Experiencing a constant strange odor, for example an ammonia smell in nose, is a common symptom, but it can be very unpleasant and worrying. There are many possible causes for this, some of which will resolve on their own while others are more serious. In this article, we’ll outline some of the more frequent reasons for constant unpleasant smells, how you can tell what you have, and what the recommended treatments are.

Possible Causes and Treatments of Ammonia Smell in Nose

1. Sweating

Excessive sweating is one of the main reasons for an ammonia smell in nose. Sweat in itself has no smell, but when it is exposed to bacteria on the skin, it can develop a foul odor. This is mostly due to bacterial digestion of apocrine sweat.

Treatments: To combat unpleasant-smelling sweat, maintain good hygiene with daily baths or showers. Wear loose cotton clothing and regularly change your underwear. A healthy balanced diet, avoiding heavy fatty food will also help. If, after these measures, you still experience an ammonia smell in nose, see a doctor to assess whether you have kidney or liver disease.

2. Phantosmia

When someone smells imaginary odors (phantom smells), this is termed phantosmia or olfactory hallucination. Phantosmia patients perceive smells in a unique, usually unpleasant way, which can ruin the taste of food and drink. Phantosmia can occur in one or both nostrils, and usually disappears over time, so it's nothing to worry about. However, if you’re concerned, and the phantosmia has gone on for a while, see a medical professional.

Treatments: Most patients’ phantosmia gets better on its own, so no treatment is needed. This is also the case with phantosmia caused by sinusitis.

However, persistent phantosmia may need treatment with the following:

• Short-term relief can be achieved by washing the nasal passages with a saline solution. This temporarily prevents smell signals traveling to the brain, although it needs to be frequently repeated.
• There are many types of nasal spray and drops to ease your symptoms. Anesthetics can numb the nerve cells in the nose. Nasal congestion may be relieved with sprays containing oxymetazoline, which constricts nasal blood vessels. Steroid sprays can also help.
• Some patients may be prescribed anti-convulsants, sedatives, or anti-depressants.

All these treatments can bring about side effects, so speak to your doctor about balancing the risks and benefits.

3. Parosmia

Parosmia, also known as troposmia, is the dysregulation of the sense of smell, so the brain cannot determine natural odors. Many substances will seem as though they have a burning, fecal, rotten, chemical or ammonia smell in nose. Some patients will instead perceive normal smells to have a particularly pleasant odor; this is termed euosmia. Parosmia can be a result of temporal lobe epilepsy, Parkinson’s disease, head trauma, and infections of the upper respiratory tract.

Treatment: There is not yet a cure for parosmia, although it does tend to improve with time in most people. Chronic sufferers may be offered levo-dopamine, but there is no evidence that this is an effective cure. In extreme cases, where patients would rather lose all sense of smell rather than constantly experience foul odors, the olfactory bulb in the brain can be surgically destroyed.

4. Sinusitis

When the tissue lining the sinuses becomes swollen and inflamed, this is called sinusitis. The sinuses cavities behind your nose and mouth, usually filled with air, become infected with bacteria, fungi, or viruses, and blocked with fluid.

Sinusitis can occur due to a common cold, nasal polyps (small protrusions in the nasal lining), allergic rhinitis (a swollen nasal lining), or a deviated septum (where the nasal cavity has become shifted).

Sinusitis can be categorized into:

• Acute sinusitis, where the patient experiences sudden cold-like symptoms, including a runny or stuffed nose, and pain in the face. The symptoms persist for at least two weeks, but disappear before four weeks have passed.
• If the inflammation continues for 4-8 weeks, this is known as subacute sinusitis.
• Sinusitis lasting more than 8 weeks is termed chronic sinusitis.
• If the patient has several sinusitis episodes a year, this is recurrent sinusitis.

Treatments: How sinusitis is treated depends on how bad it is. The symptoms of acute sinusitis can usually be relieved with steam inhalations and over-the-counter decongestants, such as Sudafed. You can also buy nasal drops and sprays from your local drugstore. However, you should only use these treatments for a maximum of 14 days, or they can be counterproductive, actually increasing congestion. Antibiotics may also be prescribed.

For chronic sinusitis, steam treatment with warm moist air may be effective. You can either inhale steam from a pan of boiling water taken off the heat, or use a vaporizer. Pain around the nose and sinus area can be relieved using warm compresses. Nasal sprays and drops containing decongestant or saline are further useful home remedies. Finally, chronic sinusitis may need antibiotics or oral steroids for symptoms to improve.

5. Liver Diseases

Your liver is located just below your rib cage on the right-hand side, and is roughly the size of an American football. It is vital for clearing the body of harmful toxins and producing the enzymes required for digestion. And if there's something wrong with the liver, it could lead to ammonia smell in nose.

Patients with liver disease often experience the following symptoms:

• Dark-colored urine
• Itchiness
• Nausea
• Vomiting
• Long-term tiredness
• Pain and swelling in the abdominal region
• Yellow skin and eyes (jaundice)
• Pale, tar-colored, or bloody stools
• Decreased appetite
• Swollen legs and ankles
• Skin that bruises easily

If your symptoms persist or you are worried about them, arrange to speak with a doctor. Emergency medical attention is required if the abdominal pain is so tense that you’re unable to sit still.

Treatments: The treatment you receive for liver disease will depend on the underlying cause. Sometimes, you can relieve your symptoms by making changes to your lifestyle, for example, by cutting out alcohol or losing weight. You will usually also require regular liver function monitoring. If lifestyle modifications are not enough, you may need drugs or surgery. In case of liver failure, a transplant may be required.

6. Kidney Diseases

The two kidneys are situated immediately above the waist at the rear abdominal region on either side of the spine. They eliminate surplus liquid and waste products from the blood, allowing the salt and mineral levels in the blood to remain constant, and they are involved in the regulation of blood pressure.

Damage to the kidneys can cause accumulation of fluid and waste products, which results in nausea, vomiting, swollen ankles, insomnia, and breathlessness. Untreated kidney disease can lead to kidney failure, which usually requires a transplant, as it is potentially life-threatening.