Bitter taste in mouth is a constant or periodic unpleasant feeling of bitterness, which is not always associated with eating. The symptom occurs in pregnant women, smokers, when eating low-quality food. The main pathological causes of a bitter taste are diseases of the liver and biliary system, gastrointestinal diseases, local processes in the oral cavity. Ultrasound, FGDS, duodenal probing, stool and blood tests are performed to identify the etiological factor. To eliminate an unpleasant taste in the mouth, enzymes, choleretics, antispasmodics are used.
Causes of bitter taste in mouth
Low-quality food
When eating poorly cooked, burnt dishes, a specific taste of bitterness appears in the mouth. The unpleasant sensation decreases after drinking water, but the residual aftertaste can persist for up to 30-40 minutes. A bitter taste on the mucous membranes of the mouth occurs when eating nuts and seeds, which include fatty acids that break down to form bitter chemical compounds. The symptom is not accompanied by pain or dyspeptic disorders.
In the elderly, there is a gradual atrophy of the mucous membrane, as a result of which the ability to distinguish tastes is lost. Therefore, during a meal, the bitter taste is most pronounced, and the rest of the taste qualities of the products are not perceived. The elderly complain of bitterness felt in the mouth, regardless of the type of food, associated with a decrease in saliva production and activation of pathogenic microflora.
Smoking
Nicotine and various harmful resins that make up cigarettes linger on the mucous membrane of the mouth and cause a bitter taste. The unpleasant feeling allows you to reduce chewing gum or sucking mints. Smokers also note a decrease in the ability to perceive the taste of food. If a metallic taste is felt in the mouth against the background of constant bitterness, you should immediately consult a doctor.
Pregnancy
The periodic development of a bitter taste in mouth during gestation is caused by natural causes. Due to the increased production of the hormone progesterone, the flow of bile into the intestinal lumen is disrupted, bile acids are thrown into the overlying gastrointestinal tract and cause unpleasant sensations. A bitter taste in the first half of pregnancy can occur with severe toxicosis, the irritating taste increases after an attack of vomiting.
The symptom is sometimes found in pathological conditions that are provoked by pregnancy. The most common etiological factor is cholestasis of pregnant women. Bitterness in the mouth begins to bother a woman from the 32nd week of gestation. Irritatingly bitter taste is accompanied by severe itching of the skin, lightening of feces and darkening of urine. If such signs appear, it is necessary to contact a women’s consultation.
Functional dyspepsia
Periodic violations of the coordinated work of the gastrointestinal tract are recorded in more than 80% of adults. The bitter taste is caused by slow digestion of food, weakening of intestinal motility. An unpleasant feeling often occurs immediately after eating against the background of heaviness in the stomach, flatulence. The feeling of bitterness can be stopped by taking water with lemon juice, mints.
The clinical picture of dyspepsia is more typical for young, emotionally labile patients. Often a bitter taste in mouth and abdominal cramps occur in schoolchildren and students during exams. The symptoms are short-lived, in most cases the condition normalizes 1-2 days after the disappearance of the stress factor. If bitterness is accompanied by severe unbearable pain, diarrhea, a specialist consultation is necessary.
Hepatitis
Liver damage has various causes, but the manifestations of all clinical variants are similar. A bitter taste in mouth as an initial symptom of hepatitis is more often noted in chronic inflammation of the hepatic parenchyma. An unpleasant sensation develops half an hour or an hour after eating, but it can also appear in the morning. If a patient with liver inflammation fell asleep during the day, waking up, he feels a sharp irritating taste in his mouth.
In patients with chronic viral hepatitis B and C, bitterness on the oral mucosa persists for 2-3 months, and in the case of fibrous degeneration of the liver, it becomes a permanent symptom. For toxic hepatitis, short-term uncomfortable taste sensations are typical, which disappear after intensive therapy. The bitter taste is aggravated by pain and heaviness in the right hypochondrium, nausea, vomiting with an admixture of bile.
