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“My Breath Smells Like An Open Sewer”

Robert’s breath had become his worst nightmare and as a consequence he knew was starting to isolate himself socially. For three years, he’d tried every over-the-counter remedy. When he walked, Tic Tacs rattled in several pockets.

Robert had seen specialists, had his teeth cleaned every three months, and followed a twice-daily oral regimen that included flossing, brushing, and jet-streaming his gums.  The finale was a vicious tongue-scraping that left his taste buds raw and aching. He’d then blast whatever was left with undiluted mouthwash.

Robert had tried everything.

“The tongue-scraping is especially horrible,” he told me. “I can actually smell that sewer odor coming from that guck I scrape off.”

One doctor said it was all in his mind, that he should see a good psychiatrist because his breath might be a symbol of some deeper issue and that he might be sinking into the terrain of obsessive-compulsive disorder. Robert was intelligent enough to consider this for a moment, but because his wife had recently remarked that his breath was interfering with their lovemaking he skipped checking the mental health benefits on his insurance.

An otorhinolaryngologist (ear, nose, throat specialist) scoped his sinuses and pronounced them clean. A gastroenterologist (GI) scoped his esophagus and stomach and found nothing out of the ordinary. The GI doc was less than hopeful. “My brother has had bad breath since he was 20. He’s 50 now and spent a fortune trying to figure it out. Nothing. Nada. He lives on Certs.”

Robert offered the doctor a Tic Tac and left the office.

My meeting with Robert
When I first saw Robert I was not hopeful. First of all, I couldn’t smell a thing, which isn’t saying much because I have a dreadful sense of smell. He’d already read one of my previous Health Tips citing poor digestion as a possible cause of bad breath, but a month of digestive enzymes and betaine didn’t make a dent.

I reviewed Robert’s entire health history and there wasn’t much. He did have some heartburn (gastroesophageal reflux disease, or GERD) that he’d self-treated on an as-needed basis with Nexium, one of the proton-pump inhibitors that reduce stomach acid. Robert told me he had frequent bloating, but generally his bowels were regular and there were no particular foods that gave him trouble. Except for seeing a dermatologist for some stubborn rosacea, there was nothing really wrong with him that decapitation couldn’t cure (I knew he’d laugh when I told him this).

Since he already had a primary physician (who had pronounced him healthy) and had been pretty thoroughly tested by other doctors, I ordered two tests of his gastrointestinal function.

  • For the first, a Comprehensive Stool Digestive Analysis, he would send stool specimens to Genova Labs to determine if he was digesting and absorbing his food normally. This test would also look for intestinal parasites and determine if there were any imbalances in his intestinal bacteria. Robert’s results were normal. He was digesting and absorbing his food well.
  • The second test would measure the contents of his breath for two gasses, hydrogen and methane. This test would determine if there were an overgrowth of bacteria in his small intestine, called SIBO for small intestine bacterial overgrowth. Some bacteria in the small intestine is allowable. But an overgrowth can produce all sorts of mischief, including bloating and impairing your digestion and absorption of food.

For the SIBO test (done at home), Robert would drink a small amount of lactulose, a harmless sugar that’s like cotton candy to the target bacteria, which promptly respond to this treat by producing more gas than ever. For the next two hours, Robert would collect samples of his breath by blowing into a specially designed balloon and then attaching a vacuum tube to extract an air sample. He’d send off six tubes of air, which looked empty, but definitely were not.

When the test results came back from the lab, I knew we had an answer. This link shows a typical mild-to-moderate case of SIBO. Note how the hydrogen-methane content rises as time passes. Robert’s started rising at the 20-minute point and remained at the very top of the graph for the rest of the two-hour collection period. His was among the highest gas levels I’d ever encountered.

Treating Robert’s SIBO
Robert’s response to Xifaxan, the antibiotic most widely prescribed for SIBO, was dramatic. On the fourth day of his ten-day Xifaxan prescription, the nauseating odor from his tongue scraping had vanished. By the tenth day, neither he nor his wife could detect any breath odor whatsoever and I hoped they were now able to resume their passions.

Just why Robert had developed SIBO is hard to say. Some people get it if they have a chronic intestinal inflammation, like Crohn’s disease. Some get SIBO as a consequence of using the Nexium family of meds, which reduce the stomach acid necessary to keep the small intestine’s bacterial population in check. SIBO has also been linked to anything that slows intestinal motility (movement), like underactive thyroid or constipation-dominant irritable bowel syndrome. But for most people with SIBO, the “why me?” is left unanswered.

Fortunately, as in Robert’s case, treatment can be dramatically successful. The only caveat is that the bacteria are stubborn and a return of symptoms can occur. We reduce this possibility using an antibiotic blend of herbs and a quality probiotic, since nobody needs to be carpet-bombing what helpful bacteria they do have by taking an antibiotic regularly.

Three intriguing points worth mentioning
First, the question of the garbage-y odor itself since the two gasses measured with SIBO testing, hydrogen and methane, are both odorless. The likely reason for the odor is that the bacteria are producing other gasses, especially hydrogen sulfide, the villain behind your odiferous farts. You’re better off not thinking about this too much.

Second, a few weeks after treatment, Robert’s rosacea had disappeared. The link between SIBO and rosacea is relatively new, first described by a group of Italian physicians in 2008. Unfortunately, testing for SIBO has been slow among US dermatologists seeking a rosacea cure, but the connection might explain how Flagyl (metronidazole) works. Flagyl, the top-prescribed drug for rosacea can also be used to treat SIBO if Xifaxan is unavailable. Perhaps dermatologists prescribing Flagyl are inadvertently curing SIBO, which in turn cures the rosacea.

Third, I have to wonder if something as thoroughly annoying as having horrible breath  ever affects celebrities and other beautiful people. There’s a real imbalance in the universe. I mean, if Brad Pitt or Taylor Swift or Princess Kate had socially isolating breath problems, they’d be able to compensate by saying, “Thank god I’m Brad Pitt” or “Wow, at least I’m Taylor Swift” or “I’d be even more miserable if I weren’t a princess.”

Instead, this stuff strikes plebes like you and me. No justice.

Be well,
David Edelberg, MD



Leave a Comment

  1. Simona Garcia says:

    Thank you so much Dr. Edelberg! You saved me and I will forever be grateful!

  2. Tammy says:

    Could not be a more timely article personally for me. Unfortunately I allowed my GI doc to prescribe Rifaxamin before doing SIBO test to determine exactly which gases were causing the left sided pouch and now ready for the delivery room bloat. Now after round 3 of Rifaxamin getting the test done. Here’s my concern possibly have created greater methane gas bacteria now and may be harder to tx. On the fence about doing elemental diet adding flagyl or using herbals suggested by Dr Scieceker from siboinfo.com

  3. Reem says:

    What herbal treatment is recommended?

  4. Tammy says:

    Check out siboinfo.Com
    Dr Siebecker describes what research supports and compares to antibiotic meds.

  5. Mary Gardier says:

    Sort of off-topic, Dr. Edelberg, but I was wondering if Clark Gable may have suffered from SIBO? Actresses who had kissing scenes with him reported that his breath was terrible!

    I enjoy reading all of your articles, and have learned so much. I try to apply them to my own health concerns.

    Take Care,
    Mary Gardier

  6. Dr E says:

    Actually Clark Gable has terrible gum disease which caused his bad breath and when all his horriblle teeth were pulled and he got dentures his breath improved.

  7. Div says:

    My daughter is 9 yrs old and has severe acid reflux. She is on Zantac but I would like to look for alternative options as these medicines can have long term impact on health. Is Homeopathy treatment a good alternate option for her? She is Asthma too and both triggering each other during Fall/ Winter

    • cliffmaurer says:

      Homeopathy is a good option to consider. Making certain that her pediatrician is informed of all of her concerns and treatments is also important.
      -Dr. M

  8. Tammie says:

    Hi Dr., how can I get my Dr. to test me for SIBO because they think my bad breath is all in my head? Should I go to my PCP or GI Dr? My dentist told me my breath and teeth were good too.

  9. George Rane says:

    Best article I have read on this condition. My breath problem I’ve broken down–oddly, it’s much more apparent when I eat or consume items with sulphite preservatives in them — beer, wine, procesed meats etc. I wondering if you have come across this before? What maybe the underlying cause.

  10. Sarah Reynolds says:

    How can I get a doctor to prescribe this medicine? I’ve seen an ENT, Gastroenterologist and dentist and all the results are the same. I have severe sinus issues and mild gastric issues nothing that nexium wouldn’t cure and my dentist says nothing wrong but otherwise I have suffered for 10 years keeping me from pursuing my dreams.

