# Wikipedia research article discussing causes of rectal Malodor at length



## ileo

http://en.wikipedia.org/wiki/Rectal_malodorThis article has been the result of a lot of research on my part. However I am not a GI doc/colorectal surgeon, so my understanding of these topics is perhaps limited.I will continue to add to this article in the future, but it is essentially finished now.


----------



## Moises

Very nice! That is one impressive list of references.


ileococcygeus said:


> http://en.wikipedia.org/wiki/Rectal_malodorThis article has been the result of a lot of research on my part. However I am not a GI doc/colorectal surgeon, co my understanding of these topics is perhaps limited.I will continue to add to this article in the future, but it is essentially finished now.


----------



## tummyrumbles

That's a really impressive wikipedia page. If you did this, it's a top job. It must have taken a while.Thanks for all the hard work if this is the case.I particularly agreed with this:_"Stool can therefore be thought of as a mass of bacteria and waste that is highly metabolically active and which releases malodorous volatile metabolites. It is logical to theorize that if such a mass were to be retained virtually constantly in the rectum, it could lead to increased volume and/or malodor of flatus, or even a mucous discharge/fecal seepage if there is resting hypotonicity of the internal sphincter."_Maybe if you're going to expand on this, you could write a bit more on this particular topic. My questions so far:Why hasn't there ever been a proper test to determine the link between incomplete evacuation and flatus?How difficult is it to intermittently xray/scan the colon, test the sphincter, and collect flatus, say over 24 hours?Would this really be too difficult/costly to set up?For example, assuming an LG sufferer stayed in a laboratory setting over 24 hours and received regular scans of the colon, along with sphincter testing and 24 hour collection of flatus. Assuming also that over this time the patient would be taking toilet breaks. If the LG sufferer has a form of delayed peristalsis, complete evacuation for them may take 2 hours, and might involve up to 10 separate bowel movements. If flatus was collected over 24 hours, it would be expected that if there is a direct link the flatus would gradually decrease with more complete emptying. Eventually after the 2 hours say, there should be little to no gas. If gas remains, then its constituents would be examined to see if it's predominantly "stool" gas or the usual digestion gas. I'm guessing the 2 gases would have a completely different composition.None of this sounds all that high-tech. It shouldn't be that difficult to set up, assuming you find the LG sufferer desperate enough to participate and researchers with a genuine desire to find answers.


----------



## ileo

tummyrumbles said:


> That's a really impressive wikipedia page. If you did this, it's a top job. It must have taken a while.Thanks for all the hard work if this is the case.


Ty, took me 2 days.


> Why hasn't there ever been a proper test to determine the link between incomplete evacuation and flatus?


I haven't gone through the lit with a fine tooth comb yet, but not come across a paper investigating this possible link. I assume this is because it is such an unglamorous research topic. Pimmentel in his book references a study which showed increased volume of flatus produced by IBS patients over a certain time, that is closest. Another researcher (Levitt http://www.ncbi.nlm.nih.gov/pubmed?term=Levitt%20MD%5BAuthor%5D%20flatus ) has done some papers of this kind:http://www.ncbi.nlm.nih.gov/pubmed/10998670


> How difficult is it to intermittently xray/scan the colon,


The closest they do is the colonic transit time test, where the patient swallows radiopaque markers and then x rays are taken each day to see how they are moving through the colon









> test the sphincter,


abulatory anorectal manometry? Or maybe they could use electrodes to monitor muscular activity of the sphincters over a particular time.


> and collect flatus, say over 24 hours?


v difficult to collect flatus i would imagine. One paper used the "bathtub sampling method" where the subject imersed the lower half of their body in a tub of water to release flatus, and the researchers tried to catch the bubbles before they were exposed to the air. Not v scientific...


> if there is a direct link the flatus would gradually decrease with more complete emptying. Eventually after the 2 hours say, there should be little to no gas.


It makes sense. However, i recently had the solesta treatment. For about 1 week after the op the seal was v tight from swelling. It was painful to have a bowel movement, causing constipation and really bad incomplete evac in this time. Normally if I had this bad incomplete evac my odor would be horrendous. But because there was temporarily such a tight seal, people around me could not detect any odor. I therefore now suspect it takes incomplete evac + some kind of already compromised sphincter for incomplete evac to cause rectal malodor, but this is opinion only based on my own case.


