{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:16:01Z","timestamp":1790612161912,"version":"4.1.0"},"reference-count":23,"publisher":"IOP Publishing","issue":"4","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/publishingsupport.iopscience.iop.org\/iop-standard\/v1"},{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"tdm","delay-in-days":6,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"funder":[{"name":"High level Specialized Backbone Physician Training Project under the Medicine, Teaching and Research Collaborative Health Service System of Minhang District","award":["2024MZYS003"],"award-info":[{"award-number":["2024MZYS003"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81900494"],"award-info":[{"award-number":["81900494"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["J. Breath Res."],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Some cases of halitosis associated with small intestinal bacterial overgrowth (SIBO) are refractory to antibiotic therapy. The low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) diet (LFD) has emerged as an alternative therapeutic option for SIBO. This retrospective study is the first to investigate the efficacy of LFD in refractory SIBO-associated halitosis. We consecutively reviewed data from 141 patients with refractory SIBO-associated halitosis who underwent a four-week LFD intervention. Halitosis was diagnosed using organoleptic test. Volatile sulfur compounds\u2014including hydrogen sulfide, methyl mercaptan (MM) and dimethyl sulfide (DMS)\u2014were quantified in nasal breath using the OralChroma device. SIBO was confirmed via hydrogen\/methane breath test. Serum nutritional parameters were measured to assess nutritional status. Dietary adherence was evaluated using the FODMAP Adherence Report Scale. All patients demonstrated good adherence to the LFD, with no significant changes in nutritional parameters post-treatment. Overall, 80.85% and 78.72% of the patients exhibited SIBO resolution and halitosis improvement, respectively. DMS levels significantly decreased after treatment [41.84 \u00b1 10.73 parts per billion (ppb) <jats:italic>vs.<\/jats:italic> 19.22 \u00b1 7.91 ppb, <jats:italic>P<\/jats:italic> &lt; 0.001]. In contrast, baseline hydrogen sulfide (17.08 \u00b1 12.30 ppb) and MM (13.50 \u00b1 5.65 ppb) levels were low and remained unchanged post-treatment (<jats:italic>P<\/jats:italic> &gt; 0.05). Moreover, post-treatment comparison between SIBO-negative and SIBO-positive groups revealed a higher rate of halitosis improvement in the SIBO-negative group (90.35% <jats:italic>vs.<\/jats:italic> 29.63%<jats:italic>, P<\/jats:italic> &lt; 0.001), accompanied by significantly lower DMS levels (17.15 \u00b1 5.81 ppb <jats:italic>vs.<\/jats:italic> 23.63 \u00b1 9.99 ppb, <jats:italic>P<\/jats:italic> = 0.006). Therefore, we conclude that a four-week LFD intervention appears effective for refractory SIBO-associated halitosis, with great adherence and no risk of malnutrition. Its mechanism likely involves SIBO alleviation, thereby reducing intestinal production and breath excretion of volatile malodorous compounds, particularly DMS.<\/jats:p>","DOI":"10.1088\/1752-7163\/ae0aec","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T22:49:10Z","timestamp":1758754150000},"page":"046007","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Therapeutic effect of the low FODMAPs diet for refractory halitosis associated with small intestinal bacterial overgrowth"],"prefix":"10.1088","volume":"19","author":[{"given":"Peng \u9e4f","family":"Gong \u9f9a","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting \u5a77","family":"Kang \u5eb7","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi Meng \u4ed5\u68a6","family":"Wang \u738b","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6559-0596","authenticated-orcid":true,"given":"Xiao Xian \u5b5d\u5148","family":"Qian \u94b1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"jbrae0aecbib1","doi-asserted-by":"publisher","first-page":"165","DOI":"10.14309\/ajg.0000000000000501","type":"journal-article","article-title":"ACG clinical guideline: small intestinal bacterial overgrowth","volume":"115","author":"Pimentel","year":"2020","journal-title":"Am. 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Oral Investig."},{"key":"jbrae0aecbib5","doi-asserted-by":"publisher","first-page":"357","DOI":"10.4155\/bio.13.306","type":"journal-article","article-title":"Detection of volatile malodorous compounds in breath: current analytical techniques and implications in human disease","volume":"6","author":"Calenic","year":"2014","journal-title":"Bioanalysis"},{"key":"jbrae0aecbib6","doi-asserted-by":"publisher","DOI":"10.1088\/1752-7155\/8\/1\/017101","type":"journal-article","article-title":"Halitosis management by the general dental practitioner\u2013results of an international consensus workshop","volume":"8","author":"Seemann","year":"2014","journal-title":"J. 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All rights, including for text and data mining, AI training, and similar technologies, are reserved.","name":"copyright_information","label":"Copyright Information"},{"value":"2025-04-26","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2025-09-24","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2025-10-07","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}