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It happens more often in people with darker skin

Reflux is causing documented esophagitis on endoscopy that is not improving

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Examples include: Diabetes , which can cause sugar to spill into urine Urinary tract infections , which can cause strong or foul odors Kidney issues , which affect how waste is filtered High-protein diets , which can increase ammonia-like smells If any of these conditions are present, urine odor changes may last longer than expected, even if semaglutide is not the direct cause

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