> If gas remains, then its constituents would be examined to see if it's predominantly "stool" gas or the usual digestion gas. I'm guessing the 2 gases would have a completely different composition.


Thats interesting thing to say, but makes perfect sense. People generally have more volume and malodorous gas when they need a bowel movement?


----------



## tummyrumbles

I don't think the solesta treatment is a good idea for leaky gas, maybe for actual fecal incontinence. The 2 problems are quite different. Leaky gas is partly psychosomatic because of physiological feed-back issues. I'm not sure there's an actual physical weakness in the sphincter, and it could be just more "sensitive" to gas. I know this because I have heard people expel gas for what seemed to be a full minute in the loo. There's no way I could hold this amount of gas in, whether due to sphincter weakness or over-sensitivity is hard to say and really doesn't matter. The point is, as a leaky gasser ANY gas will be difficult for me to hold in. I've never found anything online that links incomplete evacuation with flatus. The problem could also be due to IBS sufferers being vague with their symptoms and so the doctors are just completely baffled as to what's causing it. There's a fair bit of resistance on the boards here about incomplete evacuation causing their LG. I think deep down people don't want to accept having to spend such a large part of their life on the toilet. Complete evacuation is the only thing that works for leaky gas. Unfortunately it takes a lot of time, for me maybe one or two hours.They can collect flatus through a rectal tube connected to a gas impermeable bag. Would an ultrasound show up stool? The point of all this was to demonstrate the link between stool in the colon, sphincter activity and flatus. It's so frustrating. If we could take this to ONE IBS researcher then maybe someone could set up a test. I wouldn't know how to contact anyone high enough who could make these types of decisions.I try not to laugh at the "studies" that claim excess gas is caused by swallowing air. How the doctors can be so clueless I don't know. But again, IBS sufferers need to be honest with themselves as well as their GI and this just isn't happening.


----------



## westr

tummyrumbles said:


> I don't think the solesta treatment is a good idea for leaky gas, maybe for actual fecal incontinence. The 2 problems are quite different. Leaky gas is partly psychosomatic because of physiological feed-back issues. I'm not sure there's an actual physical weakness in the sphincter, and it could be just more "sensitive" to gas. I know this because I have heard people expel gas for what seemed to be a full minute in the loo. There's no way I could hold this amount of gas in, whether due to sphincter weakness or over-sensitivity is hard to say and really doesn't matter. The point is, as a leaky gasser ANY gas will be difficult for me to hold in. I've never found anything online that links incomplete evacuation with flatus. The problem could also be due to IBS sufferers being vague with their symptoms and so the doctors are just completely baffled as to what's causing it. There's a fair bit of resistance on the boards here about incomplete evacuation causing their LG. I think deep down people don't want to accept having to spend such a large part of their life on the toilet. Complete evacuation is the only thing that works for leaky gas. Unfortunately it takes a lot of time, for me maybe one or two hours.They can collect flatus through a rectal tube connected to a gas impermeable bag. Would an ultrasound show up stool? The point of all this was to demonstrate the link between stool in the colon, sphincter activity and flatus. It's so frustrating. If we could take this to ONE IBS researcher then maybe someone could set up a test. I wouldn't know how to contact anyone high enough who could make these types of decisions.I try not to laugh at the "studies" that claim excess gas is caused by swallowing air. How the doctors can be so clueless I don't know. But again, IBS sufferers need to be honest with themselves as well as their GI and this just isn't happening.


 lg is not psychosomatic. complete evacuation is not the only thing that works for lg, i heard it only stops it for a few hours whereas ive almost completely eliminated it through other means. the resistance is probably down to the other symptoms that come with it. why would incomplete evacuation cause sour mouth, stools with undigested food in, hardened mucus coming out following an enema, feelings of anxiety, stomach gurgling, hard stool followed by mushy stool? if there are studies which indicate gas is caused by swallowing air it has a lot more grounding than any theory you or i come out with on an internet forum.


----------



## ileo

tummyrumbles said:


> I don't think the solesta treatment is a good idea for leaky gas, maybe for actual fecal incontinence. The 2 problems are quite different. Leaky gas is partly psychosomatic because of physiological feed-back issues. I'm not sure there's an actual physical weakness in the sphincter, and it could be just more "sensitive" to gas.


Involuntary passage of gas _*IS*_ fecal incontinence, by definition, in its mildest form. My rectal odor symptom was eliminated from swelling caused by solesta (for 1 week only). This to me suggests that my symptom could be eliminated by improving the seal alone, without addressing anismus and mucus production issues (although I am researching these and waiting for tests).


