EpistemisMetallic taste in the mouth of digestive origin
Specialty: Gastrointestinal.
Why it occurs
- Non-erosive or erosive gastroesophageal reflux disease (GERD), with microleakage of gastric acid and bile salts into the oral cavity
- Active chronic infection by Helicobacter pylori in the gastric mucosa
- Gastroparesis or delayed gastric emptying that favors the imperceptible regurgitation of nitrogenous compounds
- Chronic consumption of certain digestive drugs such as metronidazole or clarithromycin (eradication therapy).
Initial workup
Upper digestive endoscopy (EDA) to evaluate reflux, hiatal hernia or gastritis | Breath test for H. pylori | Concomitant dental and otorhinolaryngological evaluation to rule out local pathology.
red flags
Involuntary weight loss, dysphagia, odynophagia, upper digestive bleeding or palpation of masses in the neck or oral cavity.
Standard management
- Proton pump inhibitors — omeprazole 20 mg daily before breakfast to control reflux of gastric contents
- Sodium alginate plus sodium bicarbonate — 10 ml after main meals to avoid microregurgitation of acid and pepsin towards the laryngopharynx
- Substitution of suspected drugs if the symptom is self-limited and secondary to previous antibiotic therapies.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Gastrointestinal
- Listed causes
- 4
- Treatment options
- 3