Gastro Exam
 
 

Foetor

 
 
 
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On this page:HalitosisFoetor HepaticusAcetone BreathAlcoholic FoetorUraemic Foetor
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Overview

  • The patient's breath may reveal information about their oral hygiene, or suggest the presence of metabolic disease.

Halitosis

  • Halitosis is also known as foetor ex ore, oral malodour and 'bad breath'. The term refers to an offensive odour that may resemble rotten eggs / meat / fish or faeces.
  • This finding is suggestive of bacterial colonisation in the mouth, pharynx, respiratory or gastrointestinal tracts.

    • Causes of Halitosis

    • Oropharyngeal

    • Xerostomia (dry mouth)
    • Poor oral hygiene
    • Mouth ulcer
    • Dental caries
    • Gingivitis
    • Tongue colonisation
    • Tonsilitis
    • Sinusitis

    • Gastrointestinal

    • Reflux
    • H pylori infection
    • Crohn's disease

    • Respiratory

    • Bronchiectasis
    • Bronchial tumour

    • Systemic

    • Cirrhosis
    • Ketosis
    • Alcohol
    • Uraemia

Foetor Hepaticus

  • Foetor hepaticus is a musty smell, sometimes described as a mix between rotten eggs and garlic. 
  • This is associated with severe liver cirrhosis, likely due to sulphur compounds such as methyl mercaptan and dimethylsulphide.

Acetone Breath

  • Acetone breath manifests as a fruity smell, similar to nail polish remover; this is a reliable indicator of plasma ketosis.

    • Causes of Ketosis

    • Diabetic ketoacidosis
    • Alcoholic ketoacidosis
    • Starvation-induced ketosis
    • Ketogenic diet - high fat, high protein, low carbohydrate
    • Toxicity - isopronanol, acetone, propylene glycol, aspirin, isoniazid

Alcoholic Foetor

  • The smell of alcohol on the breath suggests alcohol ingestion, which may indicate acute intoxication and may be present in patients with alcoholism.

Uraemic Foetor

  • Uraemic foetor manifests as the smell of ammonia, or a urine-like odour. This occurs in patients with end-stage renal failure.
 
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