----------



## tummyrumbles

The mind works with the colon, it's like the whole system has its own brain. A solesta procedure doesn't take into account the mental side of things. It's an over-simplification just to say, OK we'll make the seal tighter so gas can't escape. What about ease of evacuation? How would the mind adapt if this was suddenly more difficult and how in turn will this affect long-term sphincter behaviour?


----------



## ileo

tummyrumbles said:


> The mind works with the colon, it's like the whole system has its own brain. A solesta procedure doesn't take into account the mental side of things. It's an over-simplification just to say, OK we'll make the seal tighter so gas can't escape. What about ease of evacuation? How would the mind adapt if this was suddenly more difficult and how in turn will this affect long-term sphincter behaviour?


Enteric nervous system, or as Pimmentel calls it, "little brain".I don't really care about ease of evacuation, it is stinking of ###### that concerns me more. I grew up with pain and bloating on a daily basis, but my quality of life was relatively much higher than it is with this odor problem. I would do anything to go back to that state.I don't forsee evac ever being a problem as long as you take bulking agents and can always use a water enema if needed.I had incomplete evacuation before the solesta procedure, it hurt a while to pass stool in the days after it, but i can say now that evacuation is no different from before in terms of effort. See also, new wiki page on "Fecal leakage", and revisions to main fecal incontinence page:http://en.wikipedia.org/wiki/Fecal_leakagehttp://en.wikipedia.org/wiki/Fecal_incontinence


----------



## tummyrumbles

Did you create that other Wiki page as well? You've done a terrific job here. You must have spent a lot more than 2 days on this. I just googled wikipedia leaky gas and there's nothing on that, so maybe you could do a page called "leaky gas"?You've got the disclipline to beat this and that's more important than anything else. Maybe you could add a paragraph on delayed peristalsis. People with IBS need to know how many "cycles" they have to wait out for complete evacuation. With me the contractions start and stop maybe every 15 to 30 minutes and there could be up to ten individual contractions before I'm finished. So if your magic number is 8 but you leave the house at 6, then you're going to have problems. So everyone needs to know what their magic number is.This seems to be the hardest thing for people here to accept. The idea that they have a total number of contraction cycles that they simply have to wait out. Some people say they can continue at work later on but who can relax totally enough to do that? The smell is mostly coming from stool, and regardless of how many methods you use to move it down faster, if your cycle of contractions hasn't finished, then they will continue when they want to, even when you're at work.


----------



## ileo

The rectal malodor, rectal discharge and fecal leakage pages I researched from scratch. The fecal incontinence page was already there, I added "classification" and "normal continence mechanism" paragraphs, plus added references and more detail to several other related topics.Like I said I'm not GI/colorectal surgeon.We need experts to go over these concepts.I have flagged both pages as requiring expert review. There is a "medicine task force" of wiki users who check medical pages on wiki. I think they are just geeky docs tbh. But hopefully some of them would be able to correct things/make suggestions.The term leaky gas I would encourage ppl not to use, since it has no fixed definition...


> Patients who have gas incontinence should be differentiated from those who are continent and have abnormal flatulence (either in terms of increased volume or increased malodor).[6] Patients will frequently not think of themselves as incontinent if they lose control over gas only. In internet communities of patients who sufferer from rectal malodor-type symptoms, the term "leaky gas" has emerged.[7] This term lacks any fixed definition, and consequently is used by different patients to mean different symptom sets. Some use the term to describe an increase in volume and/or odor of flatus with no reduction of continence, others to describe what would medically be termed gas incontinence, and others use to describe a liquid sensation perianally or rectal discharge. The abbreviation LG should not be confused with the more medically recognized concept of leaky gut, a state of increased intestinal permeability purported to be linked to various medical conditions.[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]


My problem about sitting for hours in the morning is about embarrasment more than anything (house share). Plus I usually manage to go within a few mins. The normal range of bowel movements per day is 3 per week to 3 per day (something like that). If it is normal for so many people to have more than one BM per day, why do they not smell? This gets me again thinking about sphincter problems may explain a proportion of rectal malodor cases.