  11. Dr E says:

    Hi Sarah
    You can order this test directly from Genova.
    If your test is positive, your primary doc or your GI doc will likely go ahead and order Xifaxan
    Also, if you don’t do this already, buy a tongue scraper and clean the surface of your tongue every morning

  12. Candy says:

    Hi Dr. E,
    I loved your article! I have suffered with this terrible breath for almost 4 years, and the only thing that helped was Augmentin 875-125 for 14 days (but the smell returned after finishing) and then again with Flagyl for 14 days, but the smell returned. I have acid reflux and other digestive issues, and I want to know if you think that Xifaxin will still be able to help me in light of my recurrence of smell after I concluded the courses of the above mentioned antibiotics?
    Any help would be appreciated 🙂

  13. Dr E says:

    Hi Candy
    Each of the meds you listed could be used for SIBO but are not first choice and this is why the symptom may be coming back. Get tested for SIBO and if positive get an rx for Xifaxan

  14. maha says:

    Can you translate it to arabic . please

  15. VL says:

    Hello Dr. Edelberg,

    What a relief it is to read this article about Robert. I have been experiencing this same exact thing for a few years now and it feels like an absolute living nightmare. I am a female in my early 30s and this “odor” has been effecting every aspect of my life. It has made me incredibly anxious and depressed and I don’t know what to do anymore.

    It is nothing relating to my mouth/teeth. I get my teeth cleaned twice a year and meticulously take care of my teeth. I have visited with my regular doctor and a GI. Neither of them have helped. My regular doctor told me I have an iron deficiency (which I never had), so I took an iron pill for a few months. The GI did the lactose intolerance breath test and performed an endoscopy. The test proved that I am not lactose intolerant and from the endoscopy he informed me that I have GERD and prescribed pantoprazole. I started taking the pantoprazole back in March and stopped in October once I read about the negative long-term side effects.

    Just like Robert, I have GERD and experience bloating. Generally my bowels are good, but sometimes I can be constipated. Here is an overall list of everything I’ve been experiencing:
    -burping (a lot after meals)
    -I have gained a lot of weight and it’s hard for me to lose weight despite eating healthy and exercising
    -I’ve had toe nail fungus 3 times in the past few years, went to podiatrist over summer to cure (went on generic lamisil)
    -I always have beaus lines on my nails, probably from the iron deficiency?
    -trouble focusing
    -heartburn at random times…there’s no rhyme or reason to it…I get heartburn no matter what I eat, doesn’t matter if I eat something like plain chicken breast or ice cream

    What’s odd is I hardly ever smell this “odor,” but there’s constant reminders that it’s there. I’ve been asked on multiple occasions by different people if I have passed gas. Most recently a coworker of mine came into my office to chat and as soon as they entered, they asked if I farted. At home, sometimes my husband will enter the room I’ve been in and will say something like, “it smell’s so bad in here, stop farting,” and I have to laugh and play it off like I have (but haven’t at all).

    I just got over a cold, but I noticed a few things while I was sick. I noticed that the smell was much worse while I was sick (like a rotton-egg odor that could fill a big room). I took antibiotics and on day two, the odor was really bad. I was in a car with my mom, and she exclaimed that it smelled like something was dying. I tried to play it off like it was coming from outside, but I knew for sure it was me. After I was done with the antibiotics, for about 2 weeks, I had no reactions from anyone.

    These stories sound funny, but they’re honestly a nightmare. There are days where I just want to crawl in a hole.

    I noticed that the odor is much worse when I eat/drink certain things. These include: tea (especially dandelion root tea), ice cream, bananas, milk, kefir (store bought), lemon water, chocolates, sweets, cheese, wine/liquor (really embarrassing when I’m out with friends), beans (I had lentil soup for dinner one night – for that entire night and the next day my husband told me I had a smell following me).

    I’m so sorry this post is so long, I just finally feel like I can relate to someone. I’ve felt so alone and lost for so, so long.

    I’ve never been tested for SIBO, I never even heard of it. From all the researching I’ve done on the internet, I thought it could possibly be candida. I desperately wish I lived near your practice, I am out of state. Is there any way you can work with me remotely?

    Thank you in advance,

    • Tiffylu says:

      Dito…..dealing with this for years. After CURING my sons PANDAS it was now time for me! I have dumped (literally) dozens of pounds of mucoid plaque and parasites. Extreme intermittent fasting, paleo, tons of liver and small intestine cleanse supplements. I have lost 70 pounds, starting to notice lessening odor and feeling great.

    • Imogen says:

      Ive suffered the same symptoms (lines in fingernails, bad toe nails, really bad breath.) I did so much home research that i knew I had methane dominant sibo before the test! I was prescribed Neomycin and Rifaximin together (you need to take them together, not one or the other) i had bad breath problems for 30 years and I contemplated suicide i was that miserable!! MAKESURE you differentiate between constipation and Diarrhoea because methane dominant sibo usually when you’re constipated and Diarrhoea is usually Hydrogen dominant sibo. Sulfide dominant sibo tends to show NO raises in the lines of gases in the test results so its harder to tell. If you get a false negative DONT GIVE UP! doctors are good at telling us ” its in our heads” but i went with my gut (literally, lol) in the end my doctor just sent the referral to the hospital because he was tired of seeing me in his office. Being determined pays off. Its your body, youve got to live with it, nobody else. So don’t worry about you being a nuisance. Blessings

      • Alex says:

        So did it cure you? I’m confused.

      • Andrea says:

        Your story is the same as mine and today I had the most embarrassing of all bc a family member made an angry comment bc he smelled my breath while eating and he got upset. I mean, who wants to smell poop while eating!!! I’ve been in many different embarrassing situations with the same comments from people. I tried Boldo tea leaves. It helped me when I was in my 20’s but now it doesn’t help me anymore but if you try the first few times it works. It cleans the liver. I think my problem now is gastrointestinal thought.

    • Kelly says:

      Hello LV can I contact you directly? In regards of your post. I had some questions maybe you can help me.
      If you want to email me:)
      Thank you


    • Andrea says:

      Your story is the same as mine and today I had the most embarrassing of all bc a family member made an angry comment bc he smelled my breath while eating and he got upset. I mean, who wants to smell poop while eating!!! I’ve been in many different embarrassing situations with the same comments from people. I tried Boldo tea leaves. It helped me when I was in my 20’s but now it doesn’t help me anymore but if you try the first few times it works. It cleans the liver. I think my problem now is gastrointestinal thought.

    • Andrea says:

      Try Boldo leaves as a tea in the morning for 20 days before any meal…and problem solved! I tried it bc I had these problems in my 20’s. And I still have them bc it comes back but try it and you’ll see the difference the first week. eBay sells those Boldo leaves. Don’t skip a day, don’t drink alcohol, change the way you eat, avoid lactose. Boldo will really help. Research first bc not everyone can try it. Good luck and let me know your recovery process. Be prepared for some changes in your body like mood swings, light stomachaches, sleepiness and lack of energy. Don’t mix Boldo with anything, no vitamins, no antibiotics, no Tylenol.

    • Edie says:

      VL Hi im EV I understand and feel everything you are going through its a nightmare I honestly feel there is no reason for me here since this is a social world its depressing, I drink the pain away but that makes it 10x worse like a dead dog, I hold back so much and when I speak I lash out and say the most dreadful things and my breath makes it worse, I wish I could just be normal and participate with society, I am a dread to my kids and wife, I can never tell her how I really feel but I guess they are use to the smell, my mom denies it but like they say you got something only a mother can love, but even she moves to the rear passenger seat. I really appreciate my wife for holding on for so long 14 years, but i think she deserves somebody she can talk and express herself laugh together, I seriously have become anti social but even with this pandemic and face mask requirements it doesn’t really help. I’m positive I have GERD I have taken pro inhibitors, got my tonsils removed,GI did a endoscopy and nothing got blood work, stool checked, I even did a Small Intestine Bacteria Overgrowth test and it came out negative, its hard on me I cant get a job cause of this or it is very limited I am a driver i like staying on the road cause of this reason with minimal customer contact as possible, I’ve shut out my family and friends I’m seriously loosing hope, I’m on the brink of loosing my family but I want them to be happy with or without me, probably best without me with this condition. The next thing I’m thinking of doing is surgery for GERD but without a job and good insurance it is very difficult. I hope I can talk and express myself before my time is up here I know its only for a short time that we are and there are people with much worst situations but honestly i wish I cancer instead of this, you don’t know how much I would like to express myself hopefully god can give me I chance I would change my life and the bad decisions I’ve made. There are chronographs test that read different types of gasses I’ve read. Sorry for the long sentences and improper grammar but thats my story. Take care and hopefully everything turns out positive.

  16. Dr E says:

    Hi VL
    Just order the SIBO test kit directly from Genova. If positive, your primary care physician can treat it

  17. VL says:

    Thank you for the link. I will order it and will see what happens.

  18. Maha says:

    welcome . What are the results . I have the same problem . I suffered from it for 12years. I have question . does this problem appear suddenly and you haven’t a control or it is because some food . Thank you

  19. stan says:

    Hi Dr. Great piece to read,i have recently developed this terrible breath, sometimes smells like feaces, it is coming from the stomach and through the nose i am taking antacids and it is not helping , how can i deal with it?