Defeat of the biliary system
Disturbances in the work of the biliary organs cause erratic uncontrolled secretion of bile, which is associated with the appearance of a feeling of bitterness. With a mild degree of severity of the disease, the bitter taste is provoked only by the abuse of fatty and fried foods, alcoholic beverages. The symptom is accompanied by nausea, dull pains on the right side of the hypochondrium, increased stool. The condition improves after a few days of a gentle diet.
With severe inflammatory or destructive changes in the biliary system, a bitter taste constantly bothers a person. In the morning, there is a strong bitterness and nausea caused by the flow of bile into the stomach and esophagus. The appearance of white or grayish feces is characteristic, sometimes there is a painful itching of the skin. The main causes of the development of a bitter sensation in the mouth:
- Functional disorders: hyperkinetic dyskinesia, hypotonic insufficiency of the Oddi sphincter.
- Inflammatory causes: cholecystitis, cholangitis, cholecystocholangitis.
- Cholelithiasis.
- Parasitic infestations: opisthorchiasis, echinococcosis, giardiasis.
Pathologies of the gastrointestinal tract
Practically all disorders of the digestive tract are accompanied by an unpleasant taste in the mouth, since they provoke disturbances in the digestion of food and the excretion of bile into the duodenum. With chronic gastritis and duodenitis, a person periodically experiences bitterness in the oral cavity against the background of errors in the diet, nervous overstrain. Bitter taste is more often associated with meals.
Pancreatitis and other pathological causes from the pancreas are manifested by a change in taste perception. There is an unpleasant bitter taste, which is often combined with a rotten smell from the oral cavity. With exacerbation of pancreatitis, the feeling of bitterness increases, nausea is noted, vomiting with impurities of undigested food and bile is possible. Also, patients notice a grayish or yellow plaque on the tongue.
Dental diseases
The effect of bacterial causes on the oral cavity causes the development of purulent stomatitis, ulcers, which are accompanied by the appearance of bitterness in the mouth. The symptom worries constantly, the intensity of unpleasant taste sensations does not depend on meals. A specific bitter taste in combination with a fetid smell from the mouth is characteristic of deep caries.
A bitter taste is observed after medical manipulations in the mouth. When choosing a poor-quality material for fillings, it gradually begins to react with saliva enzymes and breaks down, causing unpleasant taste sensations. Similar symptoms usually occur in the initial period after the installation of dentures. Bitterness is associated with the presence of a foreign object in the mouth. If the sign is accompanied by a toothache, you need to visit a doctor.
Neurological disorders
The symptom occurs when the taste nuclei of the brain are damaged. Patients complain of a bitter taste in mouth, which appears for no apparent reason and does not disappear after brushing their teeth. A perversion of taste is typical for the clinical picture: sweet is perceived as sour or salty and vice versa. Bitterness on the oral mucosa occurs after a stroke, traumatic brain injury. In older people, the sign is often caused by Alzheimer’s disease.
Complications of pharmacotherapy
Most often, a bitter taste develops against the background of antibiotic treatment. These drugs suppress the beneficial microflora and disrupt the activity of saliva lysozyme, as a result of which fungal microorganisms are activated. Patients note constant bitterness, burning in the mouth, which increases during meals. The symptom is provoked by other medical reasons: taking chemotherapy drugs, antihistamines, cholekinetics.
Rare reasons
- Diseases of the respiratory system: alveolitis, pneumonia, purulent bronchitis.
- Endocrine diseases: hypothyroidism, hypocorticism, diabetes mellitus.
- Tumors: hepatocellular carcinoma, stomach cancer, pancreatic head cancer.
- Unloading and dietary therapy.
Diagnostics
The most common causes of bitter taste in the mouth are gastrointestinal diseases, so the patient needs to consult a gastroenterologist. First, complaints and anamnesis of the disease are collected, the connection of bitterness with eating habits or time of day is clarified. Further, special laboratory and instrumental studies are used, the most informative of which are:
- Sonography. The ultrasound method is indicated for studying the state of the digestive tract, detecting inflammatory and destructive changes, neoplasms. A targeted ultrasound of the liver and gallbladder is performed. To detail the state of the hepatic parenchyma, elastometry is used — a modern non-invasive method for determining the degree of fibrosis.