----------



## tummyrumbles

Unfortunately if you have Leaky Gas you can’t house share. This is a drastic condition and so is the cure. The best thing to do is live on your own or with understanding parents. You do need to sit for quite a while in the morning and this is the only thing that works. You need to be completely relaxed as it’s a mind/gut thing and there has to be that confidence there that you will completely evacuate, given enough time. We are naturually primed to go once a day, usually in the morning after some hot drinks, and there’s only a certain amount of stool in there, it’s not like it’s never-ending.I know other people, even here on the IBS boards, can go several times or not at all for days at a time and not have flatulence problems. But we’re Leaky Gassers and we’re different. Maybe we’re more “nervous” than other IBS sufferers, I really don’t know. But our sphincter seems to operate more “sympathetically” to constipation, and Leaky Gas is really a form of constipation.You have to experience this to know what I’m talking about and you only need to do this once. Any chance of staying somewhere overnight where you can completely relax and where you have a bit of time, say over a week-end?


----------



## ileo

tummyrumbles said:


> Unfortunately if you have Leaky Gas you can't house share. This is a drastic condition and so is the cure. The best thing to do is live on your own or with understanding parents. You do need to sit for quite a while in the morning and this is the only thing that works. You need to be completely relaxed as it's a mind/gut thing and there has to be that confidence there that you will completely evacuate, given enough time. We are naturually primed to go once a day, usually in the morning after some hot drinks, and there's only a certain amount of stool in there, it's not like it's never-ending.I know other people, even here on the IBS boards, can go several times or not at all for days at a time and not have flatulence problems. But we're Leaky Gassers and we're different. Maybe we're more "nervous" than other IBS sufferers, I really don't know. But our sphincter seems to operate more "sympathetically" to constipation, and Leaky Gas is really a form of constipation.You have to experience this to know what I'm talking about and you only need to do this once. Any chance of staying somewhere overnight where you can completely relax and where you have a bit of time, say over a week-end?


thats absolute rubbish. Why would we be "naturally primed" to have a BM once per day. We don't urinate once per day, and the peristaltic movement in the colon is continuous, but more active after eating. GI docs say that 3per week to 3 per day is the normal range. I am going to have to quote from my colorectal surgery textbook. Everyone is different. I think ppl should go only when they feel the need. For me 2 times per day is normal when i behave on my diet. For me, going once a day I would consider mild constipation.Stop using word Leaky gas, or at least define what you mean by it. I take it to mean involuntary passage of gas, which is a type of fecal incontinence.I don't really have a problem with gas, for me its more of a mucous discharge issue. When there is no mucus, the odor is usually not present. When I have C there is more mucus, and odor is worse. When there is D odor is worse, but i rarely get D. Odor is gone after a bowel movement, for a variable amount of time


----------



## ileo

> HAPCs* have also been referred to in the past as large bowel peristalsis, giant migrating contractions, and migrating long spike bursts.50 HAPC is thought to be the equivalent of mass movement.42,51,52 The main function of HAPCs is to move large amounts of colonic contents toward the anus.49,53 They occur approximately five times daily. More than 95% of HAPCs propagate toward the anus (not retrograde).50 They usually occur upon awakening, during the day, and after meals.50 They are usually associated with abdominal sensation and defecatory stimulation (or defecation).50


*high-amplitude propagated contraction (HAPC)


> Using 24-hour manometry, it has been found that the colon is continually active. There is a well-established circadian 26 rhythm with marked diminution of pressure activity at night.41,61 Immediately after waking, there is a threefold increase in colonic pressure activity. This may account for bowel patterns in some individuals who move their bowels after awakening in the morning. Colonic pressure activity also increases after meals, which in one study lasted for up to 2 hours after a meal.41 Propagating pressure waves (probably HAPCs) were seen intermittently throughout the day and especially after meals or after waking.





> Even though several studies have shown that caudally propagating HAPCs occur in close temporal association with defecation,72,73 not all HAPCs end in defecation and defecation is not always preceded by HAPCs.49 However, it does appear that usually at least one very high amplitude HAPC occurs with the sensation of the urge to defecate.68





> 1. Abnormal stool frequency (>3 stools per day or <3 stools per week)


----------



## tummyrumbles

I define Leaky Gas as involuntary release of gas. This is what most people who post in this section have. A bowel movement a day is the standard but this is beside the point. Maybe some people have no problems with going at different times during the day but what normal people get away with doesn’t necessarily translate to us. It could be that for most people it’s just a no-fuss straight in and out and they’re done, even if they’re at work. There’s a lot of confidence in being able to do that that leaky gassers probably wouldn’t have. It just never worked for me.We have the ability to change our bowel habits. There’s nothing written in stone that says 3 times a day is right for you. I decided that once a day was best for me because I have an irritable colon. Even just a small amount of stool seemed to set off a sympathetic chain of events from colon to sphincter. I can’t describe the science of what happened to me. I just know that changing to once a day, before I went to work, made all the difference.


