Breath odor

Considerations:
Some disorders will produce specific, characteristic odors to the breath.

A fruity odor to the breath occurs as the body attempts to get rid of excess acetone through the breathing. This is a characteristic sign of ketoacidosis (such as diabetic ketoacidosis ), a potentially life-threatening condition.

A fecal odor to the breath (the breath smells like feces) can occur with prolonged vomiting , especially when there is a bowel obstruction . It can also occur temporarily if the person has a nasogastric tube in place (a tube placed through the nose or mouth to the stomach to drain the stomach contents).

The breath may have an ammonia-like odor (also described as urine-like or "fishy") in people with chronic kidney failure .

Common Causes:
If previously normal breath turns into halitosis, causes could include:

Diseases that may be associated with breath odor (not presented in order of likelihood--some are extremely unlikely):

Note: There may be other causes of breath odor. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for breath odor, occurring alone or in combination with other problems.

Home Care:
Use proper dental hygiene (especially flossing) and remember that mouthwashes are not effective in treating the underlying problem. Frequent use of mouthwashes with a high alcoholic content may be associated with a higher incidence of oral cancer .

Fresh parsley or a strong mint are often effective ways to fight temporary bad breath. Avoid smoking .

Otherwise, follow prescribed therapy to treat the underlying cause.

Call Your Healthcare Provider If:

  • breath odor persists and there is not an obvious cause (such as smoking or eating odor-causing foods).
  • breath odor (particularly a fruity odor, fecal odor, or ammonia odor) is accompanied by other symptoms.



What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting breath odor in detail may include:

  • quality
    • Is there a specific odor?
      • Is there a fishy smell?
      • Does the breath smell like ammonia or urine?
      • Does the breath smell like fruit or is there a sweet-chemical smell?
      • Does the breath smell like feces?
      • Does the breath smell like alcohol?

  • aggravating factors
    • Has the person recently eaten a spicy meal, garlic, cabbage, or other "odorous" food?
    • Does the person take vitamin supplements?
    • Does the person smoke?

  • relieving factors
    • Does good oral hygiene improve the odor?
    • What home care measures have been tried? How effective are they?

  • medical history

  • other
    • What other symptoms are also present?

The physical examination will include a thorough examination of the mouth and the nose. A throat culture may be taken if the patient has a sore throat or mouth sores .

Diagnostic tests that may be performed include:

Intervention:
Antibiotics may be prescribed for some conditions. For an object in the nose, the doctor will use a special instrument to remove it.

After seeing your health care provider:
You may want to add a diagnosis related to breath odor to your personal medical record.