Smell bad at all hours: cacosmia, the olfactory disorder that warns of numerous diseases

  • Cacosmia can go unnoticed or not receive enough attention, although it can be a sign of a serious pathology

  • This smell disorder can be due to both infections, such as sinusitis, and brain disorders

  • The usual therapies can be based on medications, especially antibiotics, as well as regular washings of the nasal passages and sinuses

Among the disorders that can affect us in our daily lives, cacosmia can go unnoticed or not get enough attention. And we would be making a mistake, as it may be sign of a serious pathology. What is it and how can we combat it?

Smell… not exactly like roses

Barely known, cacosmia is defined as a altered sense of smell what makes us perceive unpleasant aromaseven though they don’t really exist. Patients who suffer from this alteration speak of a continuous bad odor in their nostrils. For them, the fragrant smell of a rose can be similar to a garbage can.

This bad smell can come from some part of our body or not really exist. In the latter case, it would be an olfactory hallucination called phantosmia. Cacosmia itself is not associated with loss of senses of taste or smell and affects unone of every 15 people.

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How is it diagnosed?

This affectation of smell can be temporary or lasting. If the problem persists, it will be necessary to go to an otolaryngologist because cacosmia can indicate the presence of serious pathology. The diagnosis will be established based on family history or the existence of allergies.

In a second phase, the doctor will carry out a rhinoscopy of the nostrils and an endoscopy, both with local anesthesia, since they are not painful tests, but they are unpleasant. Let’s think of any PCR to get an idea. For an accurate diagnosis, the specialist may also order a scanner, a blood test and one magnetic resonance.

What are the possible causes?

Cacosmia can be triggered by multiple factors organic. For this reason, it is imperative that it be diagnosed as soon as possible to see what causes it and design the appropriate treatment. Among the main pathologies:

  • Infections linked to dentition.
  • Sinusitis.
  • Nostril tumor.
  • esophageal reflux
  • Brain injury.
  • Brain tumor.
  • Allergic rhinitis.
  • Diabetes.
  • Renal insufficiency.
  • smoking.
  • Exposure to toxic products.
  • Some anatomical malformations.
  • Presence of polyps in the nostrils and sinuses.
  • Complications after otorhinolaryngological or cosmetic surgery.

brain causes

Sometimes, cacosmia can be produced as a consequence of some cerebral alteration. In other words, the perceptual alteration is not due to a poor articulation of meaning, but to an adulteration of the areas of the brain responsible for managing sensory functions. In these cases, cacosmia is related to the following diseases:

  • hypothyroidism It is a disease of the endocrine system caused, sometimes, by a malfunction of the immune system, by infections or even during pregnancy. When there is a deficient production of thyroid hormone, both physical and psychological symptoms can be triggered, with the sense of smell being frequently affected.
  • Epilepsy. Some cases of cacosmia have been recorded in temporal lobe epilepsies, these being temporary.
  • Parkinson’s disease. It is not a constant in all patients and the specific cause is not determined; however, the latest research indicates that a lack of dopamine can lead to cases of cacosmia.

How can it be treated?

There isn’t a single treatment, since it depends on the factor that gives rise to the disease. When the cause is physical, the usual therapies can be based on medicines; especially, antibiotics if it is the result of a bacterial infection. They are also good regular washings of the nasal passages and sinuses with saline liquids, such as physiological serums, a treatment that will also help alleviate rhinitis and the effects of allergies.


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