Bitterness in the mouth

Sensing bitterness in the mouth, a person does not think that at that moment the taste cells of his tongue, reacting to irritation, triggered sensory transduction - they sent the corresponding signal to the taste analyzer.

In the absence of a direct connection with food in the mouth, an unpleasant caustic taste - bitterness in the mouth - is considered an anomaly that indicates a violation in the digestive system, metabolism or hormone production.

[1]

Causes of bitterness in the mouth: underlying diseases, pathologies and conditions

Before you figure out why the bitterness in your mouth may appear, when you did not eat anything bitter, you need to emphasize that this taste is perceived by at least three dozen TAS2R receptors. Their signal through transmembrane G-proteins reaches the thalamus, and from there to the sensory center of taste in the cortex of the large hemispheres (in the parietal region of the brain). And the symptoms of bitterness in the mouth - a bitter taste and a feeling of disgust - have the same mechanism, which can not be said about the reasons for its launch.

And the causes of bitterness in the mouth are very different:

• reaction to certain substances, including poisoning with low-quality food, insecticides, heavy metal salts;
• diseases of the digestive system and the biliary system (gastritis, reflux disease, cholelithiasis, cholecystitis, chronic duodenitis, hepatitis, functional dyspepsia, pancreatic cancer, etc.);
• imbalance of intestinal flora;
• helminthiases (lyabliasis, opisthorchiasis, etc.);
• endocrine diseases (diabetes, hyperthyroidism, hyperparathyroidism);
• Infectious mononucleosis;
• deficiency of folic acid (vitamin B9), pyridoxine (vitamin B6), cyanocobalamin (vitamin B12);
• the violation of zinc in the body;
• stomatitis, candidiasis of the oral cavity, reaction to dental materials;
• pregnancy and menopause in women;
• negative side effects of medications;
• stress, increased anxiety, depression.

As you can see, in clinical practice bitterness in the mouth as a symptom of the disease is considered in a variety of diseases and metabolic disorders, as well as in cases of hormonal changes in the body.

[2], [3], [4], [5], [6]

Bitterness in the mouth in the morning

Problems that cause complaints like "wake up with bitterness in my mouth" are most often found in hepatobiliary diseases - pathologies of the gallbladder, bile ducts, liver. In the gallbladder - the main reservoir produced by the liver bile - it accumulates, so that the food is digested in the small intestine. When bile through the bile duct does not get where it should be - into the duodenum, then its excess is formed.

And this can be when forming stones in the gallbladder or in the bile duct. A medical diagnosis is known - cholelithiasis. In this case, bitterness in the mouth with cholecystitis - inflammation of the gallbladder - is also associated with the loss of concrements in the gallbladder. And patients with chronic cholecystitis can combine bitterness in the mouth and a temperature of 37 ° C, which is an indicator of a slow inflammatory process in the gallbladder.

Among the symptoms of dyskinesia biliary tract, that is, the functional disorder of their contraction, also noted bitterness in the mouth after sleep. This symptom is also caused by gastroduodenal reflux, in which bile enters the cavity of the stomach due to a disruption of the function of the sphincter between the stomach and duodenum (pylorus). In this case, even bitterness in the mouth will be felt at night, when the stomach is in a horizontal position and relaxed. Other symptoms of gastroduodenal reflux: bitterness in the mouth and heartburn, vomiting bile, bouts of nausea, bitterness in the mouth and eructation, as well as pains at the top of the abdominal cavity (under the ribs).

Bitterness in the mouth after eating

If the food is too fatty or spicy, if the portion eaten at one sitting is too large, then bitterness in the mouth after eating is a natural physiological result of overload of the stomach, pancreas and the entire digestive system.

The stomach and bitterness in the mouth hurts after about an hour after eating - a sign that gives cause to suspect irritable stomach syndrome, which develops due to eating foods that are difficult to digest (still the same fat and acute) or functional dyspepsia. Belching after eating accompanies bitterness in the mouth and the liver hurts - a consequence of the increased work of this organ, which synthesizes bile acids, necessary for digesting fatty foods (and also neutralizing alcohol).

