Job Stress Can Lead to Intestinal Inflammation and Subsequent Gut-Originated Extraoral Halitosis

Area of Science:

• Gastroenterology
• Otolaryngology
• Psychosomatic Medicine

Background:

• Stress-associated halitosis research is limited, primarily focusing on intraoral causes.
• Extraoral halitosis (EOH) linked to stress requires further investigation.
• The connection between job stress, intestinal inflammation, and EOH is not well-established.

Purpose of the Study:

• To investigate stress-associated extraoral halitosis (EOH).
• To explore the association between job stress and stress-induced intestinal inflammation.
• To identify potential biomarkers for gut-originated EOH.

Main Methods:

• Retrospective study of 664 white-collar employees reporting stress-associated halitosis.
• Assessment of halitosis using organoleptic score (OLS) and OralChroma breath test for volatile sulfur compounds (VSCs).
• Evaluation of job stress via modified Brief Job Stress Questionnaire (BJSQ), and intestinal inflammation using hydrogen/methane breath test (HMBT) and nitric oxide breath test (NOBT).

Main Results:

• 106 patients with stress-associated EOH were identified; 61 had high stress.
• High-stress individuals showed significantly higher rates of positive HMBT and NOBT, elevated OLS, and increased exhaled dimethyl sulfide (DMS).
• HMBT and NOBT positivity correlated with higher OLS and DMS levels, indicating a link between gut inflammation and EOH severity.

Conclusions:

• Job stress is a significant factor contributing to intestinal inflammation.
• Intestinal inflammation can lead to the development of gut-originated extraoral halitosis.
• This study highlights a novel pathway linking psychological stress to EOH via the gut.