Bitter Taste In The Mouth : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 24/07/2022

A bitter taste in the mouth is a constant or intermittent unpleasant feeling of bitterness that 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, diseases of the gastrointestinal tract, local processes in the oral cavity. To identify the etiological factor, ultrasound, FGDS, duodenal sounding, stool and blood tests are performed. To eliminate an unpleasant taste in the mouth, enzymes, choleretic, antispasmodics are used.

Causes of a bitter taste in the mouth

Poor 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 30-4 minutes. A bitter taste on the mucous membranes of the mouth occurs when eating nuts and seeds, which include fatty acids that decompose to form bitter chemical compounds. The symptom is not accompanied by pain or dyspeptic disorders.

Age changes

In older people, a gradual atrophy of the mucous membrane occurs, as a result of which the ability to distinguish between tastes is lost. Therefore, during the 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 are part of cigarettes linger on the mucous membrane of the mouth and cause a bitter aftertaste. The discomfort can be reduced by chewing gum or sucking on mints. Smokers also note a decrease in the ability to perceive the taste of food. If, against the background of constant bitterness, a metallic taste is felt in the mouth, you should immediately consult a doctor.

Pregnancy

The periodic development of a bitter taste in the 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 sections of the gastrointestinal tract and cause discomfort. A bitter taste in the first half of pregnancy can occur with severe toxicosis, an irritating taste intensifies after an attack of vomiting.

The symptom sometimes occurs in pathological conditions that are provoked by pregnancy. The most common etiological factor is cholestasis of pregnancy. Bitterness in the mouth begins to disturb a woman from 32 weeks of gestation. An irritating bitter taste is accompanied by severe skin itching, lightening of the feces and darkening of the urine. If such signs appear, you should contact the antenatal clinic.

functional dyspepsia

Periodic violations of the coordinated work of the gastrointestinal tract are recorded in more than 80% of adults. The bitter taste is due to slow digestion of food, weakening of intestinal motility. An unpleasant feeling often occurs immediately after eating against the background of heaviness in the abdomen, flatulence. The feeling of bitterness can be stopped by taking water with lemon juice, mint candies.

The clinical picture of dyspepsia is more typical for young, emotionally labile patients. Often, a bitter taste in the mouth and abdominal cramps occur in schoolchildren and students during exams. Symptoms are short-lived, in most cases the condition returns to normal in 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 the mouth as an initial symptom of hepatitis is more often observed in chronic inflammation of the hepatic parenchyma. An unpleasant sensation develops half an hour to an hour after eating, but may also appear in the morning. If a patient with inflammation of the liver falls asleep during the day, he wakes up with 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.

Damage to the biliary system

Violations 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 severity of the disease, a bitter aftertaste is provoked only by the abuse of fatty and fried foods, alcoholic beverages. The symptom is accompanied by nausea, dull pain in the right hypochondrium, frequent stools. The condition improves after a few days of a sparing diet.

With severe inflammatory or destructive changes in the biliary system, a bitter taste constantly worries a person. In the morning, there is a strong bitterness and nausea, due to the flow of bile into the stomach and esophagus. The appearance of white or grayish feces is characteristic, sometimes there is excruciating skin itching. The main reasons for the development of a bitter sensation in the mouth:

  • Functional disorders : hyperkinetic dyskinesia, hypotonic insufficiency of the sphincter of Oddi.
  • Inflammatory causes : cholecystitis, cholangitis, cholecystocholangitis.
  • Gallstone disease .
  • Parasitic invasions : opisthorchiasis, echinococcosis, giardiasis.

Pathologies of the digestive tract

Practically all violations of the digestive tract are accompanied by an unpleasant taste in the mouth, as they provoke violations of the digestion of food and the release 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 of 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 mouth. With exacerbation of pancreatitis, the feeling of bitterness intensifies, nausea is noted, vomiting is possible with impurities of undigested food and bile. Also, patients notice a grayish or yellow coating on the tongue.

Dental diseases

The impact of a bacterial cause 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, combined with a fetid odor from the mouth, is characteristic of deep caries.