If you do not abuse unhealthy food, feel bitterness in your mouth after eating, then any gastroenterologist, to which you must address this problem, first of all, will assume that you have either gastritis, or dyskinesia of bile ducts, or gastroesophageal (gastro- esophageal) or gastroduodenal reflux.

Bitterness in the mouth with gastritis - an inflammatory lesion of the mucous membranes of the stomach - is combined with clinical signs such as heaviness in the stomach after eating, belching stomach contents, nausea, heartburn, pain of varying intensity. In patients with gastritis, bitterness in the mouth and white tongue are also often observed.

Reflux (reverse movement of the contents of the stomach or duodenum) is characterized by bitterness in the mouth and heartburn - due to ingestion of bile in the esophagus and partly pancreatic enzymes.

With prolonged inflammation of the gallbladder - chronic cholecystitis - very often there is bitterness in the mouth when eating. This disease manifests itself and such symptoms as bitterness in the mouth, nausea and weakness, as well as pain in the subcostal area on the right side.

Systematically arising after ingestion of food, belching and bitterness in the mouth are caused not only by an elementary overeating, but may indicate a narrowing of the esophagus lumen, an excess of the stomach, as well as a violation of the gastroesophageal sphincter (a valve between the esophagus and stomach).

As practice shows, bitterness in the mouth and belching after eating in many cases are the first signals of inflammatory processes in the duodenum or pancreas. So, bitterness in the mouth with pancreatitis - it's dry mouth and bitterness, as well as the appearance of yellow plaque on the tongue. Gastroenterologists are advised to keep in mind that very similar symptoms in the initial stage of pancreatic adenocarcinoma.

[7], [8]

Nausea and bitterness in the mouth

With complaints that mouth bitterness and vomiting is in the mouth, therapists, gastroenterologists, endocrinologists face daily. First of all, bitter taste in the mouth and vomiting is included in the complex of symptoms of almost all diseases of the digestive system listed in the previous sections. A bitter taste in the mouth and diarrhea are characteristic for enteritis, chronic forms of colitis and colitis infectious etiology.

Infectionists note that attacks of nausea and bitterness in the mouth with hepatitis can not be attributed to the specific symptoms of this disease, but before the appearance of icteric sclera and skin (within the first week of infection), patients have bitter taste in the mouth and a temperature of up to 39 ° C, chills, nausea, vomiting, pain in the muscles and right under the ribs, loss of appetite and sleep disturbances. In addition, almost everyone with hepatitis (as with inflammation of the gallbladder or duodenal ulcer), there is bitterness in the mouth and a lined tongue of yellow or yellow-brown color. And in all forms of hepatitis, among the symptoms are bitterness in the mouth, nausea and weakness.

Frequent attacks of nausea, dryness and bitterness in the mouth (that is, an almost complete picture of chronic cholecystitis) appear when the bile ducts of the liver are affected by such a type of helminths as the flukes that can be picked up by eating jerky river fish contaminated with eggs. This parasitic disease is called opisthorchiasis, and with it a person has bitterness in his mouth and a liver pain.

And in case of infectious mononucleosis (caused by the Herpes IV virus type) in a person, asymptomatic malaise passes into a clear illness after a few days, at which the temperature rises, lymph nodes on the neck several times increase, the throat and bitterness in the mouth are unbearable.

Constant bitterness in the mouth

Constant bitterness in the mouth can be felt for a number of reasons. For example, with cholecystitis, the bend of the gallbladder, liver failure. With chronic folic acid deficiency (which is needed to regulate the level of hydrochloric acid in the gastric juice) and vitamin B12 (which helps in the assimilation of protein foods), digestive problems, in particular bitterness in the mouth and constipation, may appear.

As shown by biochemical studies, a long-lasting bitter taste can be due to a violation of the sensitivity of the taste buds of the tongue due to a lack or excess of zinc in the body. In the first case, taste sensitivity decreases and is defined as hypogevia, in the second - it increases (hypergeusia). And it's all about zinc, which interacts with the enzyme carbonic anhydrase IV and regulates the formation of saliva, and also provides the synthesis of alkaline phosphatase, an enzyme of the cellular membranes of taste buds.

Bitter in the mouth with diabetes by some specialists is due to exacerbation of taste buds on the soil of the distal sensorimotor polyneuropathy (which can affect nerve fibers that transmit taste signals); others believe that the fault of the balance of potassium and sodium electrolytes is to blame - in connection with a decrease in the functionality of the adrenal cortex.