  20. Christine says:

    Hi I have this problem, is there a doctor I could see in my area? *pittsburgh* area.

  21. Sol says:

    I have had this problem for years. I am a professional and I see the reaction of horror on faces when I talk in meetings and the scramble to open windows. People come into my office and ask politely if they can open the window or leave the door ajar.

    I knew I had bad breath problem but I just couldn’t tell what it smelled like. I once asked a colleague in confidence and he denied even though I saw how he squirmed sitting next to me in a meeting.

    I made this new search after visiting an old friend and being her diplomatic self, she complained that her breath smelt like a sewer, I knew it was me. I will try this and see how it goes, I have absolutely nothing to loose.

    • Andrea says:

      Try Boldo leaves as a tea in the morning for 20 days before any meal…and problem solved! I tried it bc I had these problems in my 20’s. And I still have them bc it comes back but try it and you’ll see the difference the first week. eBay sells those Boldo leaves. Don’t skip a day, don’t drink alcohol, change the way you eat, avoid lactose. Boldo will really help. Research first bc not everyone can try it. Good luck and let me know your recovery process. Be prepared for some changes in your body like mood swings, light stomachaches, sleepiness and lack of energy. Don’t mix Boldo with anything, no vitamins, no antibiotics, no Tylenol.

  22. jordan says:

    Welcome . l am from Jordan . what is thr test that i should do. I went to many doctors here . they said no its from your head . and its a strange case . nothing like this . i suffered many years . i bought the medicine xifaxan. but i dont how to use . and because i am arab i cant understand exactly . and the translation of google is weak and doesnt give the exact translation . please if any body can help to understand. Thank you

  23. maha says:

    I have the exact problem . and i am taking xifaxan now . two tablets three times for two weeks . is this a long period or not . and is there any thing to take more ?

    • cliffmaurer says:

      Many Xifaxan courses last longer than two weeks. Please check with your prescriber to see how long he or she intends to have you take the medication, and ask about what the next steps are if you’re not noticing a difference after that period of time.
      Dr M

      • Judith Henderson says:

        I found that Xifaxan gave me horrible gas that I can’t release. I have EPI (pancreas insufficiency) but I’ve had this awful breath since I was under 10yrs. old. It gets worse and worse. It’s not only the poop breath but also scorchy or like burning leaves. I’m now 70. Is there another med that might help?

        • cliffmaurer says:

          Hi Judith –
          There are other meds, supplements and dietary changes that can be helpful, but if you’re having trouble with xifaxan and you’re still having symptoms, it’s best to work one-on-one with someone to help figure out other underlying causes and design a personalized treatment approach. If you’re in the Chicago area, any of our practitioners would be able to get this process started.
          Dr M

  24. maha says:

    Thank you doctor very much . you saved me . you helped me a lot .i don’t know how ithank you . I took Xifaxan and the problem finished . i took it for two weeks . i can’t believe . but i am afraid if this problem will come back. and what is the next step if there is any medicine to take. and what is the food to avoid .

    • Alexa says:

      Hello Dr.E,

      I have the exact same symptoms that VL had, and I’ve been living with them for about 15 years. I’ve been to dentists, an ENT, and a GI doctor. All have told me that there’s no cure for the bad breath. I completely relate to everyone about feeling depressed, helpless, and very alone in this journey. I just ordered the SIBO test and I will be taking it in 2 days. I’m praying that I test positive so that I can finally be cured of this horrible bad breath. I’ve been doing a lot of research and found that there is a SIBO associated with Hydrogen Sulfide, and I have most of the symptoms associated. I’ve also read that there isn’t much know about this kind of SIBO because the test doesn’t measure sulfur gases. My question is, what causes this type of SIBO? And, is there anything that can be done to prevent the bad breath caused by sulfur containing foods? I will gladly avoid them if it means living a normal life!

  25. Jake hash says:

    I’ve been suffering with this same problem for about 7 years now. I really need a solution to this issue because it’s ruining my life. My breathe smells like an open sewer and it’s coming out of my nose also. People don’t tell me to my face but they laugh at be around the corner or cover their nose when they are passing by me. I need help ordering the SIBO test from Genova, can anyone please please help.

    • Dr. R says:

      Google Genova Diagnostics and then search for SIBO (small intestine bacterial overgrowth) under the tab Search Diagnostic Tests. If your PCP won’t order the test, search “Find a Doctor” on that page for a physician in your location who will. Good luck.

    • Andrea says:

      Try Boldo leaves for 20 days before any meal. First thing in the morning as a tea, and problem solved! I tried it bc I had these problems in my 20’s. And I still have them bc it comes back but try it and you’ll see the difference the first week. eBay sells those Boldo leaves

    • Andrea says:

      Try Boldo leaves as a tea in the morning for 20 days before any meal…and problem solved! I tried it bc I had these problems in my 20’s. And I still have them bc it comes back but try it and you’ll see the difference the first week. eBay sells those Boldo leaves. Don’t skip a day, don’t drink alcohol, change the way you eat, avoid lactose. Boldo will really help. Research first bc not everyone can try it. Good luck and let me know your recovery process. Be prepared for some changes in your body like mood swings, light stomachaches, sleepiness and lack of energy. Don’t mix Boldo with anything, no vitamins, no antibiotics, no Tylenol.

  26. maha says:

    The problem returned to me . the open sewer smell suffering . what can i do?

    • Andrea says:

      Try Boldo leaves for 20 days before any meal. First thing in the morning as a tea, and problem solved! I tried it bc I had these problems in my 20’s. And I still have them bc it comes back but try it and you’ll see the difference the first week. eBay sells those Boldo leaves

  27. Dr E says:

    Hi Maha
    SIBO has a very irritating habit of periodically returning. You may simply need retreatment

  28. SS says:

    Hi Dr E, I have somewhat similar problem of bad breath like sever & Fart. It all started with long gastric problem and irritable bowels which i ignored and later started to have metallic taste in my mouth. Now its been 5 years but i have no clue. Bad breadth is always there no matter whatsoever i eat. Its more when i have milk, tea, sweets, breads, jam,oily junk food, chicken, drinks, pulses, Cauliflower,cabbage, okra, beans etc..

    My weight is over 100 Kg, i feel stressed due to this as somewhat feel disconnected socially as stress of embarrassment is always there. I have been diagnosed of fatty liver in past while getting my check up. other than that my dental & sinus is clear. Doctor while cleaning teeth told that i have some stomach problem which is causing bad breath.

    I have reduced 10Kg weight but problem is still there. I now have more salads and fruits in diet. Stopped oily, sugar products.

    Is there are natural diet to get rid of bad breadth problem.

    Hope to hear soon

    • Dr. R says:

      SS. You might find a doctor who understands functional and integrative medicine and is willing to test you for the conditions written about in the article, “My Breath Smells Like an Open Sewer”. Google the Institute for Functional Medicine and click on their “Find a Physician” link to find a like-minded doc in your area. Good luck.

    • Jayden says:

      I’ve been suffering this horrible nightmare for about five years now and I’m only in the 11th grade. It started about 7th grade and I would then chew gum and it seemed to get rid of the smell when I would exhale out of my nose, but now it doesn’t help at all. I always have people at school sniffeling when they are around me and always comment “it smells like butt,armpits,poop,rotten eggs,fart” But I’m a very clean person so I know it’s not me smelling, but I know it comes out of my nose. I went to a Ent and they said everything looks good but I suffer from sinus problems like always having a stuffy nose, crazy amount of mucus and always having to blow my nose. I always brush my tongue and a thick film comes off. I never can smell it but I know other people can and now can tell by their actions. I’ve been bullied for being the smelly girl or the girl with bad breath but I have tried everything to get rid of the smell out my nose and nasty taste out of my mouth. It has really made me not be myself for the many of the years and my dad has suffered the same problem but his was sinusitis and now doesn’t have the bad smell out of his nose. I’m lactose intolerant. When I brush my teeth after a few minutes I have the bad taste back in my mouth like I never did brush them. Plz Someone help me cause I know it’s not all in my head.

    • Andrea says:

      Try Boldo leaves for 20 days before any meal. First thing in the morning as a tea, and problem solved! I tried it bc I had these problems in my 20’s. And I still have them bc it comes back but try it and you’ll see the difference the first week. eBay sells those Boldo leaves

  29. Nana says:

    Thank you sooo much Doc, i’ve been suffering from bad breath for 4 years now. I tried everything i could, when this started i went to the dentist and after being treated i was referred to an oral surgeon for surgical removal of wisdom teeths. After that the oral surgeon refereed me to the ent aas the condition didnt improve. The ent suggested tonsillectomy and i gave it a try (it never worked as well). i treated sinuses and went to the CT Scan and the study came back normal (no leaking fluid, everything was fine).
    I have an apointment with the gastro…specialist i will ask him about these tests.
    Its soo bad tgat i would sometimes think of taking my life (i’m alone ; cant associate my self with any1, my love-life is a nightmare, at work they even call me names and giigle everytime when i stand on my desk and when i go talk to them they cover their nose when i leave they start laughing) I sometimes feel like this is too much Bad breath for years…OMG Please help me this time

  30. Dr E says:

    Hi Nana
    Just be sure you get tested for small intestine bacterial overgrowth. Likely the bad breath is coming from this and if you test positive, it is easy to treat
    Don’t give up!

