Bad breath almost never arises from the esophagus, stomach, or intestines. The esophagus is normally collapsed and closed; an occasional belch may carry odor up from the stomach, but the possibility of air escaping continuously is remote. Thus, bad breath alone should not be an indication for gastroscopy in an otherwise healthy ambulatory patient [20]. Patients with heartburn, regurgitation, sour taste, and belching often complain of halitosis [40], but self-estimation of breath is subjective and requires objective confirmation