By the way, about neuropathy. In some cases, constant bitterness in the mouth is associated not with digestion, but with neurosomatic pathologies, when the taste-transmitting afferent fibers of the glossopharyngeal or vagus nerves are damaged. The wandering nerve can be damaged when it is infected with herpes viruses, with shingles, tumors of the medulla oblongata. A glossopharyngeal nerve can be squeezed by a tumor of the appropriate localization, for example, in the pharynx, in the pharyngeal space or at the base of the skull.

It should be noted that bitter taste in the mouth and headache, as well as bitterness in the mouth and dizziness can be satellites of arterial hypotension (low blood pressure). But not primary - idiopathic, and secondary, which occurs with such pathologies as a stomach ulcer, hepatitis, pancreatitis, diabetes, tuberculosis, alcoholism.

At the avid smokers quite often there is a question: why, as soon as has stopped to smoke, there was a bitterness in a mouth. If no other symptoms - heartburn, nausea, vomiting - no, then the disease has nothing to do with it. And the answer is that among the several thousand harmful and simply poisonous substances formed during the pyrolysis of tobacco, there is in the cigarette smoke 3-pyridinecarboxylic acid, it is nicotinic acid, it is also niacinamide, it is also a vitamin PP or B3. When in the body of this vitamin is not enough, the person feels a burning tongue and bitterness in the mouth. Therefore, having taken the right decision to quit smoking, it is necessary to replenish the body with vitamin PP, eating bread from rye flour, beef liver, turkey meat, sea fish, buckwheat, beans, mushrooms, beets, peanuts.

But the temporary filling and bitterness of the mouth suggests that the body negatively perceives the filling material that dentists use for multi-stage caries treatment. All these materials - artificial dentin, polycarboxylate cement, vinoxol - contain oxide or zinc sulphate, and how this chemical element affects taste buds has already been mentioned above.

In addition, almost 40% of postmenopausal women notice bitterness and burning sensation in the mouth, and researchers believe that this is associated with a decrease in the level of estrogen.

[9], [10]

Bitterness in the mouth in pregnant women

In pregnancy, bitterness in the mouth has at least two reasons. The first is hormonal: estrogen and progesterone contribute to a decrease in the motility of the gastrointestinal cycle and the slowing down of the digestive process, the production of which is significantly increased. In addition, just one week after the fertilization of the egg, it begins to produce human chorionic gonadotropin (hCG). All these hormones block the contractile activity of the muscular tissues of the uterus, but their "blockade" extends to the entire musculature of the visceral organs, which leads to temporary dyskinesia of the bile ducts, atony of the gallbladder and intestines.

Therefore, some women think that bitterness in the mouth is a sign of pregnancy. Of course, this is an erroneous point of view, it's just that pregnant women in early terms have such a strong toxicosis and bitterness in their mouth that they console themselves with the inevitability of these unpleasant manifestations when carrying a child. Although pregnancy bitterness in the mouth, indeed, is one of the signs of toxicosis, which is expressed in the specific interaction of the acids that make up the bile.

In addition, the pancreas in pregnant women produces more glucagon. This polypeptide hormone, on the one hand, acts as an intestinal relaxant, and on the other, activates the synthesis of ketone bodies in the liver. This also causes bitterness in the mouth during pregnancy.

The second reason is anatomical: an increase in the uterus leads to a shift in the digestive organs and the entire gastrointestinal tract from the usual physiological positions, which can provoke bitterness in the mouth in pregnant women.

And among the most probable reasons for the bitterness in the mouth after delivery, doctors call estrogen levels lower, as well as adrenal cortex function and increased cortisol production in response to postpartum stress.

[11]

Bitterness in the mouth of a child

In principle, the bitterness in the mouth of a child occurs for the same reasons as in adults, although pediatricians say that children are much less likely to have inflammatory hepatobiliary diseases (cholecystitis, etc.). But violations of the bile ducts in the liver, problems with the gall bladder, in which the child is tormented by bitterness in the mouth, nausea and weakness, are detected quite often.