  31. Sphoia says:

    i have a metallic taste in my mouth what could it be. If u can hlep me please.

    Thank you.

    • Dr. R says:

      Sphoia. The most common causes of a metallic taste in the mouth include poor oral hygiene, prescription medications, OTC vitamins/medications, upper respiratory infections, and chemical exposure. Check these out and then you may want to try some of the simple remedies that are in Dr. E’s article such as a digestive enzyme or take the article to your primary care physician to have some simple testing performed.

  32. maha says:

    Hi . lve used the xifaxan medicine for the sewer smell for once and the smell disappered then it returned back then i took this antibiotics for the second time without any result and the doctor said i should use another antibiotic . is it correct to use the same antibiotic for twice any why at first i had a result and the second time no result . what the the reason . and is there a hope to get rid from this smell forever without anyreturn or difficulty . i hope that

    • Andrea says:

      Try Boldo leaves for 20 days before any meal. First thing in the morning as a tea, and problem solved! I tried it bc I had these problems in my 20’s. And I still have them bc it comes back but try it and you’ll see the difference the first week. eBay sells those Boldo leaves

  33. maha says:

    Hi . the question is there a total solution for this problem . without return . the other question is why there are few people who suffers from this problem . not common

  34. Dr E says:

    Hi Maha
    Actually it is quite common. The diagnostic test is new and now used by a lot of primary care physicians and often not covered by insurance.
    The symptoms return periodically in 20% of cases.
    Sometimes the antibiotic neomycin is used instead of xifaxan

  35. Shelia says:

    Yes I have the same issue but worse it smells like flatus. It comes from my nose and smells up the all room I can’t smell it.
    Please advise I can’t live like this. I’m in Houston can you recommend a doctor here

  36. maha says:

    Does this smell . the sewer. Spread suddenly or all the time

  37. maha says:

    Gradually means at the first time of appearance .
    Suddenly means through the disease ….?
    Can you give me any doctor’s name here in Jordan to help me get rid of the problem ,Please ?
    Because it is a strange and uncommon case . not easily diaognised .
    Thanks alot .

    • Paul Rubin says:

      To maha. Sorry maha; we don’t have a referral for you in Jordan. You might check with the Institute for Functional Medicine’s website to find a doctor. Good luck.

  38. Terry Campbell says:

    I have been suffering with the sewer/faces smell from my nose and mouth for almost four decades. I have a history of chronic sinusitis, allergic rhinitis, IBS,and Gerd. I had sinus surgery and used several rinses for my nostrils. I used a NETI POT prescribed by the ENT. Nothing took the smell away. Fluid lodged in my ear and I discontinued the neti pot. The GI doctor did an endoscopy and said my throat was really red. I wear dentures and the smell gets on them. Sometimes I’m walking from one room to the other room at home and I smell this terrible odor only to find out it’s my breath. It’s worse now than ever because I can taste the faces smell in my mouth no matter how often I clean my dentures or clean my tongue and gums. It’s just nice to be able to talk to someone about this who understands. I’m in a training class and everyone tries to keep their distance from me when I talk. I dont blame them. I know they laugh and make horrible jokes about my breath and the smell coming from my nose. Please send me the link, I have tried everything, and I mean everything but to no avail. Thank you for listening.

    • Andrea says:

      Try Boldo leaves for 20 days before any meal. First thing in the morning as a tea, and problem solved! I tried it bc I had these problems in my 20’s. And I still have them bc it comes back but try it and you’ll see the difference the first week. eBay sells those Boldo leaves

  39. CJ says:

    Hi to everyone in the comments,

    I also suffer with the same symptoms and can relate to VL’s story the most.

    Has anyone done the SIBO test and what were the results? If so were they positive and have got treatment which has worked?

  40. Colleta says:

    My husband is suffering from chronic bad breath,he has visited hospitals where he is given antibiotics which work for a while and the bad breath returns. Our five year old girl is also suffering. Please help,can get the SIBO test in Kenya?

    • Dr. R says:

      Hi Colleta. Genova Diagnostic is the laboratory we utilize. I’d recommend asking your primary care physician to test for SIBO locally or try to reach out to our lab as they may have suggestions for other options in Kenya. Good luck.

  41. Cristian Hernandez says:

    I was tested positive for sibo and I asked if it was causing my bad breath. My Dr. said that sibo doesn’t cause bad breath and that I should go see my dentist. I brush my teeth twice a day and I floss randomly in the week. I even finish off brushing my teeth with baking soda. I’ve thought about taking my life away to, but I feel like it’s just a test from god. I have to just deal with it and live my life the best I can. It’s really hard having a normal social life when every first impression you give is with bad breath. I can’t even stand next to someone for a while without them looking around in disgust, confused on where the smell is coming from since it even comes out my nose. I usually try to hold my breath and take the least amount of breaths I can. I’m a funny person and I love talking to people. The only time I can really let myself go and feel like a social person is over the phone or when I’m playing video games on my headset. Whenever I’m in a closed off room I tend to cover my mouth under my shirt and open any windows I can. I never leave the door closed and if there’s a fan near by, I turn it on. I can’t drive in a car without the window down. No matter how cold it is outside, I have to have the window down or cracked in fear of the people I’m driving with getting hot boxed with my breath. I haven’t really talked to anybody on what causes my breath so everybody just thinks I don’t brush teeth. It feels good knowing there’s other people that go through the same thing. It makes me feel like I’m not alone. If anybody wants to talk or something. Maybe even be friends! That would be tight. You can follow me on Instagram @cristian_o_hernandez

    • Oli says:

      Brother I am so sad to hear your story, same here please don’t give up I almost took my life away one day because of this promblem I went in a station and I was half a metre from a passing train the biggest scare of my life, stay strong you are not alone, i wish there was a group for people with this condtion do it would be easier to bear

    • Jayden says:

      I know how you feel, and I’m in high school and people can be so mean about it. I am now triggered when anyone sniffles around me. I hate the people that say it out loud for other people to hear then they say ewww it does smell. I try holding my breath and walking fast to my classes.

  42. Stella says:

    I just found this site. Bad breath my whole life. I went to the dentist for sore teeth, and ended up having the roots of teeth growing way into the sinuses. Had the teeth removed and eventually got dental implants. Foreign bodies (rhinoliths) in the sinsuses smell literally like crap. All these years not a single dentist found this. It was the x-ray technician who spotted it,. I had to have a bone graft and it was complicated and painful, but after it was done I was smelling like a rose. Never had crazy baddest breath again. If you are searching, its worth a shot to ask your dentist.

  43. John kevin says:

    Heey doc. I think I have this how can I contact you about it more? I notice I have Been having bad breath for 6 plus years now and it made me dropped out of school. It’s soo bad it could stink out the whole bus and I notice people covering there mouth and giving me looks… I brush my teeth 2-3 times a day I gargle with baking soda, acv, oil pulling, and I have also tried many supplements/herbs and products and none have worked.. please help me

    • Dr. R says:

      John. Find a physician in your area to run some of the testing suggested by Dr. Edelberg in the article. In addition, read through some of the comments of others with similar symptoms. Good luck.

  44. Minnie N says:

    Dear doctor, my husband just underwent 10 days of flagyl treatment and now say I reek of halitosis! Nobody around me says that so I am very confused about my holitosis, whether it is side effect for him or is it truly my breath. This is having a huge impact on our life. This just started a week ago. Please offer me some possible options. Thanks so much.

  45. Minnie N says:

    I failed to say my husband says I breath is foul. I don’t smell it at all. I floss, brush several times daily, scrape my tongue, and use Listerine mouth wash multiple times a day.

  46. Dr E says:

    Hi Minnie
    It could be that you acquired SIBO yourself. Get tested by finding a functional medicin doc in your area

  47. Jordynn says:

    Hey Doctor I been having bad breath from the back of my throat for awhile now and muscus is always in my throat. I have tried everything to get rid of it all is there a medicine I can get over the counter to help with all this?

    • cliffmaurer says:

      Hi Jordynn –
      If it has been going on for a while, it’s best to work with someone to determine why it’s happening. There are medications that can thin and reduce mucous, but mucous is the body’s response to an irritant of some sort, often a persistent infection, food or environmental sensitivity, etc. If you’re in the Chicagoland area, Dr. Neeti Sharma, our integrative internal medicine doctor, could very likely see you in the next few weeks to start the process of figuring out what’s going on here.
      Best wishes,
      Dr M

  48. Ola says:

    Hello Dr E. I have seen many reports of SIBO being a re-occurring issue even after antibiotics. Was this the case for your patient in the article? Or was their bad breath permanently gone? What would you recommend to ensure SIBO is cured permanently?

