Q. I have taken a variety of drugs for acid reflux. If I try to stop, the heartburn comes roaring back and the pain is unbearable. I also have terrible bad breath even though I brush my teeth three times a day and floss regularly.
Do you have any recommendations for how to get off omeprazole and what I could use instead? I would also appreciate any suggestions you have for bad breath.

A. Bad breath AND heartburn could be a sign that you are suffering from a Helicobacter pylori infection in your digestive tract. One radio listener told us that after years of suffering with heartburn and ulcers he was treated for Helicobacter pylori (H. pylori). This bacterial infection is responsible for many persistent ulcers. After successful treatment with antibiotics, our listener was astonished to find that his long-standing bad breath had disappeared. His girlfriend used to complain bitterly and even his dog would retreat. He was thrilled about the unexpected bonus in curing his ulcers–his dog and his girlfriend no longer backed off.
There can be many other causes of bad breath besides bacterial infection in the digestive tract. Other causes of bad breath may include gum disease, tooth abscess, bacterial overgrowth on the tongue, tonsil troubles, sinusitis, bronchitis, diabetes or liver disease. A specialist should do a complete workup to discover the source of the odor.
One unusual cause that most health professionals have never heard of is lactose intolerance. Normally, a sensitivity to milk sugar causes gas, bloating and diarrhea. But over the last few years we have heard from people who complain that dairy products give them bad breath:
“I have a problem with terrible bad breath after eating anything with dairy in it, and also anything with sugar. I have had this problem since my early twenties and am now in my sixties. My husband says it is so bad that he can sometimes smell it from his side of our king-size bed. This is right after brushing, flossing and rinsing with mouthwash before bedtime.
“If I stay away from sugar and dairy, the smell goes away completely after four or five days. It starts again within 30 to 45 minutes of eating the offending foods.”

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“I also have bad breath after eating too much sugar or drinking milk. My daughters say they have the same problem. My solution is that I try to avoid completely anything with sugar in it with the exception of fresh fruits. I get my milk products through yogurt and I make my own because too many of the commercial yogurts have sugar in them.
“I have restricted my regular diet to fresh fruits and vegetables, eggs, fish and chicken, yogurt, nuts and whole grains. I feel so much better and have so much more energy since cutting out all the processed foods, bread and sweets. When we are invited out to eat, of course I do eat some of these things and when I do, I have bad breath the next morning.”

Joan
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We discuss H. pylori, lactose intolerance, celiac disease and other causes of intestinal discomfort in our Guide to Digestive Disorders (online at PeoplesPharmacy.com). The diagnosis and treatment will require help from an interested doctor. We also offer suggestions for getting off acid-suppressing drugs and more natural ways to treat heartburn in our book, The People’s Pharmacy Quick & Handy Home Remedies, from National Geographic (also online). In it, you’ll learn about natural remedies such as almonds (page 105), broccoli (page 110), hot peppers! (page 112), fennel (page 108) and ginger (page 109). You’ll also get recipes for Digestive Tea from the Ayurvedic medical tradition (page 108) and persimmon punch from Korea (page 111)

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  1. Leo M.
    Reply

    I sufered acid indigestion for many years specially during the night and always had remedies over the counter handy, until I started trying natural alternatives and found an excellent remedy and that is fresh papaya every time the acidity wake me up I run to my fridge and peel a slice of tasty papaya that gives me immediate relief usually for the rest of the night, and I have no need of pharmacy antacids ever since what a relief. I am sure this will help others papaya is widely available year round at the market and if you live in south Florida or the tropics you can grow your own as I do.