Bitterness in the mouth of small children can appear due to food intoxication or ingestion of lead containing dyes (which are used in the manufacture of substandard toys). Parents need to bear in mind that in children 6-12 years of bitter taste in the mouth can be associated with parasitic diseases: echinococcosis, ascariasis, opisthorchiasis, giardiasis, toxocorosis.

So, bitterness in the mouth with a cough very similar to bronchitis, or bitterness in the mouth after a cough is the consequence of giardiasis or toxocorosis, that is, the presence in the body of an intestinal ljamblia capable of damaging the liver, or toxocaria, which falls into various tissues and organs. So, watch out if the baby has a stomach ache after fatty food, if he has no cold-related chills and excessive sweating, is there no constipation or diarrhea, and does your child lose weight due to a decrease in appetite.

[12]

Bitterness in the mouth after antibiotics

Bitterness in the mouth after antibiotics - a side effect of the drugs of this pharmacological group - is due to several factors. First, the active substances of many antibiotics are metabolized and excreted from the body by the liver and act on it as toxins. And while the liver clears from them, complaints are inevitable that bitterness in the mouth and liver aches.

Secondly, there is bitterness in the mouth after antibiotics due to digestion disorders due to dysbacteriosis. By destroying pathogenic microorganisms, antibiotics can also be spread with useful - bifido- and lactobacilli, bacteroids, clostridia, zubacteria, E. Coli Escherichia coli, which constitute the obligate intestinal microflora. All these microorganisms, helping the liver and intestines, cleave and excrete metabolites; produce many vitamins and enzymes; participates in the metabolism. In general, after antibiotics that destroy this microbiocenosis, the body has to "bounce back" for a long time.

For example, the antimicrobial and antiparasitic agent Metronidazole and bitterness in the mouth, as well as its synonym Trichopol and bitterness in the mouth are due to the fact that the use of these drugs causes the cessation of DNA synthesis by the cells of not only pathogenic anaerobic microorganisms - trichomonads, gardnerella, balantidium, lamblia, entameb but and in the same way lead to the end of the existence of obligate microorganisms.

Frommylid and bitter taste in the mouth: antibiotic of the macrolide group, Frromilid (Clarithromycin) is effective in affecting the respiratory tract, soft tissues and skin with gram-positive and gram-negative bacteria of the genus Legionella, Mycoplasma, Chlamydia, Ureaplasma, Listeria, etc. Its principle of action is bacteriostatic, that is, cells of bacteria cease to synthesize proteins, and they perish. All the rest, according to the pharmacodynamics of antibiotics, occurs according to the Metronidazole scheme. And the list of side effects is also practically no different. The intake of these drugs causes severe bitterness in the mouth.

Erespal and bitterness in the mouth: this drug is not an antibiotic; on the mechanism of antiexudative action in bronchial spasm it refers to antihistamines. According to the majority of patients who used Erespal (Fenspiride), appointed by a doctor in bronchial asthma, the drug causes severe bitterness in the mouth, although the side-effect of this side effect is not indicated.

In addition to antibiotics and antihistamines (antiallergic) agents, bitterness in the mouth is a side effect of some antifungal and nonsteroidal anti-inflammatory drugs, antidepressants, as well as antitumor cytotoxic drugs used in cancer chemotherapy.

[13]

Diagnosis of bitterness in the mouth

Since bitterness in the mouth as a symptom of the disease is considered in many areas of practical medicine, then finding out any, including gastroenterological, reasons for the appearance of this sign will require a comprehensive examination.

Diagnosis of bitterness in the mouth in gastroenterology is based on:

• anamnesis, including a list of all pharmacological agents taken by the patient;
• general analysis of blood, urine and feces;
• biochemical blood test (including Helicobacter pylori and eosinophils);
• the analysis of blood for antibodies to hepatitis and herpesvirus IV type;
• analysis of blood for sugar, gastrin, liver phosphases, etc .;
• intragastric pH-metry (determination of the acidity level of gastric juice);
• fluoroscopy of the stomach (gastroscopy) and esophagogastroduodenoscopy;
• gastro- or cholescintigraphy;
• ultrasound (ultrasound) of visceral organs.

