Stomach bug could be cause of bad breath

Q. I have a problem with bad breath though I brush my teeth three times a day and use mouthwash. My dentist said, “It’s not your mouth, which is very clean.”

I have read that a stomach infection with H. pylori bacteria could cause bad breath. What can I do about this?

A. Bad breath may result from gum disease, but there are other causes. Many years ago we spoke with Nobel Prize laureate Barry Marshall, M.D. He discovered that the bacterium Helicobacter pylori could cause stomach ulcers. He told us that these germs are behind some cases of hard-to-treat bad breath.

Through the years we have heard from readers who reported success after curing the infection: “When I read about a blood test for a germ in the stomach that causes bad breath and gastritis, I saw my doctor. He hadn’t heard of this, but he gave me the blood test. It turned up positive. Now I am fine, after years of bad breath.”

Treating H. pylori requires medical supervision, so you will need to see your doctor. Multiple medications are often required to rid the stomach of this bug.

For more details about this infection and its treatment, we are sending you our Guide to Digestive Disorders. Anyone who would like a copy, please send $2 in check or money order with a long (No. 10), stamped (60 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. G-3, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded from our Web site: www.peoplespharmacy.com.

Q. I have had anxiety attacks several times in the past 15 years. Always before I have been given Xanax, and in several days I would be OK. Then I would occasionally take the pills as needed.

Last week when I went to the doctor and told him I was having anxiety attacks again, he prescribed the blood pressure pill atenolol. Have you ever known atenolol to be given for anxiety? When I tried it, I developed an upset stomach and lost my appetite.

A. Atenolol has not been approved for anxiety. Such beta blockers are primarily prescribed for blood pressure and heart problems. Doctors sometimes prescribe propranolol or atenolol for the physical symptoms associated with stage fright, but these drugs are not appropriate for general anxiety (Journal of Clinical Psychiatry, August 2006 supplemental). Alprazolam (Xanax) is approved for anxiety, and short-term use is often quite effective.

Q. Do you have any information about the safety of energy drinks like Red Bull?

A. A can of Red Bull has about 80 mg of caffeine. That’s a little less than the average cup of coffee.

It also contains added B vitamins and the amino acid taurine. One can is not likely to pose a health risk. Problems may occur, however, when people mix alcohol with caffeinated energy drinks in the mistaken belief that they will not become as intoxicated.

Q. Is there a safe and easy improvement on the method of removing head lice? My wife is a kindergarten teacher, and this annual ritual is wearing us both out. Her students bring lice from home, and they spread to the teachers and other students. Please help!

A. There is one novel approach that is both easy and safe. Dampen the hair, coat it with the facial cleanser Cetaphil and then use a blow-dryer. The Cetaphil hardens and forms a barrier that suffocates lice. Leave it on overnight, then shampoo it out in the morning (Pediatrics, September 2004).