Bitterness in the mouth. Diagnosis of causes, treatment

Symptoms

Bitterness in the mouth can manifest itself in different ways, for example:

after overeating and eating certain foods - indicates the reflux of bile into the esophagus and diseases of the bile ducts,
aftertaste after taking medications means a disruption of the normal microflora, a negative effect on the liver and the destruction of beneficial bacteria,
after sports training - speaks of liver pathologies.

Bitterness can occur at different times of the day, after physical activity and during the abuse of bad habits. Often the symptom is accompanied by nausea and vomiting, dizziness, heaviness in the side and abdominal pain, white coating on the tongue and a feeling of bloating, heartburn and belching, dry mouth. At the appointment, you need to inform the doctor in detail about each sign.

Causes of bitter taste in mouth

Bitterness in the mouth can appear due to diseases of the digestive system, teeth and gums, due to changes in hormonal levels, taking certain medications and for other reasons (Fig. 1). At the same time, the accompanying symptoms and conditions under which a person feels a bitter taste in the mouth will be different.

Figure 1. Some causes of bitterness in the mouth. Source: MedPortal

Poor quality food

Foods cooked with a lot of oil, fat or burnt can cause a bitter taste in the mouth. Sometimes the bitter taste is associated with drinking black coffee or very strong tea. It can also appear if a person has eaten sunflower seeds or nuts. The bitterness will go away if you drink cool water, but a slight unpleasant aftertaste may persist for a while. If the bitter taste comes from food, there will be no other symptoms (pain, indigestion).

Age-related changes

With age, a person's taste perception gradually changes. Older people are less able to discern tastes, but may still experience bitterness. This is associated with a number of other health changes, for example, decreased saliva production, dry mucous membranes, and a gradual deterioration in oral health.

Smoking

If a person smokes frequently, they perceive the taste of food less well, and this can increase the bitter taste in the mouth. Also, bitterness in the mouth of smokers may be associated with the taste and smell of tobacco smoke. The resins contained in it linger on the mucous membrane of the oral cavity and settle on the surface of the tooth enamel. This is the cause of bad breath, deteriorating dental health and the associated persistent bitter taste. You can beat it with chewing gum or mints, but it is better to quit smoking or at least reduce the number of cigarettes you smoke.

Pregnancy

In the first trimester, bitterness in the mouth may appear along with other symptoms of toxicosis. It usually worsens with nausea or after vomiting. Fluctuations in estrogen levels can affect the perception of tastes. Cholestasis of pregnancy can also cause bitterness. This is a relatively rare syndrome that develops in the third trimester and is characterized by pruritus and cholestatic jaundice. Cholestasis in pregnancy resolves after childbirth and is considered a relatively harmless condition, but if symptoms appear, you should inform your obstetrician-gynecologist.

Functional dyspepsia

Functional dyspepsia is a disorder in which a person does not have severe diseases of the digestive system, but experiences pain, early satiety and a feeling of fullness after eating, and a burning sensation in the upper abdomen. In this condition, the feeling of bitterness occurs due to slow digestion of food. It may be accompanied by abdominal cramps and other unpleasant sensations. Functional dyspepsia is associated with a number of factors, including stress, smoking, heredity, and recent infectious diseases. You can relieve the bitter taste in your mouth by drinking water with lemon juice. If the condition does not go away or the pain intensifies, diarrhea, vomiting or other severe symptoms appear, you should immediately consult a doctor.

Hepatitis

Bitterness in the mouth is the initial symptom of hepatitis and accompanies liver inflammation. In this case, the bitter taste appears in the morning, immediately after waking up or 30-60 minutes after eating. This is accompanied by heaviness in the right hypochondrium, pain, nausea and vomiting containing bile. With toxic hepatitis, symptoms appear for a short time and disappear after starting treatment. With viral hepatitis, bitterness in the mouth persists almost constantly.

