What causes breath to smell like urine?

Most people have had foul-smelling breath at some point in their lives. Bad breath generally occurs as a result of poor oral health. However, it is less common for breath to smell like urine, so people may find it disconcerting if they have this symptom.

There are many possible causes of a urine odor in the breath, including:

nasal congestion

stomach infection

diet

chronic kidney disease (CKD)

Read on to learn more about the possible reasons for breath that smells like urine and the treatment options.

Nasal congestion or sinusitis

Bacterial infections that can cause sinusitis and nasal congestion may result in bad breath.

Nasal congestion, or a stuffy nose, refers to a runny nose or mucus buildup in the nasal cavities.

Nasal congestion may occur on its own or link to a condition called sinusitis, which is inflammation or infection of the hollow cavities in the nose and face.

Both nasal congestion and sinusitis can result from bacterial infections, allergies, or irritation of the nasal cavities.

They often result in bad breath, which in some people could smell similar to urine.

Treating it

People can treat nasal congestion and sinusitis with one or more of the following, depending on the cause:

decongestants

antibiotics

anti-inflammatory medication

allergy medicines

nasal corticosteroid sprays

surgery (in chronic cases, to remove blockages)

Some home remedies that may provide quick relief include:

inhaling steam

using nasal irrigation techniques

increasing fluid intake to thin out mucus

applying warm towels or bottles to the affected areas to reduce the pressure buildup

Stomach infection (Helicobacter pylori)

A common bacterium called Helicobacter pylori (H. pylori) is present in nearly one-half of the world’s population. Most people, however, do not show any symptoms.

H. pylori is a bacterium that lives in the stomach, causes inflammation and ulcers, and can lead to stomach cancer in infected people. Breath that smells like ammonia or urine is a common symptom.

Additional symptoms of H. pylori complications can include persistent pain or intermittent discomfort in the stomach, lack of appetite, nausea or vomiting, bloating, weight loss, and dark-colored stools.

Treating it

People should talk to a doctor if they suspect an H. pylori infection. If the doctor diagnoses an infection, treatment may include:

medicines called proton pump inhibitors, which decrease the production of stomach acid and allow damaged tissue to heal

a course of antibiotics, lasting 1–2 weeks

management of complications such as ulcers or cancer

Diet

Diet and excessive alcohol consumption may cause breath to smell like urine.

The foods that people eat can affect their breath, on both a temporary and long-term basis.

Certain foods react in the body to produce ammonia and its byproducts, which have odors resembling that of urine.

This is common in people who consume a high-protein or ketogenic diet. A high intake of specific foods such as onions and garlic can also lead to bad breath.

Excessive alcohol consumption can also affect breath by lowering saliva production.

Treating it

In most cases, it is easy to treat bad breath when it results from dietary causes.

People should check for particular foods in their diet that could be causing the problem and reduce their intake accordingly.

A well-balanced diet with multiple daily servings of fruit and vegetables will also result in a healthy digestive system and potentially better-smelling breath.

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Chronic kidney disease (CKD)

CKD comprises a range of diseases and disorders that damage the kidneys and limit their ability to filter body waste. This leads to a serious buildup of toxins in the body, including ammonia, which causes urine-scented breath.

Other health complications that can result from CKD include anemia, high blood pressure, abnormal electrolyte levels, fluid buildup, heart disease, increased risk of stroke and heart attack, and kidney failure.

An estimated 30 million American adults have CKD. Several factors can increase a person’s risk of CKD, including diabetes, drug abuse, high blood pressure, and a family history of kidney disease.

Treating it

It is not possible to cure CKD, so treatment aims to relieve symptoms and help patients manage the condition.

To manage CKD, people will need to make lifestyle changes and possibly also take medications for high blood pressure and high cholesterol.

People with advanced stage CKD may need dialysis or a kidney transplant.

Uremia

Uremia is the end stage of kidney failure. As the kidneys will no longer be able to filter waste effectively, waste substances such as urea, creatine, and other nitrogenous products build up in the blood rather than leaving the body in the urine.

The accumulation of these nitrogenous compounds in the system often results in breath smelling like urine.

Treating it

Uremia is a severe medical condition that requires urgent care and often hospitalization. Doctors will determine the underlying cause of uremia and recommend dialysis to filter the blood.

Some people may also require a kidney transplant if the kidneys are too damaged to filter blood on their own.

How to tell if your breath smells like urine

A foul taste in the mouth is the primary indication of bad breath.

Some other quick ways to check your breath include:

Licking your wrist and allowing it to dry for a moment before smelling it.

Flossing between two teeth toward the back of your mouth and smelling the floss.

Using a tongue scraper to scrape the tongue gently, then smelling the scraper.

Quick tips to prevent breath smelling of urine

Good oral hygiene may help to avoid bad breath.

People can help to avoid bad breath by adopting the following practices:

Maintaining good oral hygiene and checking with a dentist if they observe a persistent problem with their breath odor.

Drinking plenty of fluids, including water, juices, tea, and other non- alcoholic beverages.

Reducing intake of foods and beverages such as coffee, soft drinks, dairy, red meat, and refined and processed foods.

Balancing the diet with foods that include fruit, vegetables, and legumes.

Avoiding excessive amounts of alcohol, as it decreases saliva production.

Quitting smoking to minimize damage to the mouth and gums and to improve oral health.

Takeaway

There are many conditions that can cause breath to smell like urine. Some of these are temporary and resolve on their own, while others may require medical attention.

A dentist will be able to treat many of the causes of bad breath, but people should also maintain good oral hygiene and health.

Written by Gillian D’Souza

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