  49. Ola says:

    Sorry I just re-read the article and got the answers to my questions. Thank you!!

  50. Sarah k says:

    Hi I am new here but sounds too familiar. I also believe that I have sibo. I’ve had endoscopy, been to several dentist who says it is sinus . I then go to ent and they do an endoscopy and ct scan but everything looks good. I have been dealing with this for over 20 years. I really believe it is sibo because I took Flagyl for bacteria vaginosis it helped some but the problem came back. I notice it is worst after eating anything that has sugar including dairy and alcohol. I have always consumed a lot of sugar all of my life. Doctors jut will not test for sibo. I don’t understand. The smell comes through my nose and mouth. It is so bad It can fill up a room.

    • CJ says:

      Hi Sarah,

      I’m have experienced the same symptoms as you.

      It has also proven very difficult to get a SIBO test (still waiting for this to be actioned).

      Have you been tested, if so what were your results?


  51. Ola says:

    Hi Dr. In Robert’s case, did he alter his diet in anyway while on the course of antibiotics? Some videos on the topic are saying its best to eat sugar/carbs to ensure the bad bacteria don’t go dormant and can kill everything off. What are your thoughts on this? Any suggestions on what to eat/avoid while on the antibiotics? Also, the blend of probiotics Robert used – did he take them alongside the antibiotics or after he completed them? Thank you soo much

  52. Dr E says:

    Hi Ola
    The low FODMAP diet is best for SIBO (see link)

    You’re best probiotic is the soil based Megaspore Probiotic available online and from our apothecary

  53. Dr E says:

    Hi Alexa
    The treatment for methane will cover the hydrogen sulfide

    • Alexa says:

      Thank you for your response, Dr. E! Thank you for your post, I would not have asked for a SIBO test had it not been for your website.

    • Alexa says:

      One last question, Dr. E, I did the SIBO prep diet for 4 days and the smell was completely gone on the 4th day! On day 6, after I went back to eating a normal diet, the smell came back. Do you have any suggestions on which types of foods might be causing the odor? Carbs? Sugars? Sulfites? Gluten? Thank you in advance.

  54. Maha says:

    What is the root solution for the recurrence of sibo and the bad smell. I don’t care for the disease but to the this smell

  55. Queen_Ready says:

    I have been dealing with this for years now. I have had my tonsils removed, upper endo… changed my diet, nothing works. I noticed when I floss the floss stinks like my breath, but only on certain tooth. I will try the SIBO diet and see if this helps.

    • Maha says:

      Thank you for response. It’s the 14 years with suffering. The smell is like sewer. Feces… Disgusting smell. No one contact me. I am looking for treatment and I have some new test.. I will do with God’s well

      • Mess says:

        Same issue here. I have been suffering with this bad breath like sewer for more than two decades. I am 42 now.
        It destroys my several love life in my late 20’s and early 30’s.
        I am married and have a child now. My wife always complaints about my bad breath. My co-workers and friends, always tend to keep their distance when talking to me. Covering their nose or while sitting in a car with me, they open window despite the cold weather outside.
        I have tried every thing I can like all people commented above to get rid of this bad breath I have. I wanted to take my life several times before.
        Since 5/6 years ago, i gave up trying and I persuaded my self that I can not get rid of it and start trying to distant my self from people as much as I can. It totally damaged my social life. But it was better that way than get hurt by people reactions. My wife is so supportive and different from any one I know.
        I wish there is some good Doctor in my country Ethiopia who can help me. Or any home remedies I can take.
        It is also great to know that I am not alone.
        All of you gone through all the mental suffering I have been through for decades.
        I am more than willing to do any thing to try if any one said it helped him/her to get rid of it for good.

    • AJU says:

      I had bad breath problem for the past few years. My wife complained that my breath smelled like open sewer especially in the middle of the night when I wake up to go to toilet. I had to leave the room n sleep in the hall so she can.get back to sleep. I was really sad and depressed. Recently I came across a YouTube video about the heath benefits of drinking celery juice. I started drinking celery juice on empty stomach when I woke up in the morning. To my amazement my bad breath problem disappeared in a few days of drinking the juice. The bad bacteria and pathogens were flushed out from my body. Now I feel great and confident. Please give it a try. Have a great day. Cheers 😊

    • Tiffany Jones says:

      Any luck? I have the same issue. When I floss it only smells between the same 2 teeth… why is that?

  56. Teresa says:

    Hi ! I am suffering with a terrible back in my throat sour taste. I have it since I was 10 years old . Iam 35 now and because of that I have bad breath .
    So I have to brush my teeth 3 time a day or more if I have to go somewhere .
    Every time I put something in my mouth I will taste sour again.
    So I am always positive and always was searching for answers. So Please listen to this……
    I didn’t know that I have Acid Reflux … I don’t have any of the symptoms just the sour taste in the back of my throat and post nasal drip. So the first time I when to the ENT doctor She was positive my problems were due to Acid Reflux. She was so sure that game me the feeling that … She was right!!!
    So Im against medications for that because Acid Reflux is not caused for too much acid . It is the opposite!. So I decided to buy The Pivot Protocol that gives you more understand about this issue.
    The program is expensive around $200 but in my case give me the solution without medications that I was looking for…
    – I will give you some tips for you to follow if u want .. This is some of the tips in the Pivot Protocol…
    – Eat white rice (Not Brown) Brown rice is too hard on the stomach and this one needs to heal .
    – Drink lots of soups (Miso, Fish , Turkey are great options)
    – If you eat meat eat turkey or fish ( do not eat meat at nite ) You can have other meats but for the first 2 months let first ur stomach to heal. If u take meat (anykind ) buy a good Digestive Enzimes
    – Avoid the use of Antibiotics ( Of curse only if u really need them )
    – Don’t expend money buying expensive probiotics ( Use natural ones) pickles, Miso, Kombucha etc
    – Try not to use too much supplements ( Ur body suffers to digest them ) just eat right !
    – Eat an apple after your lunch (help digestion)
    – Do not drink Cold Drink (very important )
    – Drink Green Tea ( Cleans ur body)
    – Cut on the sweets
    – Cut on the fried food
    – Eat easy digest food . Do not over eat and mix too many things together at once.
    – Listen how r u feeling after eating.. ur body will tell u when is not feeling good.
    – Exercise
    Now I will give you some of my diet. I really suggest to try this diet for at least 1 month to see if ur improve or get rid of your bad breath ….. ( You don’t have nothing to lose and lot to win!!! )
    So … Something inside me was telling me that I should start a diet to heal my stomach for at least 3 months and after this I will little by little adding more stuff.. So I decide to go Gluten Free and Dairy Free diet. Lots of soups (luch and dinner) , Gluten Free white rice . I m just having Gluten free food (As much as u can) .
    Its amazing how much gluten free food I can find in the supermarket. I love cheese too and I found cream cheese, provolone cheese and other Diary free food. An taste delicious!!!
    So my diet….
    – Brakfast: Cashew milk ( I prefer not to eat much sweet) (warm or room temperature) , G. Free bread ( I put it in the freezer the I microwave for 10 sec and then I toast it )with olives , Dairy free cream cheese, butter etc. or gluten free cereal . I found delicious G.F. Granola and Oatmeal
    – Luch: I love pasta (G.F) with anything , not red sauce but u can add veggies, olive oil.
    Rice also with Sautee veggies, or chicken in the oven (just remember to have ur enzymes after )
    – Sopus ( Miso , turkey soup, chicken soup ) Mushroom soup . Instead of regular milk use almond milk.
    Dinner: I just have soups (No meat) and I love to add rice noodles in the soup. Or rice.

    So iam in my week #3 of my diet and I am 80% better !!! No meds .
    The best thing …. The food is delicious!!! I think more and more people are G.F. and diary free that the companies are having better products now and they r improving!
    My son was suffering from bad allergies . Always congested . He had Adnoids removed. But He was the same. I decide to change his diet little by little to diary free and just in 4 days … There is a Big difference =). And it is not easy he is already 10 years old and his is half italian . Love pastas and cheese, pizza and burgers . But …. I m not giving up!!!!!
    This is all I want to say … Please Please Please … Do this diet for at least 1 month . I am so sure you will see a HUGE change .
    Forgot to tell you do meditations for 20 min. This helps a lot to calm ur stress . Its so good!
    You can finf Miso paste in Asian markets . As well as the rice noodles and other healthy stuff.
    Please le me know ur experience !! I will open my forum to see them from time to time.
    Glod bless u all =)
    Blue Bird

  57. Christine says:

    I’ve had the same issues as everyone for about 20 years. Went through every test possible. Took flagyl and my symptoms went away but came back. I will try testing for SIBO hopefully my pcp does such testing. I’m 52 and I’m at my wits end!! I consider this to be a debilitating disease

    • CJ says:

      Hi Christine,

      Hope you are well?

      Would you say your symptoms make you think this diagnoses is a sinus issue or a gut issue?

