title: Association between halitosis diagnosed by a questionnaire and halimeter and symptoms of gastroesophageal reflux disease.
abstract: OBJECTIVE
  The relationship between halitosis and gastroesophageal reflux disease (GERD) remains controversial. The aim of this study was to investigate an association between subjective and objective halitosis and GERD.
  
  
  METHODS
  The subjects were enrolled from participants who visited a health promotion center at Seoul National University Bundang Hospital. For diagnosis of halitosis, a questionnaire was requested, and volatile sulfur compounds (VSCs) were measured by Halimeter. Self-conscious halitosis was defined as halitosis perceived by himself or herself. Informed halitosis was defined as hal-itosis perceived by others. Objective halitosis was defined when mean VSCs values were > 100 parts per billion. GERD was defined based on a questionnaire and endoscopy, including erosive esophagitis and non-erosive reflux disease (NERD).
  
  
  RESULTS
  A total of 54 subjects (male:female = 33:21) with mean age of 46.0 ± 11.4 years were analyzed. The mean VSCs values were not significantly different between presence and absence of self-conscious halitosis (P = 0.322), but significantly different be-tween presence and absence of informed halitosis (P = 0.021). Informed halitosis was associated with objective halitosis (P = 0.039). GERD, erosive esophagitis and NERD did not correlate with objective halitosis (P = 0.556, 0.206 and 0.902, re-spectively). In multivariable analysis, the relationship between objective halitosis and GERD symptoms including chest pain, heart burn, acid regurgitation, epigastric pain, hoarseness, globus sensation and coughing was not significant. Besides, GERD was not associated with self-conscious halitosis, informed halitosis and objective halitosis, respectively.
  
  
  CONCLUSIONS
  GERD might not be associated with self-conscious, informed halitosis and objective halitosis indicated by Halimeter results. Informed halitosis could be correlated with objective halitosis determined by the Halimeter.(J Neurogastroenterol Motil 2014;20:483-490).
authors.affiliation: Departments of Periodontology, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea.
authors.forename: Hyo-Jung
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon-do, Korea.
authors.forename: Hee Man
authors.initials: HM
authors.lastname: Kim
authors.affiliation: Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea.
authors.forename: Nayoung
authors.initials: N
authors.lastname: Kim
authors.affiliation: Yonsei Plus Clinic, Seongnam, Gyeonggi-do, Korea.
authors.forename: Jane C
authors.initials: JC
authors.lastname: Oh
authors.affiliation: Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea.
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Jo
authors.affiliation: Departments of Periodontology, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea.
authors.forename: Jung-Tae
authors.initials: JT
authors.lastname: Lee
authors.affiliation: Department of Periodontology, School of Dentistry, Wonkwang University, Iksan, Jeollabuk-do, Korea.
authors.forename: Hee-Yung
authors.initials: HY
authors.lastname: Chang
authors.affiliation: Department of Public Health, Graduate School of Chungang University, Seoul, Korea.
authors.forename: Na-Hee
authors.initials: NH
authors.lastname: Chang
authors.affiliation: Medical Research Collaborating Center, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
authors.forename: Soyeon
authors.initials: S
authors.lastname: Ahn
authors.affiliation: Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University, Seoul, Korea.
authors.forename: Jeong-Yun
authors.initials: JY
authors.lastname: Lee
keywords: Gastroesophageal reflux; Halitosis; Questionnaires