----------



## ileo

tummyrumbles said:


> A bowel movement a day is the standard but this is beside the point.


Please read the above quotes? 1 bowel movement per day is not standard.I feel that having to sit for a few hours is a symptom of the condition rather than the cure. Normal people can go perhaps a few times per day and not stink. Normal people can even hold things in for a while without stinking. This makes me think that something else is going on besides incomplete evacuation. Probably gut dysbiosis that increases the VSC content of flatus and feces, or simply increased volume of physiologically malodorous flatus, or sphincter weakness leading to incontinence of gas/fecal leakage etc


> We have the ability to change our bowel habits. There's nothing written in stone that says 3 times a day is right for you.


Not quite true. The colon has its own "pacemaker" just like the heart, But this pace can be altered by hormones, drugs, inflammation, exercise, etc etc just like the heart rate. But I think it does have a "baseline" rate at which it operates naturally (without any other factors), and there will be a spectrum of variation of this rate between individuals.


> ICC* are the pacemaker cells of the gut that have a central role in regulation of intestinal motility.56


*interstitial cells of CajalAnd, from Pimmentel's book:


> ...by comparison, the gastrointestinal tract is the oldest and most evolved, as well as possibly the most complex, organ system; it has its own extensive nerve network, which can function independently. In fact, if all nerve connections to the brain were removed, the gastrointestinal tract would continue to function on its own.


I agree this "baseline" rate can be upregulated or downregulated fairly easily, through lifestyle changes like exercise (look at constipation syndrome in long distance runners, or constipation that comes with sedentary lifestyle), drugs (caffeine, serotonin, stress hormones), and the nature of the gut microbiota (how much methane/hydrogen is produced by fermentation), linked to this will be the diet, what the bacteria are being fed, and the amount of dietary fiber that determines the ease at which the stool can be propelled.What you are saying is that if you sit for long enough, the next HAPC will be more likely to result in another bowel movement. I do get this, but for me I would have to sit for about 5-10 mins longer (first BM happens pretty much straight away), usually have to read and completely forget I am on the toilet or text, and then suddenly I can get more out. This will not really affect the timing of the next BM for me though. However, I do not believe you empty the entire colon like this. I think you empty out enough to be socially acceptable for the day, whether this is eliminating stool which has increased malodor, or eliminating normal stool (and therefore flatus) from threatening mildly compromised sphincters.I think incomplete evacuation needs to be in conjunction with some other factor to cause rectal malodor. when I was growing up, I had incomplete evac all the time. I can remembering needing to go in school, and if it wasn't "convenient" to go, holding it in for a short time, then the urge would disappear and I would not feel the urge to go again until after school and I was at home. Despite this incomplete evac, where I must have had a fecal mass in the rectum, there was no odor. Something changed. Maybe I had anismus all my life? It has been shown to present in healthy subjects with no symptomsAlso, encopresis was shown to persist despite resolution of anismus (i.e. a cause of incomplete evac) with biofeedback (although study is in children) http://www.ncbi.nlm.nih.gov/pubmed/8813983And, I am realizing that there are many, many causes of malodorous rectal discharge that are not related to incomplete evacuation. It is oversimplification to say that complete evacuation will work for all. If you have a internal hemorrhoid, or rectal ulcer, or whatever producing mucus, or a lesion mechanically preventing the normal closure of the anal canal, this mucus (whether pathologically produced or normal physiological mucus) can leak out, independent of whether there is incomplete evacuation of stool or not. I get pain on the left wall of the rectum, above the level of puborectalis, and I get pain on the posterior aspect of the anorectal ring (i.e. level of puborectalis). I also remember recurrent bleeding from the posterior midline, and large stool would feel like it was splitting something open with pain. Now, I can guess this was a anal fissure that perhaps has healed with scarring or a defect in the internal anal sphincter, causing mucus to leak out. Or, this pain in the rectal walls could be ulceration (solitary rectal ulcer syndrome?) or internal hemorrhoids... both of which might be causes of this clear mucus


