As smell disorder or olfactory disorder is any disorder associated with the sense of smell. This can relate to both hypersensitivity to certain smells and a reduced ability to smell.
What is an odor disorder?
In medicine, there are basically three types of odor disorders: on the one hand, there are patients who suffer from so-called hyperosmia – this is how hypersensitivity to certain fragrances is described.
The opposite is hyposmia – this symptom is insensitive to certain stimuli. A significant restriction of the sense of smell up to the complete loss of the olfactory ability is in turn also referred to as anosmia in the technical language. All of these three types of odor disorder are broadly summarized as quantitative odor disorders.
On the other hand, there are the qualitative disorders of the olfactory ability – this is how one describes changed perceptions of a scent. Patients who suffer from such qualitative disturbances either perceive odors although they are not present at all or perceive existing odors in a greatly changed manner.
Odor disorders are quite widespread in Germany – after all, around 80,000 people go to the doctor every year because of a changed smell.
The causes of odor disorders are basically divided into sinunasal and non-sinunasal causes. The former are mostly due to diseases of the nose or the paranasal sinuses. The non-sinunasal causes, on the other hand, are usually damage to the olfactory system.
In the case of allergies or polyps, for example, there is often a change or even failure of the olfactory system – only in rare cases is a serious illness such as a brain tumor behind the disorders. Even anatomical irregularities such as a crooked nasal septum or other misalignments can lead to the olfactory ability being restricted or changed.
Possible non-sinonasal causes for this symptom are, for example, side effects of medication, head injuries or contact with a wide variety of irritants.
Pregnant women also often complain of a reduced or changed olfactory ability – but after the child is born, these symptoms usually go away on their own. In Alzheimer’s disease, an olfactory disorder is also very common – after all, around 80 to 90 percent of Alzheimer’s patients are from Smell disorders affected.
Symptoms, ailments & signs
An odor disorder can cause various symptoms depending on its type and severity. Typically, there is a noticeable decrease in the sense of smell in dysosmia. The person concerned can no longer perceive certain smells or can only perceive them weakly, and certain smells are often perceived as unpleasant.
The phantosmia manifests itself in the fact that smells are perceived that are not there. In parosmia, familiar smells are perceived differently and perceived as unpleasant or irritating. Pseudoosmia is associated with a reinterpretation of smells. This unconscious “false smell” is usually associated with further emotional complaints.
In the case of olfactory intolerance, those affected react very sensitively to smells, usually also having psychological causes. In the case of a quantitative olfactory disorder, fragrances have a stronger or less strong effect than usual. Depending on its form, the quantitative olfactory disorder can be associated with a complete loss of olfactory ability or a tolerance to certain fragrances.
Most of the time, the sense of smell is greatly reduced and the affected person can perceive smells much more poorly. What the various odor disorders have in common is that they are no longer perceived as such after a while. You get used to it quickly and the lack of smells is masked by, for example, over-seasoning food or using an excessive amount of deodorant.
In many of the patients, the odor disorder disappears on its own within a few days. For other people, however, extensive examinations are necessary in order to first clarify the exact causes.
The treatment of these patients is correspondingly difficult and the odor disorder can drag on for weeks or even months or even become chronic.
The odor disorder itself is not a complication and does not have a negative impact on the patient’s health. Therefore, life expectancy is not reduced with an odor disorder and there are no further complaints and complications with this disease. However, the disorder reduces the quality of life and makes everyday life difficult for the patient.
It is also no longer possible to enjoy food and liquids in the usual way. In dangerous situations, the odor disturbance can, in the worst case, lead to death if certain dangers cannot be recognized due to the lack of a sense of smell. Furthermore, the odor disorder can also lead to psychological complaints and depression.
The person affected is socially excluded or ashamed of their illness. Treatment of the odor disorder is only possible to a limited extent. In many cases, the person affected will have to live with the disorder their entire life. Treatment with antibiotics or zinc can, however, be carried out. However, it cannot be predicted whether this will be successful. The life expectancy is not influenced by the odor disturbance and is not reduced.
When should you go to the doctor?
In many cases, there are no major problems with an odor disorder in everyday life. People who suffer from impaired smell should still consult a doctor as a matter of principle. If the changes are only minimal in direct comparison to other people, a visit to the doctor is recommended in order to determine the cause and to be able to assess the course of the disease.
A detailed explanation of the disease and the discussion of warning signals are essential in order to avoid a life-threatening condition in everyday life. If the impairments increase, the consultation of a doctor is necessary. If you experience breathlessness, interruptions in breathing or fears arise, a doctor should be consulted. If the fears trigger changes in behavior, if there is social withdrawal or a social phobia, a doctor’s visit is necessary.
