What is fetor hepaticus?
Fetor hepaticus is a distinct smell on the breath of someone with liver disease. It happens when your liver can’t filter certain toxic substances from your blood anymore. These substances build up in your blood and come out in your breath. You may also detect the same smell in your pee or sweat.
Unlike common bad breath, fetor hepaticus isn’t related to what you eat, your oral hygiene or gum disease. It’s constant, and you can’t wash it away or treat the smell directly. But it’s important to see a healthcare provider about your underlying condition. Fetor hepaticus is a symptom of serious illness.
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What does fetor hepaticus smell like?
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Healthcare providers who recognize the smell of fetor hepaticus have described it as musty, pungent, oddly sweet and occasionally fecal (poop-like). While smells are somewhat subjective and hard to define, fetor hepaticus is different from other bad breath smells that can accompany other conditions.
Writers have compared it to:
- Rotten eggs and garlic.
- Freshly mown hay.
- Scorched fruit.
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Fetor hepaticus is different from:
- Trimethylaminuria (fish odor syndrome). Trimethylaminuria, a buildup of trimethylamine in your blood, is a different metabolic condition. Although some people with liver disease may also develop trimethylaminuria, fish odor isn’t the dominant smell in fetor hepaticus.
- Uremic fetor (“ammonia breath”). An ammonia or bleach smell on your breath is a symptom of kidney failure. It happens when your kidneys stop filtering urea from your blood. Ammonia may play a small part in fetor hepaticus, but it’s not one of the dominant smells.
- “Keto breath.” A fruity or acetone smell (resembling nail polish remover) on your breath is a byproduct of ketosis, and sometimes, diabetes-related ketoacidosis. Some acetone may be in the mix of gases that make up fetor hepaticus, but it’s not the dominant smell.
What does fetor hepaticus mean?
Fetor hepaticus means “fetid liver” or “liver stench”. Of course, it’s not your liver itself that smells. But the smell does mean that your liver is failing to filter your blood as it should. This is usually a result of long-term (chronic) liver disease. Occasionally, an acute (temporary) condition may cause it.
Regardless of the specific cause, fetor hepaticus means that you need to seek healthcare right away. Your condition has reached a new and very serious stage. If toxins have accumulated in your blood at high enough levels to smell on your breath, they may begin to affect your brain and nervous system.
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