----------



## tummyrumbles

I’ve been on this board for 7 years and everyone here refers to the involuntary passing of gas as “Leaky Gas”. I think it’s a good term. Some people are aware of the gas, others aren’t - but most of us agree that the odour is caused by gas. No-one seems to agree on what exactly is causing the gas but we mostly agree it leaks out. If you are only going to discuss recognised symptoms that have papers written about them you’ll in be strife. I can’t find my condition anywhere. Anismus doesn’t accurately describe my symptoms as I don’t experience a feeling of blockage or resistance. It’s simply that the contraction dies off.I’m not bothered by soiling/seepage. IBS problems are not all centred around the sphincter. The sphincter is simply part of the problem. My IBS problem concerns the mind, colon & sphincter and it’s impossible to isolate any of those things from each other. They all work in concert and there seems to be a feedback system between all 3.Involuntary gas may not necessarily be caused by sphincter “problems”. As I have said before there is a mental element to all this as well. There is a huge difference between a clinically diagnosed problem and a “sensitivity”. I have a sensitive, irritable bowel which is probably why I post to the Irritable Bowel Syndrome boards. If I solely had problems with my sphincter, and nothing else, chances are the problem wouldn’t be IBS related. IBS is a blanket term that covers a wide range of people, and the only thing we have in common is that we have un unspecified irritability of the colon.I do believe I evacuate totally doing this as stool gas is completely eliminated. When I had leaky gas the pressure felt different to digestion gas. Stool gas feels like a lower weight or pressure in the lower colon. It’s an unmistakable feeling when you no longer have it. Digestion gas feels higher up and “bubbly”. The 2 gasses are quite different and I have become very attuned to their differences. After complete evacuation in the morning I feel light and empty. But you can still get digestion gas later on in the day and this in turn will put pressure on the sphincter. Not necessarily because there is any inherent weakness in the sphincter, but because the sphincter may have developed a “sensitivity” to gas because of how my mind processes this information.I am saying that I believe complete evacuation will work for most people with leaky gas. People with internal hemorroids or rectal ulcers or other clinical conditions will not necessarily have IBS.


----------



## ileo

tummyrumbles said:


> I've been on this board for 7 years and everyone here refers to the involuntary passing of gas as "Leaky Gas". I think it's a good term. Some people are aware of the gas, others aren't - but most of us agree that the odour is caused by gas. No-one seems to agree on what exactly is causing the gas but we mostly agree it leaks out. If you are only going to discuss recognised symptoms that have papers written about them you'll in be strife. I can't find my condition anywhere.


the condition would be called gas incontinence/incontinence of gas, the only place you will find mention of it is in the fecal incontinence literature.


> Anismus doesn't accurately describe my symptoms as I don't experience a feeling of blockage or resistance. It's simply that the contraction dies off.


yes agreed doesn't sound like it is present for you, however this would require anorectal manometry to be sure (or defacography)


> IBS problems are not all centred around the sphincter. The sphincter is simply part of the problem. My IBS problem concerns the mind, colon & sphincter and it's impossible to isolate any of those things from each other. They all work in concert and there seems to be a feedback system between all 3.


I'm not talking about IBS, I'm talking about causes of the rectal malodor. I am sorry if i am sounding rude, but I am not really focussed on "airy fairy" discussions. I still don't understand the wide range of physical causes of rectal malodor. I will try to research these before moving on to more esoteric & complicated subjects.


> Involuntary gas may not necessarily be caused by sphincter "problems". As I have said before there is a mental element to all this as well. There is a huge difference between a clinically diagnosed problem and a "sensitivity". I have a sensitive, irritable bowel which is probably why I post to the Irritable Bowel Syndrome boards.


if you have involuntary passage of gas, this certainly represents a diagnosis, (or rather a symptom). i.e. I would not call this a sesitivity, this is a problem and would need investigation, anorectal manometry and endoanal ultrasound to assess the structure and functioning of the sphincter.


> I am saying that I believe complete evacuation will work for most people with leaky gas.


yeah i would tend to think that incomplete evacuation is a significant contributor to rectal malodor in a proportion of cases, but it is not based on any evidence, it is opinion. I have no idea of the proportions of different causes of this symptom.


> People with internal hemorroids or rectal ulcers or other clinical conditions will not necessarily have IBS.


agreed, but see point above about IBS not being the only cause of rectal malodor (not by a long way).


