Related Experiment Video
Updated: Jan 17, 2026
Therapeutic Effectiveness of a Dietary Supplement for Management of Halitosis in Dogs
Published on: July 6, 2015
Therapeutic effect of the low FODMAPs diet for refractory halitosis associated with small intestinal bacterial
Peng Gong1, Ting Kang2, Shi Meng Wang3
1Department of Gastroenterology and Halitosis Clinic, Minhang Hospital, Fudan University, Shanghai 201199, People's Republic of China.
Abstract:
Some cases of halitosis associated with small intestinal bacterial overgrowth (SIBO) are refractory to antibiotic therapy. The low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) diet (LFD) has emerged as an alternative therapeutic option for SIBO. This retrospective study is the first to investigate the efficacy of LFD in refractory SIBO-associated halitosis. We consecutively reviewed data from 141 patients with refractory SIBO-associated halitosis who underwent a four-week LFD intervention. Halitosis was diagnosed using organoleptic test. Volatile sulfur compounds-including hydrogen sulfide, methyl mercaptan (MM) and dimethyl sulfide (DMS)-were quantified in nasal breath using the OralChroma device. SIBO was confirmed via hydrogen/methane breath test. Serum nutritional parameters were measured to assess nutritional status. Dietary adherence was evaluated using the FODMAP Adherence Report Scale. All patients demonstrated good adherence to the LFD, with no significant changes in nutritional parameters post-treatment. Overall, 80.85% and 78.72% of the patients exhibited SIBO resolution and halitosis improvement, respectively. DMS levels significantly decreased after treatment [41.84 ± 10.73 parts per billion (ppb)vs.19.22 ± 7.91 ppb,P< 0.001]. In contrast, baseline hydrogen sulfide (17.08 ± 12.30 ppb) and MM (13.50 ± 5.65 ppb) levels were low and remained unchanged post-treatment (P> 0.05). Moreover, post-treatment comparison between SIBO-negative and SIBO-positive groups revealed a higher rate of halitosis improvement in the SIBO-negative group (90.35%vs.29.63%, P< 0.001), accompanied by significantly lower DMS levels (17.15 ± 5.81 ppbvs.23.63 ± 9.99 ppb,P= 0.006). Therefore, we conclude that a four-week LFD intervention appears effective for refractory SIBO-associated halitosis, with great adherence and no risk of malnutrition. Its mechanism likely involves SIBO alleviation, thereby reducing intestinal production and breath excretion of volatile malodorous compounds, particularly DMS.
Insights
The low FODMAP diet (LFD) effectively treated halitosis in patients with small intestinal bacterial overgrowth (SIBO) refractory to antibiotics. This dietary intervention resolved SIBO in over 80% of patients, significantly reducing breath odor compounds.
Area of Science:
- Gastroenterology
- Microbiology
- Nutritional Science
Background:
- Small intestinal bacterial overgrowth (SIBO) can cause halitosis refractory to antibiotic treatment.
- The low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) diet (LFD) is a potential alternative therapy for SIBO.
Purpose of the Study:
- To investigate the efficacy of the LFD in patients with SIBO-associated halitosis resistant to conventional therapies.
- To assess the impact of LFD on SIBO resolution, halitosis improvement, and breath volatile sulfur compounds.
Main Methods:
- Retrospective review of 141 patients with refractory SIBO-associated halitosis undergoing a four-week LFD intervention.
- Diagnosis of halitosis via organoleptic testing; SIBO confirmation by hydrogen/methane breath test.
- Quantification of volatile sulfur compounds (hydrogen sulfide, methyl mercaptan, dimethyl sulfide) using OralChroma; assessment of dietary adherence and nutritional status.
Main Results:
- 80.85% SIBO resolution and 78.72% halitosis improvement were observed.
- Dimethyl sulfide (DMS) levels significantly decreased post-LFD (41.84 ± 10.73 ppb to 19.22 ± 7.91 ppb, P < 0.001).
- Higher halitosis improvement rates (90.35%) and lower DMS levels were noted in SIBO-negative patients post-treatment.
Conclusions:
- A four-week LFD intervention is effective for refractory SIBO-associated halitosis, demonstrating good patient adherence.
- The LFD appears to alleviate halitosis by reducing SIBO and subsequent production of volatile malodorous compounds, particularly DMS.
- The LFD intervention showed no adverse effects on nutritional parameters, indicating a safe therapeutic option.
Related Concept Videos
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:30Irritable Bowel Syndrome III: Medical and Nursing Management
01:17Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
01:21Drugs for Treatment of Constipation-Predominant IBS
01:29Bacterial Flora of the Large Intestine
The normal gut flora of the colon plays a critical role in generating essential vitamins such as vitamins K, B5, and B7.
01:50What is Monogastric Digestion?