      I’ve been dealing with this on and off for almost 10 years and have been going in circle with the doctors to believe what is the root cause; I.e. sinuses or gut or possibly lungs?

      I’ve too truly had enough of not know what is causing this.

      All I know is many factors can trigger it, wether that is food, drink, or smoke (in the past – shisha), or illness.

      It used to not affect me as greatly as before but now that I’m older and trying to build a life this is become extremely difficult!

      I do hope we all get some answers soon : )

  58. Hallo says:

    hi, I’ve had very strong bad odor coming from my nose and mouth after drinking the colon cleansing drink for colonoscopy. I also had pain on the right side of my kidney. whenever I’m exhausted frustrated this smell comes.

    I’m currently on Risperdal and when I stop taking it for like a week i start to notice a pain on my right side of kidney and a very bad smell from my nose! What could this mean? Can someone please help me out. 😞

  59. Yasmine says:

    Hi , I’ve bad breath for most 8 years and at the begining i thought that becomes my intestine or my liver but today i believe that becomes my Stomach; i note that whatever i eat and espacially bad food my breath is important and when i drink bitters plants , celeri juice , green apple , coffee in a empty stomach, pepsi my breath becomes better or disappears . I believe that i had a low level of stomach acid so i took betaine hcl but it didn’t matter, i think that i should take digestive enzymes . However , i’ m certain that my breath comes to my stomach ; i precise that i don’t have acid reflux but often after meal i have burp. Please do you have any solutions ?

  60. Dr E says:

    Dear Hallo and Yasmine
    You both need to be tested and treated for SIBO.Order the “Breath Test for SIBO” from Genova Diagnostics and if positive,ask your doctor for a prescription for Xifaxan

  61. Emmanuel Mahlinza says:

    Bad breath

  62. John Bode says:

    Hi all, my particular similar breath problem is greatly increased when consuming food and drinks containing sulfites (in their many forms) — wine, spirits, beer, processed foods etc. At times even sulfur ladened foods cause the same issue. Try searching on CBS SOUX. Black tea which i believe is dried with sulfur? is a problem but green tea is fine (with me anyway). I need to verify the catalyst with a medical expert but it coud be a gene mutation matter

    • John Bode says:

      To add, possibly the sulfur compounds in my blood stream, not deal with like in a typical perons system, are exhaled in my breath and could, along with stress, increase the likelyhood of SIBO?

  63. Dr E says:

    Hi John
    This is the best article on sulfur intolerance I’ve seen. Try following this doctor’s advice

    • Mr. A says:

      Hi all, can only join on all of your comments written before. Am battling with same or similar smelly breath problems like you are.
      Short chronography of mine:
      Maybe it hasn’t got anything to do with it but the bad breath you are all referring to, started on my side back in 2012 (when i was about 20ish years old), right after half a year of taking Isotrethexal medication, which cured my acne.
      It all started very mildly, but has gotten more and more aggressive.
      Have gone on general checks (everything as self-payer/private clinics) two personal doctors, two otolaryngologist, gastroscopy, they assumed helicobacter pylori, for which I’ve taken the medication/antibiotics for the eradication of it (BEST RESULTS) but the bad breath came back after a week, took on tonsillectomy (don’t do it guys, long recovery) ORL said said, maybe i just have too much “bad” bacteria in my organism, same comment as one of mine personal doctors, but they didn’t want to give me more antibiotics that helped me before (too invasive for the stomach), i understood what they meant. After i took a very strict diet 6 months with many best supplements and much personal training, nothing has helped.
      Took also the respiratory test for helicobacter AND gave blood samples for 3-4x symptoms, it showed then nothing, only the best comments from the doctors.
      Generally i’m young, very fit, have a healthy lifestyle, not much stress at work, put much of money in this thing, nothing has come out.
      Just ordered the SIBO respiratory test (QUINTRON Easy Sampler) to me at home, I’m from the central EU.
      Ordered it over a functional medicine guy here in mu country, he is like their middle-man, will see how this gonna work out or what the results will be.
      Only reason can be, somewhere in my body, as with all of you out there mentioning the same problem, there are “bad” bacteria generating which i’m unable to locate and which are only causing bad breath for me, nothing more. In the time of 3-6 months of my diet, i was taking per day through capsules 18-36 Billion “good” bacteria into my system. Nothing. Maybe will try now while I have time, 60 Billion per day with a new formula of capsule which degrade not in Stomach but in small intestine with a mix of extra HCL.
      Will keep you updated on the SIBO results and the very expensive probiotic + HCL mix, on which i’m not counting that much. Greetings

      • KMQ says:

        How did it go my friend?

        • Mr. A says:

          Tested twice for SIBO, both tezts negative, took on the given instruction from an expert doses of HCL and Prodegin (probiotic especially for the mouth), did a detailed “mud”/shit test, everything almost perfect, minor fungi, now taking dygestive encima and an antiseptic with the name A-FNG in drops for the last 1 month, it is not getting better. Think it is really as some say in the methabolism, that food and toxins are not being decomposed/eliminated from the body. That goes through blood-flow into our lungs and that rotten smell is then leaving our body via mouth, nose. In 3-4 weeks im taking a detailed metabolic test. After that nothing is to be done anymore… 🙂

  64. John Bode says:

    Thank you Dr E

  65. Patrick Gee says:

    For the past 20+ years, I’ve noticed that when I eat things like hamburgers, even slightly undercooked eggs, drink coffee, immediately I get this same thing happen, my breath smell gawd awful, like poo. It can last anywhere from 8 days to 2 weeks. I’ve tried everything, I’ve had doctors tell me it’s in my mind, that it’s acid reflux, and everything in between. I stopped drinking coffee, but found a coffee, BulletProof, that processed theirs to ensure no mold or bacteria and so I drink that now without issue. Could it be this SIBO.

  66. mohamed says:

    What a relief it is to read this article about Robert. I have been experiencing this same exact thing for ten years now and it feels like an absolute living nightmare. I am a male in my early 30s and this “odor” has been effecting every aspect of my life. It has made me incredibly isolated,anxious and depressed and I don’t know what to do anymore.
    I visited psychiatry and prescribed me olanzapine and paroxtine for six months,my smell become ok,but after I finished it returned.so please help be how to get rid of for this.and return my life normally.

  67. Dr E says:

    Go back on these meds if they worked for you. They are quite safe for long term use

  68. Leslie says:

    This is so surreal that I found this group. I am calling my PCP tomorrow. Every word and concern that you all have has been my entire world for 10 years or more. I don’t have friends; I have no desire to do anything and have to literally drag my self out of bed for work chores and errands. It’s been real hard, but now some hope.

  69. Ola says:

    Hey everyone, I wanted to come back and post this in case it might possibly help others because I have dealt with the same despair. After completing my 2nd round of SIBO treatment last year, the nasal fart/poop smell was still there. I came across a post on another forumn that talked about digestive enzymes. Keep in mind, that I have tried other digestive enzymes and diet restrictions in the past and nothing worked. So please know that it must be an enzyme that contains the below ingredients. I found one and the poop “sewer” smell was gone within 24 hours, I was literally in shock!!! I still cannot believe that it could have been this easy all along. It looks like SIBO or possibly overusing antibiotics and/or probiotics through the years, depletes the normal enzymes that are supposed to be in the gut. When these enzymes are missing, your body is unable to break down anything you eat [hence why, even eating “healthy foods” or “low fodmap foods” makes no difference for us]. So the food will continue to rot inside you and ferment, then releases these odorous gases.

    Once again, it doesnt matter the brand… just find digestive enzymes that contain all the below ingredients and use it before each meal:

    PROTEASE (I, II, III, IV, V), papain, amylase, lactase, lipase, cellulase, alpha galactosidase, maltase, PEPTIZIMA, invertase, pectinase, Glucoamylase, hemicellulase, phytase, bromelain

    • Abi says:

      Hi Ola,

      Hope all is well.

      What brand did you use?

    • Kitkat says:

      Hi Ola,
      What is the name and brand of the digestive enzymes you are using? I plan on buying a bottle.Thank you so much for your post.

    • B says:

      Would love to know what brand you found this all in. I’ve been researching and coming up short to find them all.

    • Ola says:

      Hi all, sorry I cant post the brand because I dont think they will allow it. But if you google digestive enzymes, there are many out there with these enzymes, you just need to make sure to read the ingredients before buying

    • Maha says:

      Hi ola. How did it disappear within 24 hours. Was the smell continuous for 24 hours? Then disappears. To me I can’t judge. I can decide with the same past conditions that when the stomach is full and follow it with water and Because the smell spreads suddenly. not permanent. What do you think?

    • Ola says:

      Hi Maha, The smell was always there until after I took the enzymes. I was able to smell it if I took a really deep breath or burped and ofcourse the reactions from other ppl. Is there someone you can maybe trust to ask

      • Antonio says:

        Hello Ola,and Maha. Maha,sometimes you can tell if you have a bad breath by licking the finger,or rub your finger all over the tongue,and immediately smell it.