Pathologies of the gastrointestinal tract

If food digestion is impaired, an unpleasant taste appears in the mouth. The sensation of bitterness may occur due to a change in taste perception. It occurs, for example, with pancreatitis and may be accompanied by vomiting and the appearance of a yellow or grayish coating on the tongue. A common cause of bitterness in the mouth is gastroesophageal reflux disease (GERD). In this disease, stomach contents (stomach juice and food particles) regularly back up into the esophagus, causing heartburn and a bitter taste in the mouth (video 1).

Video 1. Symptoms of gastroesophageal reflux disease.

If a person has chronic gastritis or duodenitis, a bitter taste appears when he violates the recommended diet. In diseases of the digestive system, a feeling of bitterness in the mouth is always associated with food intake (appears some time after it).

Biliary system damage

A bitter taste may appear in the mouth due to cholelithiasis, cholecystitis, cholangitis and other diseases of the biliary system (gall bladder and bile ducts). At first, bitterness may appear only after drinking alcohol, fatty or fried foods.

“Burning in the mouth, tongue covered with a yellow coating, discomfort, and so on. In 95% of cases, this is due to the reflux of bile from the duodenum into the stomach. In the stomach, this bile is mixed with hydrochloric acid, thrown into the esophagus and then into the oral cavity.”

Karasev Ivan Alexandrovich

expert

FSBI "N.N. Blokhin National Medical Research Center of Oncology", endoscopist

Without treatment, the condition will gradually worsen. The bitter taste will bother you more often and last longer. Along with it, nausea, pain in the hypochondrium on the right side, and stool disorders may occur. The feeling of bitterness becomes permanent if a severe inflammatory disease of the gallbladder or bile ducts develops (cholangitis, cholecystocholangitis, cholecystitis and others). Also among the possible causes are biliary dyskinesia, due to which the outflow of bile is disrupted, and cholelithiasis. Less commonly, the disorder is associated with parasitic liver disease (giardiasis, opisthorchiasis or echinococcosis).

Dental diseases

The feeling of bitterness can be caused by the presence of tartar, caries, gingivitis or other dental problems. There are usually other symptoms:

toothache;
enamel sensitivity (reaction to cold or hot, sweet, sour);
bleeding gums;
tooth mobility;
gums look red or swollen;
There is a noticeable plaque on the enamel that cannot be removed by regular teeth brushing.

Problems with the health of teeth and gums may be associated with xerostomia, a condition in which insufficient saliva is produced and the mouth constantly feels dry. This increases the risk of tooth decay and gum disease, and causes an unpleasant odor in the mouth, which is perceived as bitter. Xerostomia can occur due to smoking, mouth breathing, aging, diabetes, or autoimmune diseases. This condition requires consultation with a dentist.

Sometimes bitterness in the mouth appears after dental treatment. This may be due to the use of certain medications or materials, or the installation of dentures, braces and other structures in the mouth. If the bitter taste does not go away or persists for several days, you should contact your dentist.

Neurological disorders

The mouth may taste bitter due to damage to the brain structures that process taste information. In this case, taste perception is disrupted: for example, sour foods may seem sweet, salty foods may seem sour, and a person may not perceive some tastes. This can occur after a traumatic brain injury or stroke. Sometimes taste disturbances are associated with Alzheimer's disease and other age-related diseases in which neurodegenerative processes occur.

Complications of pharmacotherapy

There are more than 250 types of medications that can cause taste disturbances, including the appearance of bitterness in the mouth. This can happen if the drug affects the taste buds of the brain, if part of it remains in the saliva and changes its taste, if the drug suppresses the microflora, which is why fungal diseases develop. Among the drugs that can cause a bitter taste in the mouth:

antibiotics;
medications for arrhythmia, diuretics, statins and other drugs used for cardiovascular diseases;
drugs used in chemotherapy;
muscle relaxants, migraine medications and other neurological drugs;
neuroleptics, sedatives, hypnotics, antidepressants;
non-steroidal anti-inflammatory drugs;
bronchodilators;
antihistamines;
antiviral drugs;
nicotine replacement therapy products.