  2. JS
    Reply

    Genetics has a lot to do with what a person can digest or not digest. If a person has trouble digesting carbohydrates, the result is that yeast flourish because they have plenty to grow on. They produce toxic substances, which can cause heart burn. To keep it short, I deal with the issue of indigestion by eating anti-inflammatory foods that are fairly easy to digest. I also take betaine HCl (hydrochloric acid) and digestive enzymes with meals. Here is part of an article I did on the subject of correcting digestive problems:
    ** Main meals, breakfast and lunch (about 800 Calories per meal):
    — Lean turkey – 3-4 oz. white or dark meat with broth; It contains protein, antioxidant amino acids methionine and cystine, minerals, vitamins, unsaturated and saturated fatty acids.
    — Green vegetables – celery, bok choy, kale, collard greens, cabbage; Vitamins A, B, C, E, lutein, antioxidants, alkaline minerals, chlorophyll, prebiotics
    — Nuts – almonds, cashew nuts, walnuts, sunflower seeds ~ 5 oz. per meal (boiled and drained to facilitate digestion)(pecans, filberts and pumpkin seeds are less tolerable because of tannins, phytates, indigestible carbs etc.); They contain protein, essential fatty acids, minerals, vitamins, fiber.
    — Beans – 4-8 ounces dry weight per day; They can be alternated with meals containing nuts. Beans provide protein, carbohydrates, minerals and nutrients that support favorable intestinal flora.
    ** Spices and herbs: (It adds up to about eight ounces per week of mixture.)
    — Sweet basil (6-8 heaping teaspoons (ht), marjoram (6-8 ht), (sometimes savory, parsley, chervil), cayenne (1/2 t) or chapotle, stevia (1t), turmeric (1 or 2 ht)(contains curcumin – antioxidant, anti-tumor, anti-inflammatory properties – absorbed much better if combined with a little oil and black pepper, which contains piperine; minerals, vitamins, antioxidants, emulsifiers, flavor
    — Black pepper (1t), fennel (2 or 3 ht), coriander (2 or3 ht) (reputed to inhibit methane-forming microbes) all freshly ground in a pepper grinder (Amounts are variable. The strategy is to increase vitamins, minerals, antioxidant, anti-inflammatory and yeast inhibiting herbs, which usually taste bitter. Sweetness is added through ground stevia, as with spaghetti sauce, to make it taste better.)
    ** Tea – The more the better.
    Green tea – works together with substances in beans to reduce inflammation.
    Cinnamon ~ two or three heaping teaspoons, or three or four sticks; chromium and other substances to regulate blood sugar
    Celery seed – two or three heaping teaspoons; antioxidants, minerals
    Fennel – one or two heaping teaspoons; antioxidants, minerals, anti-yeast
    Milk-thistle ~ two or more heaping teaspoons; sylimarin – a very potent antioxidant and liver nutrient, vitamins and minerals
    Kelp – one or two heaping teaspoons; Iodine, minerals from the sea (Kelp contains sugars that are pro-inflammatory. It can be used at the beginning of exposure to colds or flu to stimulate an immune response. It may be best to avoid it when trying to reduce excess inflammation.)
    Lavender – two heaping teaspoons; flavor, essential oils, anti-yeast properties
    Dandelion leaf or root – one heaping teaspoon; liver and kidney cleanse
    Other herbs, depending on taste or actions desired
    ** References:
    1. Impact on DNA Methylation in Cancer Prevention and Therapy by Bioactive Dietary Components – Y. Li, T. O. Tollefsbol – 2010
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904405/?tool=pubmed
    In this article, the authors describe some mechanisms of action behind DNA methylation and the efficacy of green tea and soybeans, various polyphenols and selenium. Complicated concepts are described in a fairly simple and concise way.
    2. The Role of Herbs and Spices in Cancer Prevention
    C. M. Kaefer, J. A. Milner – 2008
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771684/?tool=pubmed
    This article is written for the lay-person. Table 1 lists over 25 common herbs and spices and the bioactive food components. Much of the article is dedicated to explaining what the scientific data means in everyday terms. Herbs such as thyme, rosemary, sage and marjoram were measured to be high in antioxidants. Oregano, cinnamon, turmeric, black pepper, basil, allspice, garlic, ginger and citrus fruits are also portrayed as having the ability to reduce inflammation related gene products.
    3. Molecular Targets of Nutraceuticals Derived from Dietary Spices: Potential Role in Suppression of Inflammation and Tumorigenesis – Bharat B. Aggarwal,1 Michelle E. Van Kuiken, Laxmi H. Iyer, Kuzhuvelil B. Harikumar, and Bokyung Sung – 2009
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3141288/?tool=pubmed
    This very understandable article is written using the common names of foods and herbs. Table 1 lists about 25 foods and herbs that limit inflammation. Table 3 is a little more complicated. It lists about 15 natural substances and related biological actions. Table 4 lists about 15 natural substances that induce apoptosis, or the recycling of damaged cells.
    4. Regulation of Survival, Proliferation, Invasion, Angiogenesis, and Metastasis of Tumor Cells through Modulation of Inflammatory Pathways by Nutraceuticals –
    Subash C. Gupta, Ji Hye Kim, Sahdeo Prasad, and Bharat B. Aggarwal – 2010
    http://ukpmc.ac.uk/articles/PMC2996866
    This article is fairly complicated as it goes into technical explanations of bioactive food substances and their effects on cellular functions such as regulation of tumor cell invasion, angiogenesis and similar phenomena.