        Ola,i tried to find the supplement all over the internet,i just couldnt,can you somehow help without giving the name of the brand?

        Does is have to have those ingridients,and are you doing better now?

        • Maha says:

          Hi. This test you mean (Smell TEST) is for halitosis smell. Not sewer. Thank you

          • Nadine says:

            Wow I am so happy I found this page. My terrible chronic bad breath has made me want to take my life. With friends making fun of me and workers. I won’t even go on dates because of this. I’ve been to dentists everything and they tell me everything looks good. I have a tongue scraper but the white coating just keeps coming. My teeth/ breath never feel clean ever. People have told me it smells like I’m farting. I have no social life because I’d rather be at home then be out embarrassing myself. I’m going to try the sibo & pray it comes back positive so I can get treatment.

            • Rem E says:

              In have been experiencing the same thing, I’ve excluded myself from everything, have no social life cause if I am home by myself then I am not embarrassed. So glad I found you guys so I know I am not alone in this. Help me please!

            • Carolina 。*★ 。* says:

              Hi Nadine,

              Have you gotten checked for oral thrush? I saw that you mentioned white coating on your tongue, which is a common symptom.

              I also struggle with bad breath and a white-coated tongue and just recently got diagnosed with oral thrush. The medication that was prescribed has f’sho been helping!

              I was taking pictures of my tongue every day and comparing them to pictures of oral thrush online. If you think there’s similarities, reach out to your dentist and let him/her check the pictures and your tongue out!

              Good luck 🙂

              • Nadine says:

                I just tested positive for SIBO. Today is my first day taking medication. I pray this works! $400 for 14 days of pills. I recently just lost a guy I was seeing because I was to embarrassed to communicate and go out with his friends due to my terrible breath. I always isolate myself due to it, and I don’t allow him to kiss me.

                I pray pray pray this works. I’m losing hope, & I’m losing my life from this

                • Nadine says:

                  Update: I have 4 days left on Rifaximn after being told I have sibo & my bad breath has cleared up 90% I have never ever felt more confident again!!even in the morning time I have zero bad tastes in my mouth.

                  I am so so happy, I lost the one relationship due to not talking to his friends due to me being afraid of bad breath

                  Now. I have to retrain myself and not be scared to talk again.

                  Anyone suffering from terrible breath get tested for sibo. I went to doctors and dentists for years and no one would help me until I came across this amazing group & I took the test!

            • Renee says:

              Take a daily zinc supplement. It is proven to kill candida, which causes oral thrush.

              • Nadine says:

                My bad breath has returned I lost my relationship over it. I’m at my end point… I don’t want to live anymore I can’t handle this

      • Maha says:

        What happened?

    • Memma says:

      Hi Ola,

      This is like looking for a needle in a haystack if you cannot tell us the brand you used. I just wish you’d drop a hint!


    • Maha says:

      Hi Ola.
      Are you still okay now? Did the smell come back?
      Are you following taking the enzymes?
      Please inform us more how do you do?

    • Maha says:

      Hi Ola. Whats the name of the brand of the digestive enzyme?

  70. P shem says:

    Hi I have this same problem for long time now.. I have try everything … few months age I had tonsillectomy but didint help at all… I have problems at work because of this… just have enough. I have been trying with a lot of doctors but they was useless. (sorry for my english).

  71. Carolina 。*★ 。* says:

    Hi all,

    I’ve also had this problem for close to two years now and it’s terrible.
    I used to be the most social person, and now hardly want to go out.
    I’ve felt restricted in every aspect of my life, and fear that I’m embarrassing myself every second of every day. It’s heartbreaking.

    I recently went to my dentist and got diagnosed with oral thrush. I’m on my second round of medication now, and while it hasn’t completely solved the problem, it’s really helped! If this second round doesn’t do the job, I’ll go to my doctor and see if there’s a bigger issue going on. I’m happy to post again if so…

    If you have white coating on your tongue, especially when you wake up, you might have oral thrush and should go see a dentist or doctor! I’m almost certain now that the smell has been coming from that so I’ve been taking the medication prescribed 5x a day, rinsing with salt water 2x a day, using a tongue scraper 2x a day, and flossing of course.

    I wanted to share, and will keep sharing, because I can relate to everyone’s pain on here as this stuff is so freaking isolating…


  72. John broade says:

    My particular similar issue is worsened when consuming foods and drinks with sulfites — preservatives mostly. Most beers and wines, some less aged spirits, processed foods etc. There is a range of sulfite preservative types and they are in lots of things — dried fruits, bottled lemon juice, some drugs, processed meats…. I have issues with black tea but green seems to be okay. At times sulfur ladened foods cause the breath problem like spinach, cabbage, eggs etc — but these foods are essential like sulfur intake so you would need professioal advice here. I’m looking at genetic type causes searching on CBS and SUOX and sulfur pathways. Perhaps the mis-processed sulfur sulfites in my bloodstream are expelled as gasses in my breath. Any way best to everyone J B

  73. Jennifer says:

    This is really flipping gross but sometimes I have a white thick mucous that comes out when I have a bowel movement. Usually the day after constipation cramps and inflammation pains in my abdomen area. Also have most of the previously mentioned symptoms. Is this likely SIBO as well?

    • cliffmaurer says:

      Hi Jennifer –
      This can be caused by a number of problems and should be explored with a functional medicine practitioner. In particular, Dr. Scott and Dr. Edelberg see a lot of this type of thing and would be happy to see you over a telemedicine visit to help you figure out what’s going on and what to do about it. Please call 773.296.6700 to schedule. Telemedicine visits can be submitted to your health insurance as well.
      Hope we can help you get to the bottom of this!
      -Dr M

  74. Memma says:

    Jesus Christ! And I thought I was alone in my suffering. I can’t stand my own breath and I am embarrassed when I have company. In fact, I have lately been avoiding meeting with associates under the pretense of social distancing. But I am just embarrassed to stand close when I speak to another human being.

    I know I don’t have Acid reflux, SIBO or any such affliction but I am pretty sure my bad breath is from an irritated nasal mucosa in the back of the nose. I also have cyclical neutropenia so that my weakened immune system is unable to deal with with low level infections that just fall short of making me sick. This is because when the phlegm from the back of nose trickles down and I cough it up, I can see that it is yellowish brown in contrast to white spittle that comes with it.

    My ENT specialist assures me that there is not much I can do about it since the condition is chronic and very common in the population. My bad breath is strictly from the nose and hardly affects my mouth. When I breathe, I can literally smell sewer gas filling up the space around me. I use a nasal rinse regularly to no avail. I am so sick of this that I am considering either killing myself or adopting a smoking habit to mask the smell. I wish there was a health professional out there that can help with my condition. I am at my wits end and I don’t know what else to do. I need help, please.

  75. Dr E says:

    Hi Memma
    Ask your doctor for a single week of Flagyl (metronidazole) 250 mg three times a day. This takes care of a lot of breath issues. If it works, then you can have it made into a mouthwash, used once daily and spit out

  76. C Pitt says:

    I truly feel for everybody on this message board. I’m in my 40’s and I’ve had this miserable problem since I was 13 years old. I’m healthy, have perfect oral hygiene, floss and brush daily, I’ve had my tonsils removed, yet my mouth is completely overrun by gram-negative horrendous-smelling bacteria. I tested positive for SIBO, even though I don’t have an stomach issues or digestive problems. I’m fit and eat a healthy diet. I’ve taken antibiotics like xifaxan, amoxicillin, ciprofloxacin and metronidazole. They will kill 90% of the different types of foul-smelling bacteria, but within a few days, the 10% that the antibiotics can’t kill will survive and multiply so the next time you take the antibiotic it will not work since the only bacteria left in your mouth are now resistant to the antibiotic. My entire family has this issue so I believe it is hereditary in my case. There’s been some research about a genetic mutation in the SELENEBP1 gene that produces proteins that break down smelly sulfuric compounds. There’s a simple genetic test you can take that will tell you if you have this mutation, but it’s not covered by insurance and it costs about $800 and I can’t convince my PCP to authorize it. Since there is no treatment or cure for the mutation, there’s really no point in taking the test. This is a horrible, frustrating, embarrassing thing to live with and I’ve definitely thought of ending my life over it. My biggest fear is that it passes to my 2 young children and they have to live with this condition for the rest of their lives. I’m Hoping my wife’s genetics win out. I’m working with my GI doctor and he’s having me get some different X-Rays taken. I’ll let you know if anything encouraging comes from it. Be well.

    • CJ says:


      Thank you for sharing your story.

      I too have been dealing with this for almost 10 years, I’ve had my tonsils and adenoids removed, seen multiple ENT and gastro specialist and several dentist, all to come too the same result – test negative (can’t find a problem). I also believe this has do with how our bodies breakdown the certain compounds which releases gasses through our mouth/nose. I’ve tried multiple rinses, antibiotics to help improve this situation but so far nothing has been successful.