The set of specific diagnostic methods will depend on the specificity of the manifestation of this symptom and is determined by the physician of the specialization in whose competence the etiology is located, that is, the root cause of bitterness in the mouth: gastroenterology, endocrinology, parasitology, gynecology,

[14], [15], [16], [17]

Treatment of bitterness in the mouth

From a medical point of view, the only correct in any situation, the treatment of bitterness in the mouth can mean symptomatic therapy, since bitterness in the mouth is a sign of one or another pathology. That is a consequence, not a cause.

That is why the question of patients what to do with bitterness in the mouth, doctors respond: to treat the disease that is accompanied by this symptom.

However, in the arsenal of symptomatic treatment, there are medications - pills for bitterness in the mouth.

Thus, the stimulating synthesis of bile Allochol with bitterness in the mouth is indicated for use in pathologies such as cholecystitis and chronic non-natural hepatitis. The recommended dose for adults and children over 7 years of age is two tablets three times a day (after meals); for children under 7 years - one tablet.

Cholitic and hepatoprotective agent Hofitol from bitterness in the mouth (other names - Artihol, Holiver, Tsinarix) is prescribed for the chronic form of cholecystitis and hepatitis, cirrhosis of the liver, reduction of the contractile function of the bile ducts: 1-2 tablets three times a day (before meals) adults and children after 12 years; on a tablet three times a day - to children of 6-12 years. Side effects include heartburn, nausea, diarrhea, pain in the epigastric region. Hofitol is contraindicated in the presence of stones in the gallbladder and in cases of conduction disorders in the bile ducts.

Having an extract of the thistle plant as an active substance, Karsil from bitterness in the mouth (Silibor, Gepabene, Legalon) acts as a hepatoprotector, which provides restoration of the structure of infected liver cells with chronic inflammation and after hepatitis in adults (three times a day 1-2 pills). Neither pregnant women, nor preschool children, this medication is not prescribed.

Ursosan and bitterness in the mouth: a drug based on ursodeoxycholic acid (synonyms - Ursohol, Ursolizin, Ursodex) is designed to dissolve cholesterol gallstones in the gallbladder, for the treatment of gastritis with gastroesophageal reflux and primary cirrhosis. One capsule (250 mg) is taken per day, at night. Contra-indications of Ursosan: acute inflammation and violation of gallbladder motility, calcified concrements in the gallbladder, obstruction of the biliary tract, dysfunction of the liver and kidneys, the first trimester of pregnancy, children under 6 years. Side effects of this remedy are expressed in the form of diarrhea, pain in the liver and urticaria.

Bitterness in the mouth and Odeston: this drug (synonyms - Gimecromone, Isohol, Cholestil, etc.) is a derivative of coumarin and refers to choleretic, simultaneously removes spasmodic contractions of the ducts and sphincters of the biliary system. Assigned to 0.2 g (one tablet) three times a day, 30 minutes before meals. Odeston is contraindicated in children under 14 years of age, pregnant and lactating women, as well as patients with stomach ulcers, obstruction of the biliary tract and inflammation of the liver. In many EU countries and in the US, this means of use is prohibited.

De-Nol and bitterness in the mouth: the drug De-Nol (Bismuth sub-citrate, Bismofalk, Gastro-norms, Bisnol) is prescribed for peptic ulcer and irritable bowel syndrome as an antacid agent forming a protective mucous-bicarbonate film on the mucous membranes of the stomach and duodenum guts. Reduces the activity of pepsin and the level of acidity of gastric juice; leads to immobilization of the bacterium Helicobacter pylori. Recommended dosage: one tablet 3-4 times a day, half an hour before a meal. Among the possible side effects of De-Nol are: nausea, vomiting, diarrhea, constipation, darkening of the mucous tongue and feces, itching rashes on the skin. During pregnancy, it is contraindicated to apply De-Nol.

Drug treatment of bitterness in the mouth associated with problems of the digestive system also includes proton pump inhibitors - drugs that suppress the production of gastric juice (with gastroesophageal reflux or gastroduodenal reflux) and prokinetics - a means to accelerate the progress of food in the stomach (with functional dyspepsia and gastrointestinal dyskinesia).

The first includes such a means to reduce the acidity of gastric juice, like Rabimak (Rabeprazole sodium, Barol, Zulbex, Rabezol, etc.). The tablet of the drug (20 mg) is taken once a day (in the morning). Contraindications to the use of Rabimak include pregnancy, childhood and the presence of malignant tumors of the gastrointestinal tract, and side effects - headache, nausea, diarrhea and dry mouth.

