was to evaluate the prevalence of H. pylori infection and gastrointestinal (GI) symptoms in patients with IDDM. METHODS: 116 patients (50 males and 66 females, mean age: 35 +/- 11 years) affected by IDDM were evaluated; 50 healthy subjects matched for age and sex were utilized as a control group. H. pylori infection was determined by a [13C]urea breath test. IDDM duration, daily dosage of insulin and prevalence of GI symptoms (bloating, pyrosis, epigastric pain, belching, halitosis, nausea) were assessed. RESULTS: The prevalence of H. pylori infection was similar in IDDM patients and in controls (37 vs 34%, respectively). In both groups, the mean age was higher in infected subjects. The mean IDDM duration was significantly greater in infected patients (19 +/- 12 vs 13 +/- 10 years, P < 0.006). Prevalence of infection was directly related to the duration of IDDM (<1 year, 23%; 1-3 years, 32%; >3 years, 40%). The daily dosage of insulin did not differ between infected and non-infected subjects. H. pylori contaminated patients showed a significantly higher prevalence of bloating, pyrosis and epigastric pain when compared with non-infected subjects; conversely, prevalence of belching, halitosis and nausea did not differ between groups. CONCLUSION: The prevalence of H. pylori infection is high in patients affected by IDDM; however, it does not differ from the infection rate observed in a control group. The rate of infection increases with IDDM duration. Bloating, pyrosis and epigastric pain appear to define infection status better.

Adult↗
PubMed2005

Analysis of clinical characteristics of dyspeptic symptoms in Shanghai patients.

OBJECTIVE: To improve the management of dyspepsia by analyzing the clinical characteristics of dyspeptic symptoms in patients from Shanghai. METHODS: 782 patients with functional dyspepsia (FD) or organic dyspepsia (OD) completed a questionnaire about dyspepsia. The questionnaire asked participants to score 12 previously validated common upper abdominal symptoms. The clinical characteristics of dyspepsia including severe symptoms; and the relationship between symptoms and meals were then analyzed. RESULTS: Among the 782 dyspeptic patients, 543 cases (69.4%) were classed as FD and 239 (30.6%) OD. The proportion of males was significantly higher in the OD group. There was no difference in average dyspepsia scores between the 2 dyspeptic groups (21.5 vs 20.4, P > 0.05), but the scores of 'stomach' pain and 'stomach' pain before meals were higher in OD patients than in FD patients (2.65 +/- 1.11 vs 2.16 +/- 0.92, 2.26 +/- 1.26 vs 1.79 +/- 0.92, P < 0.05). In 45.2% of the OD patients and 47.7% of the FD patients, respectively, the severity of symptoms was not related to meals. In subgroups of ulcer-like, dysmotility-like and unspecified dyspepsia, the proportion of patients with symptoms not related to meals was 59.6%, 50.9% and 35.2%, respectively. 2.5% (6/239) of OD patients presented with progressive dysphagia, compared with 2.8% (15/543) of FD patients who presented with intermittent dysphagia. Approximately 8.8% (21/239) of OD patients reported dramatic weight loss accompanied with other severe symptoms, compared with 5.9% (32/543) of FD patients who had no other severe symptoms. A shift in symptom subtypes during the follow-up period was found in 13.8% of FD patients. The infection rate of Helicobacter pylori was higher in the OD group than in the FD group (53.1%vs 42.2%, P < 0.01), but no difference was found among the three subgroups of FD patients (P > 0.05). Halitosis was more often found in dyspeptic patients with H. pylori infection (44.9%vs 17.0% in OD, 47.3%vs 25.4% in FD, P < 0.01). CONCLUSIONS: When dyspepsia patients present with 'stomach' pain or 'stomach' pain before meals, a diagnosis of OD should be considered. Intermittent dysphagia, weight loss not accompanied with other severe symptoms, and halitosis (more often seen in patients with H. pylori infection) might be regarded as the relatively unique symptoms of dyspepsia in some FD patients. In FD, we found that the severity of dyspepsia symptoms was not related to meals in half of the patients, and symptom subtypes might shift over time, this adds difficulty to the management of FD.

China↗