Rare causes

Sometimes bitterness in the mouth becomes a symptom of endocrine disorders: diabetes mellitus, hypothyroidism, hypocortisolism and others. It can accompany some cancers and respiratory diseases. Rarely, the cause is an infection of the salivary glands. A bitter taste may occur in cases of poisoning due to accidental ingestion of a toxic substance. In all these cases, the appearance of bitterness is accompanied by other symptoms of the underlying disease.

Which doctor treats bitterness in the mouth?

First of all, bitterness in the mouth is considered as a symptom of gastroenterological disorders, so when the first signs appear, you need to make an appointment with a gastroenterologist.

To make an appointment with a doctor, choose any method:

call the clinic +7 (495) 103-99-55,
order a call back,
leave a request for an appointment using a convenient form on the website:

Often people do not pay attention to bitterness in the mouth, explaining the occurrence of the symptom with overeating, an uncomfortable position in bed and some other reasons.

IMPORTANT! Rarely does anyone think that bitterness in the mouth is a signal indicating the development of serious pathology of the liver and gastrointestinal tract.

If you have been experiencing this symptom for a long time, do not engage in self-diagnosis and self-medication - make an appointment with a specialist at the Kuntsevo Treatment and Rehabilitation Center! An experienced gastroenterologist will collect anamnesis, complaints, conduct an objective examination, and refer you for laboratory and instrumental diagnostics to understand the cause of the pathology.

Diagnostics

For your information! Sometimes bitterness in the mouth appears without other symptoms, and after hygiene procedures it disappears and does not appear again.

Most likely, in this case, the reason was precisely overeating or excessive alcohol consumption.

The presence of bitterness throughout the day, which does not disappear after brushing your teeth and appears the next day, should be a reason to consult a doctor.

To begin with, you can go to your local physician and tell about all your symptoms.

In this case, it is important to remember what was eaten on the eve of vomiting, which caused nausea and, possibly, to indicate the nature of the vomit (solid, liquid, with bile).

If a person knows for sure that bitterness and vomiting are associated with exacerbation of diseases of the gastrointestinal tract, you can immediately contact a gastroenterologist.

You should know! During the examination, the doctor prescribes a number of standard tests:

general blood test, urine test;
coprogram;
blood biochemistry;
Ultrasound;
FGDS;
radiography.

If the internal organs are healthy and no diseases have been identified, the person is sent to a cardiologist.

He conducts a survey, prescribes an ECG and EEG to confirm or refute vegetative-vascular dystonia.

After this, you can visit an otorhinolaryngologist and dentist . It is quite possible that the bitterness in the mouth was always present, but the person noticed it only during vomiting and connected the two symptoms together.

It is worth noting! Diseases of the teeth and gums may also cause a bitter taste in the mouth.

Treatment methods

Basically, the treatment of bitterness in the mouth comes down to taking medications. The specialist selects complex therapy based on the results of tests and instrumental examinations. The gastroenterologist identifies one of three problems:

Liver disorders. Means are prescribed to stabilize the operation of the “filter”,
Digestive tract dysfunction. Drugs that affect the digestive system normalize the work
Uncontrolled bile production. Eliminated by drugs that affect the level of secretion, for example, anticholinergics.

Drug therapy

Diagnosis of gastrointestinal diseases

Treatment of bitterness in the mouth and nausea, or rather the causes of their occurrence, is a complex measure, which invariably consists of:

Diagnosis of the disease, determination of its pathogenesis and symptoms exhibited by the patient.
Relief of unpleasant symptoms.
The main course of treatment aimed at combating the cause of bitterness and nausea.
Maintaining the obtained result.
Prevention of gastrointestinal diseases.

