instruction: hello doctor I have an extremely embarrassing issue with bad breath it is not your typical bad breath it smells like dog poop I am so embarrassed to say that but it is true it smells terrible even after I brush it has affected me my whole life over the years I have had people consistently make comments about how bad my breath is I have great dental hygiene see the dentist twice a year brush twice a day floss throughout the day mouthwash etc and nothing helps finally now that I am a 38 year old woman I mustered up the courage to talk to my dentist about it and also to see an ent doctor about it and they both have stated they do not believe it is a mouth or ear nose throat issue probably about 15 years ago I was on an antibiotic for something and it amazingly took my bad breath away and when I had a bowel movement the smell was not as bad either that is also an odor issue I have I am extremely embarrassed about my bathroom smells I have is so it is a common thing in my life I remember when I took this antibiotic noticing that it took away my bad smells I had typical not so pleasant odors but nothing extreme and I could also tell in my mouth I did not have this kind of yucky taste that I commonly have I was so relieved but that was short lived once the antibiotics were gone I cannot remember at all what the antibiotic was maybe doxycycline or metronidazole I am desperate for advise or help this has effected me in so many ways in my life I try not to get close to people when I talk and I avoid my husband like the plague when he tries to get close I am desperate to find some help with this issue
output: hi I have read your query and yes it seems likely that this is a medical issue and not a dental one since this is a long standing issue diabetes or kidney disease seems unlikely as you would definitely have had other symptoms too by now you already suffer from is which could be secondary to acidity the cause for bad breath and bad taste of mouth usually dietary modification and medicine are good enough for management but considering your history of breath getting better with antibiotics you should get tested for pyloric a bacteria causing gastritis if positive for it follow up for a proper antibiotic course also not to neglect other causes do get abc hba1c and urea and creatinine tested also in the meantime avoid spicy oily or rich in proteins foods increase carbohydrates and use yoghurt if you cannot tolerate milk elevate head end of bed walk at least 15 minutes after dinner do not lie down til hour post meals drink fluids with meals to decrease acidity eat dinner hours before bedtime eat smaller portions for ease of digestion simultaneously using omeprazole 40 my at night will improve things