- Duodenal probing. To prove the connection of bitter taste with biliary diseases, 5 portions of bile are sequentially selected. The specialist evaluates the amount and rate of bile entering the intestine in a natural mode and with pharmacological stimulation. Next, a bacteriological study is performed.
- Endoscopic examination. For the diagnosis of diseases of the esophagus and gastroduodenal zone, EGD is prescribed. During endoscopy, attention is paid to the integrity of the mucous membrane, the presence of areas of inflammation or atrophy. Check the condition of the large duodenal papilla and the initial parts of the duodenum 12, perform a biopsy.
- Analysis of feces. Many diseases, which are characterized by a bitter taste in the mouth, cause specific changes in feces. In case of violations of the bile-secreting function, a large number of fatty inclusions are found in the feces, when the pancreas is affected, the feces contain undigested fibers and large carbohydrate molecules.
- Laboratory diagnostics. Women must be tested for hCG and sex hormones to exclude or confirm pregnancy. In the biochemical analysis of blood with cholecystitis, the levels of bilirubin and the enzyme alkaline phosphatase are increased. If viral causes of hepatitis are suspected, serological examination of markers is required.
- Additional methods. An examination by a dentist is necessary to detect carious cavities, chronic periodontitis and other pathologies that cause a feeling of bitterness in the mouth. Cholangiopancreatography is performed to diagnose lesions of the biliary system. Patients with a burdened history need to be examined by a neurologist.
Treatment
Help before diagnosis
To reduce unpleasant sensations during diagnostic procedures, it is necessary to revise the diet: switch to frequent fractional meals, exclude fatty meals, alcohol. Careful oral hygiene with toothpastes, dental floss, and irrigators is important. Doctors advise to give up smoking or to minimize the number of cigarettes smoked per day.
With a strong bitter taste, you need to regularly rinse your mouth with boiled water with lemon juice, at work you can eat a mint candy or a slice of lemon. The feeling of bitterness helps to reduce the rational drinking regime with the consumption of at least 1.5 water per day. If the symptom is accompanied by severe abdominal pain, repeated vomiting or other dyspeptic disorders, you should immediately visit a doctor.
Conservative therapy
Therapeutic measures are selected taking into account the cause of bitterness in the mouth. An important component of therapy is a special diet that allows you to improve the digestive processes, physiotherapy techniques are also actively used. The main direction is drug etiotropic and pathogenetic therapy. Most often used:
- Choleretic agents. Prescribe drugs that improve the colloidal properties of bile (choleretics) and stimulate its excretion through the bile ducts (cholekinetics). Medications are recommended for cholecystitis and cholangitis to normalize digestive function.
- Antispasmodics. The products relax the smooth muscles of the gastrointestinal tract, relieve abdominal pain, which often occur simultaneously with a bitter taste. Analgesics from the group of nonsteroidal anti-inflammatory drugs are indicated for the treatment of inflammatory diseases.
- Enzymes. Combined preparations of pancreatic enzymes and bile acids stimulate digestion, so that bitterness disappears in the mouth. With hepatitis and infectious liver lesions, they must be combined with hepatoprotectors.
- Anthelmintic drugs. Recommended for helminthiasis, which affects the biliary tract and liver tissue – opisthorchiasis, echinococcosis. Specific antiparasitic medications are effective to eliminate giardiasis.
- Antiviral agents. In the treatment of hepatitis caused by viruses B or C, separate protocols are used, which involve the use of inhibitors of the assembly and formation of viral particles. Pegylated interferons are also prescribed.
Surgical treatment
In cholelithiasis with a small size of concretions, extracorporeal shock wave lithotripsy becomes the method of choice. In the case of total damage to the gallbladder, an open or laparoscopic cholecystectomy is indicated. Periodontitis and pulpitis are treated by surgical opening of the cavity of the channels of the tooth, followed by washing with antibacterial solutions, the imposition of therapeutic pastes
