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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6803
Experience:  14 years as clinician in the field of Family Practice
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I am a 50 yr old female in good health,workout daily,low body

Customer Question

I am a 50 yr old female in good health,workout daily,low body fat,excellent bloodwork.i'v had GERD for more than 20 yrs and believe that the GERD givs me very bad breath.I am obsessive with oral hygiene and have even been scolded by my dentist for scraping my tongue obessively. I have an obession with oral hygiene thinking that was were my bad breath was originating.I realize that the odor is coming from my stomach.I can smell the odor whenexersing and even when i bend over to tie my shoes.help!
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD : Hello!
Customer: hello
Anthony Bray MD : With regard to the reflux issue I suspect that you are right....
Anthony Bray MD : You may benefit as a start to observe reflux precautions...
Customer: short of surgery to keep my sphincter closed, how can i deodorize the odors in my stomach?
Anthony Bray MD : These include waiting for 1.5 hours after you eat before you lie down and to elevate the head of your bed by 4 to 6 inches with blocks under the bedposts at the head side part of the bed...
Customer: I already sleep on a wedge the length of my bed, I may be a little lax on eating to close to bedtime
Anthony Bray MD : Certain foods may irritate the esophagus with recurrent reflux --- watch out and take care with eating hot spicy foods and acidic foods--- these include citrus fruits( needed for nutrients like vitamin C) tomatoes, onions and peppers.
Anthony Bray MD : also watch for alcohol and coffee....
Customer: this problem with breath odor is more painful emotionally than the acid reflux itself... it is really affecting my self worth ans keeps more always distant to people
Customer: can eating all the right things and taking meds actually encourage the sphincter to stay closed, or could it be too defective to fix other than surgery?
Anthony Bray MD : You may benefit to consult a gastroenterologist for further evaluation of the problem. Common factors may include a hiatal hernia( 40 percent of people have this) and/or decreased tone of the lower esophageal sphincter.
Customer: i gave up coffee and citrus
Anthony Bray MD : Only the worst cases would be advised to consider a procedure such as a Nissan fun duplication to prevent reflux....
Customer: lets say that i have a defective lower sphincter, can i take any type of over the counter supplement to deodorize the smell? I
Anthony Bray MD : As for the brushing the tongue this should help with the odor problem but do keep this to a moderate degree and not injure your tongue!!
Customer: the reflux has caused a swallowing defect, and I get spams many times after swallowing, I have seen a gastro dr. ans need to go back
Anthony Bray MD : Yes there are products over the counter to help with GI related odors that you may try. I am not specifically that familiar with these products to advise you much with regard to these but I would advocate giving them a try. I would try to find a product with activated charcoal.
Customer: i have heard of a new procedure that puts a magnetic bracelet around the lower acct-4fy8fq1.ddmi.intra.renhsc.com to keep it closed, no you know anything about this. at massesschusets general hospital
Anthony Bray MD : I agree with good oral hygiene but try not to be overly obsessive in this regard so as to be destructive and counter- productive.
Customer: sorry about the insert of a login
Customer: must have copied it early today
Customer: the bracelet keep the lower esophagus closed
Anthony Bray MD : No I have not heard of that ....frankly I fail to understand how a magnetic bracelet would help this particular problem....
Anthony Bray MD : Now there are new techniques being introduced with magnetic treatments for certain psychiatric conditions.
Customer: i appreciate your help, and am really desperate for a fix, it is a constant fear and affects me painfully.
Customer: this is a link to the article
Customer: http://www.massgeneral.org/digestive/about/newsarticle.aspx?id=3641
Anthony Bray MD : Raglan is a medication that works to speed the exit of food from the stomach and should help some to increase tone of the lower esophageal sphincter. This may hold some benefit for you as an option.
Customer: are you saying that even if the sphincter stayed closed, I would still ahve a bad breath problem?
Customer: I will look into the Raglan
Anthony Bray MD : Ok I will review your link sometime today and post a response back to you with regard to this....
Customer: I take 500 mg daily of magnesium as instructed by my internist for headaches......I know it realaxes the muscles, could it be making my lax shincter worse?
Anthony Bray MD : It is Reglan... You may look up multiple sources on this at www.drugs.com and the enter search for Reglan...
Anthony Bray MD : i am not saying that would still have bad breath problem. It is hard to predict the extent of improvement that you may have from this...
Customer: understand
Anthony Bray MD : another consideration could be a sinus infection and post- nasal drainage...
Customer: been to an ent and no problems, cat scan looked great no drainage
Anthony Bray MD : a tonsillar infection or dental infection could also produce a bad breath problem...
Customer: all these have been ruled out, as I go to my dentist every six months
Customer: when i physically bend over I can smell the oder in my breath. it has been confimed by others that I trust
Customer: seem that bending over may force the sphincter to open?
Customer: do you think the magnesuim may be making the problem worse?
Anthony Bray MD : II see. Well it does seem that you have been thoroughly evaluated for the problem. I think further evaluation by a gastroenterologist may yield helpful information for you and would be an important aspect to consider.
Customer: thank you, XXXXX XXXXX an appt in JUne. just hoping to find a way to deorderize this oder until I can be helped with a more permanent fix
Anthony Bray MD : It is an interesting question with regard to the magnesium as this does tend to relax smooth muscle. I am not aware of magnesium being associated with this as a problem however.
Anthony Bray MD : The.bending over leading to problems sounds to be consistent with a possible hiatal hernia as a probable cause of this.
Customer: thanks for your help, i will discuss all this with my gastro doctor
Anthony Bray MD : I would try some of the OTC products that purport to help with this problem. I wish that I could guide you further with this but I am not specifically that familiar with these products and I don' t know how well that they live up to their claims. If you decide to try one or more of these I would love to hear back from you on regard to your experience!
Customer: thank you, XXXXX XXXXX
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6803
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 6 other Health Specialists are ready to help you
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

I read the article that you mentioned and this procedure and system ( LINX) using the band with magnetized titanium beads implanted to surround the lower esophagus does sound quite promising! I' m not sure how available this procedure may be to you at this time or how soon that it may be. I agree that it does sound quite promising at this time. I would ask if this would interfere with future MRI Procedures. Titanium typically would not interfere with MRI's but this metal is not typically magnetic. This I suspect may be one drawback.

I hope this helps. Let me know if you have further questions! Best regards,

Anthony Bray MD

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