Please can anyone help me,
 Since my surgery 4 months ago I have developed really bad breath coming from probably somewhere inside stomach or elsewhere but not my mouth or teeth absolutely nothing will help more than 5 minutes . Does anyone have any idea what could have happened during surgery or recently that is causing such a serious problem? I had my surgery outside the states so its not like I can just go back to my doctor. Any suggestions please, I am so down i cant get near anyone to talk to its really that bad. Thanks. PS any suggestions on what type of special doctor to see?

Getting the Facts Straight About
Bad Breath and Ketosis

If you have ever heard anything about bad breath and ketosis, the first thing that probably comes to mind is:  what the heck is ketosis?  This is a very fair question and unless you are on some low carb diet such as Atkins or South Beach—it honestly will have no relevance to your own bad breath problems.  However, for those determined to shed pounds with a low carb diet and wondering why they are suddenly having a bad breath problem, it is important to understand ketosis and its effect upon your body.

Ketosis is a process of increased metabolism that people on the Atkins or South Beach diet are trying to attain in order to lose weight.  When you consume food, it typically is processed by the digestive system and broken down into its constituent parts.  Nutrients are removed and used while much of the food is converted into fat and then stored for later use.  Then, when the body needs energy at later times, it turns to the fat stores.

Carbohydrates are different than proteins or fats because they are so much easier to convert directly into energy.  In other words, if you eat a heaping pile of spaghetti, the carbohydrates in the pasta can immediately be used for existing energy requirements.  The body does not convert carbs into fat unless there are no pressing needs for energy.  When this happens, the fat stores are not used and this is how the pounds pile on.

The reason why a low carb diet and bad breath are connected is because of ketosis.  When carb levels are lowered to around 20 grams per day, the body is forced to convert fat into energy—this is ketosis.  However, ketosis tends to cause bad breath problems because of ketones which are help convert fat stores into energy.  Ketones are chemicals that change the pH of your body and cause bad breath problems.

Also, another reason why low carb diets tend to cause bad breath is because they tend to be diuretic in nature.  That is to say that the process of ketosis demands a greater amount of water than normal so dehydration is common on such diets.  Dehydration lowers salivation rates which leads to an increase in the population of anaerobic bacteria responsible for bad breath.

Fortunately, there is little chance of a low carb diet causing chronic bad breath because most plans (including Atkins and South Beach) call for a gradual re-introduction of carbohydrates into the diet once certain weight loss goals are met or after a set period of time.  However, don’t be fooled—the halitosis that results because of ketosis is no “bad breath kid!”  The odor is very acrid and will definitely motivate you to attain your weight loss goals as quickly as possible so you can add back some carbohydrates to get rid of this particular type of bad breath and the ketosis that caused it!

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It is ketosis and is a natural byproduct of the low carb diet and rapid weight loss.  It will eventually get better on its own. 

Red

Just FYI, sometimes it's not always ketosis, either.  Sometimes it can be solved by Flagyl, as mine has.  If you can, drink more water.  That also helped.

Probably most likely ketosis.
However, I also got stomach acid really bad post-op that I never had pre-op, so an antacid (Rx) helped clear that up and the bad breath that came along with it.

It is probably ketosis, which DOES come from "inside", i.e. the lungs, in your breath  ...  Brushing your teeth, tongue, using mouthwash, etc. will not get rid of it, therefore ..     

  btw, you say on your avatar that Dr. Swain is your surgeon, but his profile says he is in AZ, not outside the U.S.