      I’m really interested that you mentioned the SELENBP1 gene, I’m going to research into this.

      I’ll keep you updated with my progress (if any!)

      Stay safe,

    • Maha says:

      Whats new with this problem?

    • K says:

      Hello, have you been able to fix your cure? As i suffer from it and its been a terrible experience as I as well have had the same thoughts and its just a humiliating thing to have is a really bad odor in my mouth each time I speak. I NEED HELP!

  77. I can assure you that I don’t fart but immediately 5 minuets after brushing my breath smells like fart I have visited a dentist for deep cleaning for twice but still have the problem and visited ENT but still have the problem,took pantoprazole and gaviscon but still has that fecal smell been treated on H pylori but still has bad breath can SIBO love the cause of my bad breath

    • cliffmaurer says:

      Hi Kamal,
      SIBO would be on the list of things that could cause problems like this; I recommend scheduling a telemedicine visit with one of our functional medicine providers to get to the bottom of this.
      -Dr M

  78. Maha says:

    So what’s the use of the the test and if the result is positive

  79. Maha says:

    So what’s the use of the the test and if the result is positive if there’s no treatment.

  80. C Pitt says:

    Here’s a link to the article about the SELENEBP1 gene. It’s a couple of years old, but it says there is no current treatment. I’ve tried to google for updates, but I haven’t found any.


  81. Kathrin says:

    What’s the solution to get rid from this disaster?????!!!!!!

  82. Maha says:

    So what’s the solution to get rid from this disaster.?????!!!!!

  83. Dr. E says:

    To be honest, I am very skeptical about this ‘bad breath gene’ which even the researchers say ‘may effect up to 3% of patinets with chronic halitosis.’ Three out of a hundred is a pretty small number.
    Also, they are not clinicians and did not test nor comment about the type of gas that might be produced. From the chemistry they’re tossing about, it’s probably one of the methanes which may respond to an intestinal antibiotic like xifaxan or neomycin. Anyway, without further handwringing, have someone test your breath for both hydrogen and methane

    • C Pitt says:

      My mother, father, and brother all suffer from the same problem; therefore I believe it is genetic in my case. We all have healthy teeth and gums. We all go to the dentist twice per year. And we all have breath so bad that it’s almost indescribable. The fact is it’s extremely doubtful anything can be done to cure it. The doctors on this board are perplexed, the people on this board are perplexed, and I am perplexed. Antibiotics will work for a short while, but the only kill 99% of the bacteria. The 1% that are resistant will survive and multiply and then the antibiotic will no longer be effective.

  84. Colin says:

    I have been dealing with this problem on and off for 20 years now. It first started late 1999. I got cured by a homeopath in 2006. It came back again in 2010 and since then nothing i have tried have worked, even working with the same homeopath that cured me before didn’t work. Since 2010, i have done root canals, removed my tonsils, treated acid reflux and even did LINX reflux surgery. Dentists and Oral Surgeons say i’m ok and have refused to remove my wisdom teeth – they say they are fine. I have done candida diet, did H.pylori test which came back negative.
    After learning about SIBO, i met with a functional medicine doctor who also happened to be an MD. He refused to prescribe xifaxan and opted for elemental diet instead. I have since completed the elemental diet. While some digestive issues improved, the major symptoms of bad breath is still there. He prescribed supplements i have been using Betaine hcl, probiotic, digestive enzymes, but the bad breath is still there. I don’t know what else to do. If i get a doctor to prescribe me xifaxan will that help me? I’m just so confused at this moment. My symptoms are: bad breath, mucus in nose(feels like one nose is slightly blocked) coated tongue, bad taste in mouth, mucus in throat, occasional throat clearing and i wake up with mouth full with saliva in the morning.

    • cliffmaurer says:

      Hi Colin –

      This definitely sounds like a complex case, deserving of some time and attention by a functional medicine provider who can help go through your history and determine the best course of action. I recommend calling in and schedule an in-person or telemedicine visit with one of our functional medicine providers. Our nurse practitioner Wendy Ploegstra or naturopathic doctor Caley Scott likely have openings in the near future.

      Looking forward to serving you!
      -Dr. M

    • Gelonaxy says:

      @Colin: I have exaxctly the same symptoms. What a nightmare! badbreathhalitosis.com is a good forum.

  85. Maha says:

    Thanks for your interest. I have been suffering with this problem since along time. Actually, I’ve tried xifaxan twice along with proboitic. I had an improvement since the 5th day and gradually the smell disappeared within 2 weeks. But after a month it returned back with a worse effect. I don’t understand that. Thank you

  86. John Sacramento says:

    Hi Dr. I’m having pretty much the same symptoms. I’ve noticed that my BB is reduced or goes away for a day or two after drinking a larger amount of alcohol on a night out (whiskey usually). Could it be that the alcohol washes away the accumulation in the small intestine or somehow paralyzes the gas producing bacteria for a while? I also typically get a better stool movement and reduced bloating in this hangover period as well. Thanks for your answer (if you have one that is).

  87. Dr. E. says:

    Probably not the safest of treatments. Interesting idea if you’re not troubled with the thought that the treatment is more dangerous than the condition

    • D says:

      Hello Dr. E,
      What should I do? I’ve had bad breath, constant bloating, gas, diarrhea, sometimes constipation. The doctors all said I have IBS. However, I have been getting comments asking if I passed gas when I didn’t. These comments have been happening for 7 years now. Is this SIBO related?

      • John Broade says:

        as mentioned earlier, my similar issues are bought about by sulfite and sulfur rich foods like eggs, dark leafy veges, cabbage, some fruit drinks, etc etc etc. Sulfite preservatives are in almost everything — dried fruit, most beers, wines, less aged spirits, processed meets etc etc some medicines antibiotics and drugs. I believe (still needs confirmation from a medical professional) Sulfuration pathway problems, CBS, genetic faults or mutations or similar makes my body less prepared to deal with sulfur elements so they build up in my blood and are expelled from my breath. Sulfur is essential so you may need expert advice here about what too much reduction will do but definitely limit sulfite preservatives from your diet and see if that helps — I’m looking into genetic fault causes and a gene editing science (Crisper) that may be a future benefit — all the best.

  88. Kelly says:

    Hello, i am 27 yers old and i have suffered frlm bad breath for years and its been so emberassing i feel like over the years its gotten worse. Its the worse thing thats ever happened to me as im embaressed to even talk to people. Where can i get this ASAP?! PLEASE ive tried dentist, GERD ive spenf so much money on things thinking itll work and it doesnt. HELP!!!

  89. Maha says:

    Hi. These words will concern everyone here. Its about the treatment of this smell. First of all, I prayed God to give me the solution and the treatment. And by his giveness he guided and inspired me to this attempt. Thank God always and forever -Alhamdulellah_ and by that l used the digestive enzymes that ola _here_ in the page pointed to. I tried some of them and the smell disappeared al hamdullellah. So first of all.Thank you God.and next thank you my dear ola. I advice everyone here to try and write down the results and happen.Wishing you all well.

    • C says:

      What are the enzymes?

    • Carolina 。*★ 。* says:

      Hi Maha,

      Thanks for sharing!

      Are you able to share the product you use? 🙂

      If not, did you order then online?

      Thanks in advance!

      • Maha says:

        The digestive enzymes is vita-zyme

        • CPIT says:

          Hi Maha. Thank you for sharing this. I wasn’t able to find a single digestive enzyme supplement that contained all of the ingredients that Ola recommended so I had to combine three different supplements to make sure I was taking all of the ingredients she recommended. Unfortunately, it made no difference in my case. My breath is still absolutely horrible all the time. Maybe I’ll give vita-zyme a try. Please let me know if you noticed an improvement with vita-zyme. Thank you.

    • Lisa says:

      What product helped you??

  90. Jill Smith says:

    Hello All,

    I’ve been doing with the same problems since I was 14 and I am 30 now. This happens with and without eating. It’s worse after I eat because there a really thick white or yellow coating on my tongue and an even more foul odor coming from my mouth. I don’t know what do to. If life continues like this, I don’t even want to live anymore because it’s not worth living. Please help!

    • cliffmaurer says:

      Hi Jill,

      We’d be happy to help – please give our Patient Services staff a call and ask to schedule with one of our functional medicine practitioners. We should be able to accommodate you with a telemedicine visit within a week or so.

      Best wishes – I hope we can help get you some answers soon!
      -Dr M

  91. Lisa says:

    If it’s hydrogen sulfide that is causing the smell couldn’t we drink or take something that would dilute this?? I’ve heard that celery can combat sulfur smells. One would think that a scientist would come up with a concoction that would help us all. If they market it for bad breath it would make a lot of money.

    • cliffmaurer says:

      Hi Lisa,
      This is a great question. The problem is that diluting hydrogen sulfide would really just cover up the symptom, rather than addressing the problem. Gut issues like these can cause other health related problems, and the bad breath is just the symptom. Best to get to the bottom of things.
      Hope this helps!
      -Dr M

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