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Why do I get strange acid fumes in my upper nose ?

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ENT Specialist
Practicing since : 1991
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I have recently begun suffering strange acrid fumes in my upper nose and sinuses which when at their strongest make my eyes water and make me feel a bit light headed. The fumes seem to have the strong prickly character of ammonia gas, but the smell is also reminiscent of burnt dust. This occurs most commonly while shallow breathing at rest and can be persistent for an hour or more at a time. My best friend was kind enough to smell my exhaled breath when I had a bad bout of this and he detected what he described it as 'really acidic and gets you in the back of the throat'. I have no sinus pain or chest infection that I'm aware of. So, does anyone have any ideas before I go and see my GP about this??
Posted Tue, 8 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 2 hours later

Thank you for your query.

1. The most common cause for these symptoms will be a nasal / sinus infection. Stasis of nasal secretions causes infections. Sometimes fungal, and build up of waste products of inflammation, infection, immune system by-products and gases like nitric oxide and ammonia. This would explain the acrid, pungent, ammonia or burnt dust like smell which you experience.

2. The sinuses may harbor silent infection. Fungal infections may exist only within the sinuses (as against invasive fungal infections) and yet cause allergic reactions. This constitutes Allergic Fungal Rhino Sinusitis (AFRS). Such fungal infections may be missed out on CT Scans and requires MRI Scans to detect.

3. Due to their unique design, airflow through our sinuses and their ventilation occurs gently and passively during expiration. This may explain why you get the smell mostly with shallow breathing.

4. I view of your NSU, get a renal profile done and also remember to rule out early diabetes. These conditions can also cause similar symptoms. A high protein diet may also cause these symptoms.

5. Since the smell is apparent to others, it is unlikely to be an olfactory hallucination or damage to the (olfactory) smell area of the nose.

6. Conditions like atrophic rhinitis, post nasal drip and acid reflux may also co-exist. Get a detailed ENT evaluation done.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

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