Perhaps all of the described stages can be independently organized by the patient. The most difficult step, most likely, will be the first step, which is diagnosis. Its difficulty lies in the fact that in no case should mistakes be made during diagnosis.

Therefore, if, with the help of medical reference books with a detailed description of each gastrointestinal ailment, you were unable to determine the pathology specifically in your case, it is better not to spend a week on home therapy, but to go for treatment together with a gastroenterologist.

The remaining stages of therapy are relatively simple, since their organization directly depends on the patient’s existing disease. For general information purposes, we present a general list of drugs used to get rid of the symptoms being considered today:

To relieve unpleasant symptoms (nausea, abdominal pain, bitter taste, etc.), various drugs are used, among the most used of which are: antiemetics (Domperidone), sorbents (Smecta, activated carbon) and antispasmodics (No-Shpa).
To combat the cause of the pathology - antiemetic medications (for general gastrointestinal disorders), anti-inflammatory drugs (for inflammation in the stomach), antibacterial agents (for bacterial lesions) and so on.

Maintaining the results obtained and preventing them are usually carried out without the use of medications. Often it is enough to introduce a healthy lifestyle and a diet that excludes the intake of foods that are difficult for the gastrointestinal tract.

In case of a long-term stable condition after therapy, it is permissible to abandon the diet, diversifying the food with all products (naturally, without fanaticism).

Why do we need to treat bitterness in the mouth?

Since an unpleasant taste in the mouth is a symptom of some pathology, a comprehensive examination is needed, without which it is impossible to establish a diagnosis. Our clinic has the latest equipment for ultrasound diagnostics of the liver and gallbladder, gastroscopy, etc., which help identify the pathological process in a short time. Our own laboratory allows you to get test results within a few hours. It is the quick examination process that attracts many Moscow residents to our clinic, as well as experienced, qualified staff ready to help every patient.

Clinical symptoms

Impaired sense of taste is associated with a large number of diseases. Depending on the type of pathological process occurring, the patient may experience many associated symptoms:

state of lethargy and weakness;
a grayish or whitish coating forms on the tongue;
pain and discomfort affect the area of the right hypochondrium or the iliac region;
frequent belching with the smell of consumed food, air;
feeling of stale breath, feeling of heaviness on the side;
change in the standard color of the skin and whites of the eyes to yellowish shades;
slowdown of metabolic processes with hair loss;
constipation, diarrhea and other intestinal disorders.

If the source of the unpleasant taste is the formation of stones in the cavity of the gallbladder, then the clinical picture is complemented by painful sensations due to their movement.

Treatment

Diseases of the stomach, liver, intestines, gall bladder and other internal organs are treated primarily with diet.

All fatty, fried foods, smoked foods, hot and spicy seasonings, canned food, sausages, heavy foods, alcohol, coffee and sparkling water are excluded from the diet.

Depending on the diagnosis, a therapeutic diet can be selected.

For gastritis or reflux disease, medications that reduce the acidity of gastric juice or antacids are prescribed .

It could be Rennie, Almagel.

antispasmodics (No-shpa, Spazmalgon), antiemetic medications (Motilium, Domrid), and antipyretics (Paracetamol, Ibuprofen) can be prescribed

How to remove? Smecta, Vikalin, Motoricum, and choleretic drugs help normalize the functioning of the stomach and intestines.

If an exacerbation of gastrointestinal diseases occurs due to stress, sedatives are prescribed (Motherwort, Valerian).

For diseases of the liver and gall bladder, drugs from the group of hepatoprotectors (Carsil, Essentiale Forte, Gepabene) and enzymes are prescribed .

In advanced cases, surgical methods are resorted to.

Auxiliary methods of treatment for identified diagnoses are physiotherapy and therapy using traditional recipes .

It is imperative to give up bad habits, smoking and drinking alcohol to prevent the condition from worsening and the disease progressing.

In case of dental diseases, teeth are removed or treated is performed . The diet is also adjusted.