What causes a bitter taste in the mouth?
Sep 19, 2025
Source: Cainiu Health
Dr. Liu Chao
Introduction
Bitter taste in the mouth may be caused by factors such as imbalance of the oral environment, emotional and neurological regulation, gastrointestinal motility disorders, abnormal liver and gallbladder metabolism, or medication effects. It is recommended to maintain a daily water intake of more than 1500 ml, consume moderate amounts of hawthorn and dried tangerine peel to aid digestion, and avoid smoking and limit alcohol consumption. If bitter taste persists for over a week or is accompanied by abdominal pain, jaundice, or significant weight loss, you should visit a gastroenterology or dental clinic for further evaluation, including gastroscopy.
Under normal circumstances, a bitter taste in the mouth may be caused by factors such as oral environment imbalance, emotional and neurological regulation, gastrointestinal motility disorders, abnormal liver and gallbladder metabolism, or medication effects. If discomfort occurs, timely medical consultation is recommended. Specific analyses are as follows:
1. Oral Environment Imbalance: Plaque buildup, gingivitis, or dental caries create a favorable environment for bacteria, whose metabolic products include bitter-tasting amines. Consistently using the Bass brushing technique, flossing daily, and receiving professional cleaning every six months can significantly reduce oral odor. In cases of established infection, short-term use of chlorhexidine mouthwash or topical application of metronidazole patches can help control bacterial load.
2. Emotional and Neurological Regulation: Prolonged anxiety and insufficient sleep reduce saliva secretion, causing oral solutes to become concentrated and more likely to produce a bitter taste. Engaging in 30 minutes of brisk walking daily, practicing diaphragmatic breathing exercises, and maintaining a bedtime before 11 PM can enhance parasympathetic nervous system activity.
3. Gastrointestinal Motility Disorders: Stomach acid and bile reflux onto the back of the tongue can directly cause bitterness, often accompanied by belching and epigastric burning. Eating regular meals, reducing intake of high-fat and spicy foods, and avoiding food three hours before bedtime are fundamental measures. When necessary, under medical guidance, prokinetic agents such as domperidone tablets or acid-suppressing medications like rabeprazole sodium enteric-coated capsules may be used to interrupt the reflux cycle.
4. Abnormal Liver and Gallbladder Metabolism: Conditions such as cholecystitis or gallstones can obstruct bile excretion, leading to elevated serum bile acids that stimulate taste buds. Patients often experience dull pain in the upper right abdomen or jaundice, which can be confirmed via ultrasound. Mild cases may be treated with oral ursodeoxycholic acid to promote bile flow, while severe cases may require cholecystectomy. Bitter taste typically resolves as bile flow is restored.
5. Medication-Induced Taste Alterations: Antibiotics, certain antihypertensives, and antidepressants may temporarily interfere with taste receptors, with symptoms usually resolving after discontinuation. If bitterness is significant, consult your physician to adjust dosage or switch medications—do not discontinue treatment without medical advice.
Maintain daily water intake of at least 1500 mL, consume moderate amounts of hawthorn and dried tangerine peel to aid digestion, and avoid smoking and excessive alcohol consumption. If a bitter taste persists beyond one week or is accompanied by abdominal pain, jaundice, or significant weight loss, seek evaluation from a gastroenterologist or dentist to undergo further testing—including endoscopy, liver function tests, and abdominal ultrasound—to rule out organic diseases.
