Fetor hepaticus is a breath odor associated with hepatic encephalopathy, a condition caused by toxins building up in the bloodstream due to liver failure. Symptoms include abdominal discomfort, cognitive impairment, and confusion. Treatment ranges from dietary changes to medication, and prompt treatment is necessary to increase survival chances. If left untreated, it can lead to irreversible brain damage and death.
Fetor hepaticus is a characteristic breath odor associated with hepatic encephalopathy, a condition resulting from the buildup of toxins in the bloodstream that impairs brain function. The breath of someone with hepatic encephalopathy is often characterized as moldy and sometimes referred to as the breath of the dead. Associated with late-stage liver disease, treatment for liver stench and hepatic encephalopathy can range from dietary changes to the use of medications designed to flush toxins from the body. If left untreated, hepatic encephalopathy can be fatal.
The liver is responsible for filtering and neutralizing toxic substances that enter the body. When liver function is impaired due to disease or injury, the filtration process can be disrupted. Unneutralized toxins pose a serious risk to blood health and organ function. Prolonged liver failure can cause toxins to build up in the bloodstream, putting vital organs, such as the brain and nervous system, at risk of hepatic encephalopathy.
When the liver fails to filter toxins, such as ammonia, there is no place for the toxins to go except in the blood. A significant accumulation of toxins causes hepatic encephalopathy or impaired brain function. With hepatic encephalopathy, as contaminated blood moves through the lungs, toxins are expelled in the breath, creating fetor hepaticus.
Several tests are used to confirm a diagnosis of hepatic encephalopathy. Liver function tests are the primary tool used to measure organ function. Imaging tests are used to evaluate the physical condition of the liver and check for signs of scarring. Blood tests may also be ordered to check potassium levels and for signs suggestive of infection and disease.
Individuals with fetor hepaticus show additional signs and symptoms of hepatic encephalopathy. Abdominal discomfort, speech impairment, and delayed motor movements may occur. It is not uncommon for some individuals to experience cognitive impairment and confusion. Personality changes and significant lethargy are also signs of hepatic encephalopathy. During its more advanced stages, hepatic encephalopathy can induce a comatose state.
Considered a medical emergency, hepatic stench and hepatic encephalopathy require prompt treatment to increase the chances of survival. Individuals with this condition are considered to be in the late stages of hepatic encephalopathy. Treatment depends on the removal of toxins from the blood.
Individuals with fetor hepaticus and hepatic encephalopathy usually have a significantly elevated concentration of ammonia in their system. Changing your diet to limit protein-rich foods can help reduce blood ammonia levels. Cases of severe hepatic encephalopathy may require a person to be fed intravenously while undergoing additional treatment.
Sometimes drugs designed to inhibit the production of ammonia within the digestive system are given. Those showing significant signs of impaired organ function and those at risk for intracranial swelling may receive mechanical support, such as supplemental oxygen. Individuals with acute hepatic encephalopathy have a good prognosis if treatment is prompt and appropriate. If the person has been diagnosed with a chronic liver condition, such as cirrhosis, they are at an increased risk of recurring liver encephalopathic infection. If hepatic encephalopathy is not treated, irreversible brain damage and death can occur.
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