Cirrhosis of the Liver Community
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Avatar universal

ammonia in urine, cirrhosis

my husband has cirrhosis of the liver.  He won't return to the doctor since being diagnosed over 2 years ago.  He drinks 2 ltrs of wine a day.  He has a terrible body odor of ammonia and the bathroom has a constant ammonia odor I find terribly offensive.  I feel I need to clean it all the time.  I think I started this post just to ask if he would excrete ammonia in his urine if his levels were high; it's beginning to appear to me that this is the case.  Any idea if this is an early or later sign of the progression of this disease?  Without him agreeing to see the doctor, I have to depend on the knowledge of others.
5 Responses
446474 tn?1446351282
Hello and welcome to the cirrhosis community.

I am sorry to hear of your husband's cirrhosis and continuing alcoholism.
For anyone with cirrhosis who continues to drink alcohol (which is toxic to the liver) we know that their cirrhosis is progressing and will continue to progress more quickly than it normally might without the addition of alcohol. That is a basic fact of liver disease. So you don't have to wonder if his liver disease is getting worse, unfortunately it is and will continue to get worse as long as he continues to drink.

Regarding ammonia buildup...With advanced cirrhosis increasingly metabolic and chemical disturbances can occur in the body. One aspect of this is the development of Hepatic Encephalopathy (HE). Chemicals (one being ammonia) normally detoxified by the liver accumulate in the bloodstream because the liver is too damaged to properly clean them from the blood so these toxins go to the brain and can disrupt normal brain function causing confusion, sleep disturbances, slurred speech, drowsiness, stupor and finally coma, which can be fatal without emergency care. It can also cause physical symptoms as well such as difficulty writing or doing other small hand movements, breath that smells musty or sweet, slurred speech (as if drunk), and the shaking or flapping of hands or arms.

Fetor hepaticus is "a unique musty odor of the breath and urine" that occurs in patients with advanced cirrhosis and portal hypertension.  Normally the liver would chemically modify these toxins into odorless compounds, but since it now doesn't get the chance to do this because of loss of function, the chemicals reach the lungs (and urine) largely unadulterated. And when they are breathed (or urinated) out, they give off their distinctive odor. Some people call it the "breath of the dead" and it can be quite repulsive to some people. As with the breath normally, the cirrhotic is unaware of the smell as we become adjusted to our own smell over time.

Only if a person chooses to stop drinking and receives proper medical care can cirrhosis and its complications be properly managed, hopefully before it becomes irreversible and will lead to liver failure.

I hope your husband will choose to want to live before it is too late.
I would suggest you post on MedHelp's "Alcoholic, Living with an Community" where others dealing with similar issues can be found who may be of help in dealing with his alcoholism.

My best to you.

Avatar universal
Hector, you have been wonderful.  Such a fount of information.  You even answered the question of the "breath" that I didn't ask.  For whatever reason, he is so locked into some sort of denial that he could die from what he is doing, that he has no desire to stop.  I know I can't do more than I have done and believe me we have talked about what drinking does and how I want him to stop and be with me.  It doesn't seem to phase him.  How do I now post to this other community that you mentioned?
446474 tn?1446351282
* Go to/view the top of this web page.
* Next to "MedHelp" on the far left you will see the headline "Communities".
* Put your mouse over "All Communities" and click.
* On the left side you see should see a list of "Medical Support Communities"
* Look down and you should see "Alcoholic, Living with an" community.
* Click on it and you will be in the community and you can read and post as you have done here in the cirrhosis community.

You can also try this link to get there...

Sadly we see your situation at the hospital all to often. Only the alcoholic can save themselves. Nobody else can do it for them.

317787 tn?1473362051
I realize this is old however it struck me so I have to respond.

"Sadly we see your situation at the hospital all to often. Only the alcoholic can save themselves. Nobody else can do it for them"

I have been trying so hard to convince my friend and his wife that without intervention he is going to die that I guess I forgot the above.
Only he can save himself.  I can print out information, relay everything I have learned. His wife just asked me if he will get a funny smell.
No one can fix this but him.
Bless you Hector!!
Avatar universal
My husband had cirrhosis and Hep C, along with emphysema and COPD, last night his ankles were terribly swollen.  And yes he drinks alcohol daily and still smokes!  He takes a medication for high pressure in the right side of his heart and lactalose for the ammonia levels,he is also on blood pressure medication, he takes these when he feels he needs them but not like he should.  What would you say is causing the swelling in his ankles?
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317787 tn?1473362051
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