To activate gastrointestinal motility, gastroenterologists prescribe prokinetics. For example, the medicine Domperidon (Damelium, Peridon, Motilium, Motilak, Nauzelin, etc.) helps with such dyspeptic symptoms as nausea, vomiting, pain and bloating in the abdomen. Adults are recommended to take one tablet (0.01 g) three times a day (before eating); children weighing 20-30 kg - half a tablet twice a day, over 30 kg - on the whole tablet. Pregnant and children weighing less than 20 kg this medicine is contraindicated.

Alternative remedies for bitterness in the mouth

Virtually all alternative means of bitterness in the mouth imply the use of medicinal plants in the pathologies of the gallbladder. And two of the "distracting" home remedies for fighting this symptom are effective: 1) every day for 20-30 minutes before breakfast, drink a glass of ordinary water; 2) a couple of times a day chewing cloves - one dry bud of clove tree (we usually put them in marinades).

The benefits of water, drunk on an empty stomach, are known to everyone, and it is simply impossible to balance the acid-alkaline composition of the liquid medium in an organism without H2O. In addition, we probably forgot that water is one of the basic elements of a healthy human diet ...

But the clove has in its composition a fragrant essential oil, consisting of eugenol, gumulene and karyophyllene. Eugenol is a phenolic compound and is therefore a strong antiseptic; gumulene and caryophyllene belong to the alkaloid terpenic series (like most phytoncides of conifers) and exhibit the properties of antioxidants.

To rinse the mouth, you can prepare a herbal decoction of chamomile, peppermint, thyme (thyme): at the rate of two tablespoons of dry herbs for a glass of boiling water (insist in a sealed container before cooling down). Some people are helped by mouth rinsing with simple baking soda: a teaspoon in 200 ml of boiled cool water.

But to use inside the alternative means of bitterness in the mouth - various herbal decoctions and infusions - without asking the real cause of this problem, most likely, it is not worth it.

[18], [19], [20]

Eating with bitterness in the mouth

As gastroenterologists advise, nutrition with bitterness in the mouth should be correct. With such pathologies as cholecystitis (not in acute form), cholelithiasis, dyskinesia of intrahepatic bile ducts and bile ducts, chronic pancreatitis and hepatitis, a diet with bitterness in the mouth is the classical medical diet No. 5 in Pevzner.

Compliance is appointed by the doctor following the results of the examination and the determination of the exact diagnosis.

But in any case, proper nutrition with bitterness in the mouth suggests giving up all fatty and roasted, from spicy condiments, sauces and spices, from any kind of canned food and fast foods, carbonated drinks and alcohol. Butter is better to replace vegetable, meat broths in the first dishes - vegetable soups with cereals and pasta. Instead of pork, you should eat poultry and rabbit meat, instead of pickles, fresh vegetables.

Meat is more expedient to extinguish, bake or boil, instead of to fry in a frying pan in a plenty of fat. Fresh white bread and rolls, of course, are very tasty, but this is too heavy food for the stomach, if you are concerned about bitterness in your mouth.

It is more useful to take food not three times a day, but five, but more modest portions. Between dinner and sleep should take at least three hours, and then bitterness in the mouth after sleep will bother you much less often.

What to drink with bitterness in your mouth? Instead of coffee it is better to drink tea, and green; kefir and yogurt should be low-fat - so they are better and more easily absorbed by the body. Berry jelly, fruit juices - not acidic and not containing preservatives - will also be useful. If the acidity of the gastric juice is normal, you can prepare the briar infusion. And do not forget to drink plain water - at least 1-1.5 liters per day.

What is the prevention of bitterness in the mouth? If you adhere to the medical point of view, and she, as already said, is the only correct one in any situation related to our health, then you need to treat the diseases in a timely manner. After all, our diseases are part of our lives, and our task is to take care that they do not spoil this life too much. And the forecast of bitterness in the mouth will largely depend on it.

We hope that this information will prompt you to treat such a symptom as bitterness in the mouth, more seriously and in case of its occurrence will force you to seek qualified medical help.