Hideyuki Miyachi

Background and Aim Although patients report either improved or worsened halitosis after Helicobacter pylori eradication therapy, such complaints are subjective. Only a few studies have objectively evaluated reports of changes in halitosis after H. pylori eradication; thus, this study aimed to investigate these changes after a successful H. pylori eradication. Methods Between February 2015 and October 2018, 56 347 patients visited the clinic. Informed consent for participation in this study was obtained from 164 patients scheduled to undergo upper gastrointestinal endoscopy due to halitosis. Of the 91 patients with H. pylori infection, the halitosis values were evaluated as Refres breath (RB) values using a Total Gas Detector™ System and compared before and after successful H. pylori eradication, as confirmed with urea breath testing. Results Among the 91 patients treated, 77 patients were successfully eradicated of H. pylori and had their Refres values measured (21 men and 56 women; mean age, 64.2 ± 11.5 years, including 10 smokers); among these 77 patients, 27 showed RB values of > 60. Their RB values significantly improved from 73.5 Â (95% confidence interval [CI], 64.1–82.9) to 59.4 Â (95% CI, 50.0–68.8) ( P = 0.038). Of the 30 patients who could be followed up for > 2 years after successful H. pylori eradication, 8 with an RB value ≥ 60 showed significant RB value improvements from 77.9 Â (95% CI, 59.4–96.4) to 30.1 Â (95% CI, 11.6–48.6) ( P = 0.0016). Conclusions Helicobacter pylori eradication therapy could improve halitosis, and such improvement could be maintained even 2 years after successful eradication.