  3. M. H.
    Reply

    Apple cider vinegar mixed into water with a little sugar may help you, also eliminate acid producing foods.

  4. Myrna H.
    Reply

    I suffered from heart burn for years, I decided not to take any drugs. I changed my diet, eliminating acid producing food and sauces. That helped , but I heard about a natural way of healing the asophagus. It was malaluka honey. I used it in anything I drank, tea, cereal or whatever. I also eliminated coffee and most dairy products. I stopped toasting my bread [too rough], peeled any tomato and added sugar to it to cut the acid. It took awhile for the body to heal but it did. I hope this input will help. One tbls of honey is sufficient.

  5. JEB
    Reply

    Bad breath can also be caused by tonsiliths. Crevices that have occurred in the tonsils can become engorged with small amounts of food debris and then start to ‘go bad’ as they are trapped. They can sometimes be (very carefully)’pushed’ out of the crevice in the tonsils, and if you take the tiny amount dispelled (like tiny cottage cheese) to your nose, you will understand how a bad smell can come from something so innocuous.
    Apparently dairy products do cause some of this problem and one might be advised to avoid them (difficult). Having the tonsils removed at a late stage in life is dangerous (and I’m not sure it cures the problem, I would have to look this up further), and a water pik cleaner may help – difficult to get used to, but try if this is a problem.

  6. abigail
    Reply

    After dissolving lactose based homeopathic pellets in my mouth I feel as though I have not brushed my teeth and might have bad breath.

  7. Darcy
    Reply

    I have suffered from acid reflux for many years due to a weak upper stomach muscle (the doctor said it was not hiatal hernia). I started taking Omeprazole and have that under control. Through all of this I had very bad breath. I also had trouble with constipation; though, not terribly bad. I started taking Acidophilus (1 billion per day when needed). The constipation went away and along with it the bad breath. I’m not sure what affected which (or vice versa) but am happily breathing close to people without worrying whether I had made them feel bad because of my breath. I don’t have to take the Acidophilus every day now, only when I need regulating. Another benefit is that flatulence is odorless.
    I have followed your advice on many things in the past and wish to thank you for being there for people like me. I am allergic to so many medications that I have to take over-the-counter remedies mostly to try to aid a problem.

  8. MM
    Reply

    Regarding H. pylori… My mother was treated for H. pylori and after learning the symptoms, I asked my MD to test me also. He said it was “unlikely” that I would also have it, but I insisted that I be tested. The blood test was POSITIVE and I DID HAVE H. pylori (so did my sister, but our husbands were negative)!
    I continued to have symptoms after the treatment but my doctor said it was unlikely that the H. pylori was still present. He said once you test positive, it will always test positive and the only way to be sure was a GI scope so I insisted on that… and it was STILL PRESENT. I went through treatment again and this time the GI scope was negative.
    Several years later, I developed the same “dog breath” that I had before (my husband could smell it across the car). I planned to have another GI scope, but first, I had a diverticulitis attack that landed me in the ER. After taking the antibiotics (same used for H. pylori), my breath immediately cleared up. The doctor was surprised at the magnitude of my diverticulitis attack since I only had 2 tiny pockets.
    I am wondering if these two conditions are related and commonly present together?

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