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What Causes Foul Smell Stuck In Nose?

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Posted on Fri, 20 Jun 2014
Question: Doctor: my symptoms are: when I am laying down at night mostly and on my right side, I smell a scent. It is like an onion, sour smell. It is not a taste; and when I ask someone if they smell it also, they say no, they don't. I've had this for over a year now; it comes and goes. I have asked doctors about it; I have gone for a brain scan; the doctor sees nothing; I have had my jaw and teeth checked, nothing. I did have a root canal just prior to my starting this sensation; the dentist has checked root xrays and sees nothing. Sineses checked. Just before, I also started taking Activia (yogurt) could it be a spore, or some fungus, releasing? what could this be? from my stomach, perhaps, from my lungs ? an allergy? any ideas; sometimes it is worse than other times. thank you very much. YYYY@YYYY
doctor
Answered by Dr. Sumit Bhatti (51 minutes later)
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for your query.

1. If the root canal was done on a tooth in the upper jaw, then this specific history matches a sinusitis.

2. Get a CT PNS (Para Nasal Sinuses) done and upload the images.

3. The bad smell that you get through your nose when you inhale is most likely due to a mild sinus infection or stagnant mucus draining in the dependent position.

4. Have you had a recent cold, cough or fever? The inflammation may be fungal. Foreign bodies are rare in adults but must be ruled out if it is one sided. A nasal swab sent for culture may help.

5. A sour onion smell usually means a sulphur containing compound usually produced by a bacterial infection. You may discuss the possibility of Biofilm formation in your sinuses with your physicians. Sometimes there are fungal infections and build up of waste products of inflammation, infection, immune system by-products and gases like nitric oxide and ammonia. This would explain the onion like smell which you experience. 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 occasionally.

6. Oral infections, inflammation including gum and dental (such as the recent root), acid reflux and Tonsilloliths are leading causes for a bad smell in the nose. Get a general check-up done as many diseases such as diabetes, liver diseases, nasal polyps, tumors, dehydration and so on should be ruled out.

7. 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. If there is nasal and sinus inflammation you may take a trial of treatment including antibiotics, anti-allergic decongestants, saline nasal washes, mouthwashes, tongue cleaning, anti-reflux medication and probiotics.

8. If no cause is found, it may be a an olfactory hallucination. This a commonly seen with damage to the olfactory mucosa or olfactory bulb and tract, esp. some years after a head injury. This will show up on imaging such as CT/MRI. Do you have any occupational exposure to extreme cold, constant air conditioning or chemicals? Conditions like atrophic rhinitis, post nasal drip and acid reflux may also co-exist.

9. You may follow up with the answers to the above questions, results of the above investigations and treatment for further recommendations.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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What Causes Foul Smell Stuck In Nose?

Brief Answer: As below: Detailed Answer: Hi, Thank you for your query. 1. If the root canal was done on a tooth in the upper jaw, then this specific history matches a sinusitis. 2. Get a CT PNS (Para Nasal Sinuses) done and upload the images. 3. The bad smell that you get through your nose when you inhale is most likely due to a mild sinus infection or stagnant mucus draining in the dependent position. 4. Have you had a recent cold, cough or fever? The inflammation may be fungal. Foreign bodies are rare in adults but must be ruled out if it is one sided. A nasal swab sent for culture may help. 5. A sour onion smell usually means a sulphur containing compound usually produced by a bacterial infection. You may discuss the possibility of Biofilm formation in your sinuses with your physicians. Sometimes there are fungal infections and build up of waste products of inflammation, infection, immune system by-products and gases like nitric oxide and ammonia. This would explain the onion like smell which you experience. 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 occasionally. 6. Oral infections, inflammation including gum and dental (such as the recent root), acid reflux and Tonsilloliths are leading causes for a bad smell in the nose. Get a general check-up done as many diseases such as diabetes, liver diseases, nasal polyps, tumors, dehydration and so on should be ruled out. 7. 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. If there is nasal and sinus inflammation you may take a trial of treatment including antibiotics, anti-allergic decongestants, saline nasal washes, mouthwashes, tongue cleaning, anti-reflux medication and probiotics. 8. If no cause is found, it may be a an olfactory hallucination. This a commonly seen with damage to the olfactory mucosa or olfactory bulb and tract, esp. some years after a head injury. This will show up on imaging such as CT/MRI. Do you have any occupational exposure to extreme cold, constant air conditioning or chemicals? Conditions like atrophic rhinitis, post nasal drip and acid reflux may also co-exist. 9. You may follow up with the answers to the above questions, results of the above investigations and treatment for further recommendations. I hope that I have answered your queries. If you have any further questions, I will be available to answer them. Regards. Above answer was