If you have head pain, a feeling of pressure in the head, a runny nose or nosebleed, it is advisable to consult a doctor. If you have a blocked nose, nasal speech, or swelling in your nose, you should see a doctor. If the person concerned suffers from dizziness, nausea, or vomiting, a doctor is needed. In individual cases, a suddenly acute, health-threatening condition occurs. In these cases, an ambulance service must be called so that there is no threat to life.
Treatment & Therapy
In order to guarantee efficient treatment, the doctor will first ask the patient exactly about the extent of the disease. Above all, it is important to know how exactly the type of olfactory disorder expresses itself or whether there are other complaints such as a disorder of the sense of taste.
The doctor will then carefully examine the nose, including the olfactory fissure and throat. With the help of smell tests, one can usually give more precise information about the type of odor disorder – some patients, however, also require comprehensive neurological examinations. Therapy usually depends on the underlying cause. In the event of an anatomical change, such as a crooked nasal septum as the cause of the odor disorder, this can easily be corrected surgically.
For other causes, on the other hand, treatment can be quite difficult. If there are hormonal causes of the disease, hormone substitution may help. Steroids, zinc and antibiotics are also popular – the extent to which these can really help against odor disorders is still largely unexplored and controversial.
Patients can consider themselves lucky if the odor disorder disappears on its own within a few days.
Outlook & forecast
The prognosis for an olfactory or olfactory disorder depends on whether it is a temporary disorder of the olfactory sense or a permanent olfactory disorder or a complete failure of the olfactory sense.
The olfactory disorder is a complex problem. This has a better prognosis, especially in younger people. The previous therapeutic approaches are unfortunately not always successful. In addition, age-related olfactory disorders are just as untreatable as a congenital olfactory disorder. It is known that around two thirds of all those affected who experience olfactory disorders after a virus infection experience spontaneous improvements. The odor disturbance persists in a third of the patients.
The prognoses are quite good when drugs or pollutants have triggered the disturbance of the sense of smell. Most of the time, the disorders regress when the drug is stopped. In the event of exposure to pollutants, avoidance of the triggering substance must be achieved in order to improve the prognosis. Odor disorders often occur after severe sinus-nasal infections and diseases of the respiratory system. As soon as the treatment takes effect, the symptoms will in many cases go away.
It is different when the olfactory ability arose as a result of a head injury or an operation. In these cases, the prognosis can only be positive for a small proportion of those affected. The conditions for complete recovery vary from person to person and depend on the causes.
There is hardly any direct prevention against the odor disorder. However, if you already suffer from this and know the exact cause, you can at least try to contain it. If, for example, medication is the trigger for the olfactory disorder, it is advisable to switch to another medication.
Direct follow-up options are usually not possible in the event of an odor disorder. It cannot be universally predicted whether the odor disorder can be completely cured. First and foremost, those affected depend on medical treatment from a doctor so that further complications can be prevented. How this disorder is treated depends very much on the exact cause.
In some cases, drugs or antibiotics can be used to treat the condition. The person affected must always ensure that the medication is taken regularly. Parents must also ensure that their children take the medicines regularly. Antibiotics should not be taken together with alcohol, otherwise their effect will be weakened.
In some cases, the odor disorder disappears on its own, so that no direct treatment or aftercare is necessary. However, it can also occur throughout life. If a certain substance is responsible for the odor disturbance, it must of course be avoided.
In many cases, it makes sense to get in touch with other people affected by the disease, as it can lead to an exchange of helpful information. The life expectancy of the patient is not limited by this disorder.
You can do that yourself
In everyday life, special care should be taken with an olfactory disorder. The person concerned cannot take specific measures to cure or alleviate the symptoms. For the sick person, the focus should be on preventing further complaints and avoiding health risks.
Immediately leave places where toxins can be inhaled. Food should only be consumed if it has been purchased commercially and it can therefore be ruled out that it is toxic or incompatible. Due to the lack of smell, the person concerned has lost an important warning signal in the event of danger. As a result, food abroad should only be consumed after consultation and security by local experts.
In this way it can be ensured that they are edible. The consumption of foods whose best before date has expired should be avoided. If the cold chain has been interrupted in the case of fresh dairy products, meat or sausage products, they must always be disposed of. Unusual discoloration on the food is also an indication of an inedible product.
Staying in closed rooms or garages with exhaust gases, chemicals or paints represents a danger zone. In these cases, it is helpful to have an accompanying person who can point out a possible risk of poisoning in good time. In addition, it is advisable to wear a face mask in the named rooms.