A bitter taste is observed after medical manipulations in the mouth. When choosing a low-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 symptom is accompanied by 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 the mouth that appears for no apparent reason and does not disappear after brushing their teeth. For the clinical picture, taste perversion is typical: 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 symptom is often due to 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 sensation in the mouth, which intensifies during meals. The symptom is also provoked by other medical causes: taking chemotherapy drugs, antihistamines, cholekinetics.

Rare Causes

  • Diseases of the respiratory system : alveolitis, pneumonia, purulent bronchitis.
  • Endocrine diseases : hypothyroidism, hypocorticism, diabetes mellitus.
  • Tumors : hepatocellular carcinoma, gastric cancer, pancreatic head cancer.
  • Unloading - dietary therapy .

Diagnostics

The most common causes of a bitter taste in the mouth are gastrointestinal diseases, so the patient should consult a gastroenterologist. First, complaints and anamnesis of the disease are collected, the relationship of bitterness with eating habits or time of day is clarified. Further, special laboratory and instrumental studies are applied, the most informative of which are:

  • Sonography . The ultrasound method is indicated for studying the state of the digestive tract, identifying 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 sounding . To prove the connection of a bitter taste with biliary diseases, 5 servings of bile are sequentially selected. The specialist evaluates the amount and rate of bile entry into the intestine in a natural manner and with pharmacological stimulation. Next, a bacteriological examination is performed.
  • Endoscopic examination . EGDS is prescribed for the diagnosis of diseases of the esophagus and gastroduodenal zone. During endoscopy, attention is paid to the integrity of the mucous membrane, the presence of areas of inflammation or atrophy. The condition of the major duodenal papilla and the initial sections of the duodenum is checked, and a biopsy is performed.
  • Fecal analysis . Many diseases that are characterized by a bitter taste in the mouth cause specific changes in the feces. In case of violations of the bile secretion function, a large amount of fatty inclusions are found in the feces; in case of damage to the pancreas, the stool contains undigested fibers and large molecules of carbohydrates.
  • 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 elevated. If a viral cause of hepatitis is suspected, a serological study 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. To diagnose lesions of the biliary system, cholangiopancreatography is performed. Patients with a burdened history should be examined by a neurologist.

 

Treatment

Help before diagnosis

To reduce discomfort during the diagnostic procedures, it is necessary to revise the diet: switch to frequent fractional meals, exclude fatty foods, and alcohol. Careful oral hygiene is important with the help of toothpastes, dental floss, irrigators. Doctors advise quitting smoking or reducing the number of cigarettes smoked per day as much as possible.

With a strong bitter taste, you need to regularly rinse your mouth with boiled water with the addition of lemon juice, at work you can eat 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 sharp pains in the abdomen, 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 improves digestion processes; physiotherapy methods 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). Medicines are recommended for cholecystitis and cholangitis to normalize digestive function.
  • Antispasmodics . Means relax the smooth muscles of the gastrointestinal tract, relieve pain in the abdomen, which often occurs simultaneously with a bitter aftertaste. Analgesics from the group of non-steroidal 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. In hepatitis and infectious liver lesions, they must be combined with hepatoprotectors.
  • Anthelmintic drugs. Recommended for helminthiases that affect the bile ducts and liver tissue - opisthorchiasis, echinococcosis. To eliminate giardiasis, specific antiparasitic drugs are effective.
  • Antivirals . In the treatment of hepatitis caused by viruses B or C, separate protocols are used that involve the use of inhibitors of the assembly and formation of viral particles. Pegylated interferons are also prescribed.

Surgery

In cholelithiasis with small stones, extracorporeal shock wave lithotripsy becomes the method of choice. In the case of a total lesion of the gallbladder, open or laparoscopic cholecystectomy is indicated. Periodontitis and pulpitis are treated by surgically opening the cavity of the canals of the tooth, followed by washing with antibacterial solutions, applying therapeutic pastes.

Latest Articles

  1. Noise in ears (September 30)
  2. Stamping gait (September 30)
  3. Wobbly gait (September 30)
  4. Shuffling gait (September 30)
  5. Sneezing (September 30)
  6. Cylindruria (September 30)
  7. Lameness (September 30)
  8. Chorea (September 30)
  9. Cold sweat (September 29)
  10. Chyluria (September 29)