What Causes Breath To Smell Like Urine & What Can Be Done About It?

Foul odor from the breath is something which is quite common and everyone has had it at some point in their lives. Poor oral health and diet are believed to be the two most common causes for a person having bad breath. However, what is not common is that the smell of urine coming from the breath. People who have it find it very discomforting. Even people around them may find it difficult to interact with them. The smell of urine coming from breath is medically termed as Ammonia Breath.[1, 2, 3]

In a healthy person, ammonia is converted to urea in the liver which then travels through the blood to the kidneys from where it gets eliminated through urine. People with certain medical conditions like chronic kidney disease are more likely to have breath that smells like urine. This is because the urea is not able to be filtered out by the kidneys and it gets degraded into ammonia by the salivary urease. This ammonia is then expelled through breath giving the odor of urine.[1, 2, 3]

In fact, many studies have mentioned that checking the breath of a person can be a simple and accurate test of whether the kidneys are functioning. There are also other reasons as to why a person has a breath that smells of urine. It may be due to nasal congestion, infection in the stomach, and even diet to some extent.[1, 2, 3] In this article, we explore in more detail the various causes and the treatment options available for Breath that smells like urine.

What Causes Breath To Smell Like Urine and What Can Be Done About It?

  1. Nasal Congestion: Certain bacterial infections which cause the nose to get congested can at times result in a person having breath smelling of urine. Nasal congestion occurs when there is excess build up of mucous in the nasal cavities. A person can have a congested nose due to inflammation of the sinuses or in cases of infection like cough and cold. Certain environmental allergens can also lead to nasal congestion. Due to this nasal congestion, a person at times may have a breath that smells of urine.[3]

    Treatment: The best way to treat nasal congestion is by using decongestants which can be taken over the counter and are quite effective. To treat bacterial infection, a person may require antibiotics and allergy medications to treat congested nose due to allergens. There are also some home remedies that are quite effective in treating nasal congestion. These include inhaling steam and increased fluid intake to thin out the mucous so that it can flow out easily. Once nasal congestion is treated the foul odor of urine from the breath will also disappear.[3]

  2. Helicobacter Pylori Infection: This is a stomach infection caused by the bacterium H. Pylori. This bacterium is present naturally in the body but is in an inactive state. However, sometimes when this bacterium acts up it can cause inflammation and ulcers.[3]

    One of the symptoms of this stomach infection is breath smelling of urine or ammonia. Other symptoms include stomach discomfort, poor appetite, bloating, nausea or vomiting.[3]

    Treatment: H. Pylori is an infection that will require a physician consultation. The physician will prescribe PPIs or proton pump inhibitors which reduce acid production in the stomach and promotes healing of damaged tissues. The physician will also prescribe antibiotics to treat the infection for a course of a couple of weeks. Once the infection is treated, then the smell of urine from the breath also goes way.[3]

  3. Diet: There are certain foods that can also cause breath that smells of urine. Additionally, excessive alcohol use is also one of the reasons for it. Food is something that affects the breath on a short term and long-term basis. There are certain foods that release ammonia and its by-products which sometimes smell like urine. This is commonly seen in people who eat ketogenic diet or diet consisting abundant proteins. Bad breath can also be caused due to foods like garlic and onion.[3]

    Treatment: The best way to deal with this problem is to identify what foods may be causing the bad breath and eliminating them from the diet. Eating a balanced diet rich in fruits and vegetables is a great option for not only good health but also preventing bad breath.[3]

  4. Chronic Kidney Disease: A breath that smells of urine is one of the indicators that something is not right with the kidneys. This is because breath that smells of urine is caused due to the kidney not being able to filter and get rid of the excess ammonia that is produced in the body.[3]

    It is estimated that nearly 30 million adults in the United States have some form of kidney disease. Some of the risk factors for chronic kidney disease include diabetes, recreational drug abuse, alcohol abuse, hypertension, or a family history of kidney disease.[3]

    Treatment: There is no cure for chronic kidney disease so treatment is basically supportive and symptomatic. It requires certain lifestyle changes and taking medications to control blood sugar, blood pressure, and cholesterol diligently. Kidney transplant and dialysis is necessary for those who have end-stage kidney disease.[3]

  5. Uremia: This is yet another cause for a person having breath that smells of urine. This condition is the last stage of kidney failure. This clearly explains that the kidney is no longer able to filter out waste products from the body, including ammonia. This causes a build up of toxins resulting in a breath that smells of urine.[3]

    Treatment: Uremia is an emergent medical condition and requires prompt medical attention. The physicians will determine a cause for it and start treatment accordingly. They can also recommend dialysis to filter out the accumulated toxins and waste products from the body. In severe cases where kidneys are damaged beyond treatment then a kidney transplant will be recommended.[3]

How To Tell If Your Breath Smells Like Urine?

Some of the ways to check whether breath smells like urine is to:

  • Lick the wrist and allowing it to dry for a minute before smelling it.[3]
  • Scraping the tongue with a scraper and then smelling it.[3]
  • Flossing the teeth and then smelling the floss.[3]

In conclusion, a breath that smells of urine can be caused due to certain food products, especially those that produce ammonia and its biproducts. Alcohol abuse is also one of the common causes of smell of urine from the breath. In addition, there are certain medical reasons for breath to smell like urine.[1, 2, 3]

Among all the medical conditions, chronic kidney disease is the most common cause. This is because the kidneys are no longer able to filter out the waste products from the body which includes ammonia the build-up of which causes the breath to smell like urine. Stomach infections are also a common cause of bad breath and needs to be treated with antibiotics.[1, 2, 3]

In most cases, once the cause of the bad breath is taken care of the odor disappears. However, in cases of kidney diseases a thorough investigation is required to determine the extent of the disease and a treatment plan is formulated accordingly. Aside from the medical causes, maintaining a good oral hygiene is a must to keep bad breath away, including breath that smells like urine.[1, 2, 3]

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