----------



## ileo

new wiki pages added, as well as many edits to related pages not listed:http://en.wikipedia.org/wiki/Rectal_dischargehttp://en.wikipedia.org/wiki/Solitary_rectal_ulcer_syndromehttp://en.wikipedia.org/wiki/Internal_intussusceptionhttp://en.wikipedia.org/wiki/Mucosal_prolapsehttp://en.wikipedia.org/wiki/Rectal_prolapse (existing article expanded and referenced)The "mucosal prolapse syndrome" conditions: Intussusception-SRUS & prolapse were really complicated to get my head around. Hope the articles are clear.It's gonna take a lot of work, but basically eventually I plan for the main rectal malodor page to be the top of a branching tree of every possible known cause with its own page, all referenced on pubmed, textbooks and reliable web sources. http://en.wikipedia.org/wiki/Rectal_malodor


----------



## tummyrumbles

The whole point is to get better. You won’t find the cure you are seeking in textbooks. I believe you have IBS, not a clinical condition. The mind has such a huge part to play in IBS that for this reason IBS will never be a science. It’s helpful to have a basic understanding of how the colon works, but really that’s all the science that’s needed. The only way to minimise the symptoms of IBS is by listening to your body. I genuinely believe a lot of people here, not just on the Leaky Gas section, have a problem with delayed peristalsis. Complete evacuation won’t cure IBS, but it is crucial for the management of leaky gas.Have a read through these boards and people here have had every test imaginable. No-one has been cured of their IBS through testing. There is no cure for IBS because personal experiences, emotions and the colon are all inextricably linked. It’s because of the mind that IBS is such a difficult thing to treat and for people to understand. You will have a long and frustrating road ahead of you if you feel medical science can offer a solution.


----------



## Moises

Hey ileo,I have IBS-like symptoms but no LG.But one of your posts caught my eye. What if LG were a dysbiosis issue? If you read the accounts of people who have undergone fecal transplants (FT) they all say, "My farts now smell like my donors farts."Science's grasp of the enteric system is small, but not nonexistent.One could theorize at least two mechanisms by which FT might help LG. First, it might just be as simple as healthy microorganisms do not produce malodorous vapors. This strikes me as unlikely, since the feces of even healthy people stink. But, I hope I am wrong.Second, we know that enteric microorganisms interact with their hosts in lots of ways, many of which we do not know. It is conceivable that a healthy enteric ecosystem could supply the large intestine with the correct dosing of neurotransmitters, or who knows what, that allow your anal, rectal or whatever nerves and muscles to coordinate their activities properly.LG is not a well-recognized diseased. I admire your work to rectify this with your Wikipedia contributions. It might be that the sufferers of this disease will find their own cure before doctors find it for them.


----------



## westr

Moises said:


> Second, we know that enteric microorganisms interact with their hosts in lots of ways, many of which we do not know. It is conceivable that a healthy enteric ecosystem could supply the large intestine with the correct dosing of neurotransmitters, or who knows what, that allow your anal, rectal or whatever nerves and muscles to coordinate their activities properly.


 i like that idea. if i stop taking probiotic i get LG, i get the impression the problem is physically based but the physical factor is created by bad bacteria. when my LG is non existant i get a good sound to my wind that i can control. when I have LG although I have wind I can control, when it comes out it has virtually no sound. I used to think it was due to the quality of the wind, as though wind created by bad bacteria just isnt explosive which is why our bodies has toruble sensing it. now I htink muscles/nerves are affected by bad bacteria. I get a twitchy eyelid when I had LG too. Lots of subtle clues we just need to be aware of I suppose.


----------



## ileo

westr said:


> i like that idea. if i stop taking probiotic i get LG, i get the impression the problem is physically based but the physical factor is created by bad bacteria. when my LG is non existant i get a good sound to my wind that i can control. when I have LG although I have wind I can control, when it comes out it has virtually no sound. I used to think it was due to the quality of the wind, as though wind created by bad bacteria just isnt explosive which is why our bodies has toruble sensing it. now I htink muscles/nerves are affected by bad bacteria. I get a twitchy eyelid when I had LG too. Lots of subtle clues we just need to be aware of I suppose.


I'm not happy about your coexistant symptom,the sound flatus makes is more related to the tonicity of the sphincter muscles. A lose sphincter will not create noise, and vice versa. It is entirely possible that fluctuations in a dysbiosis could lead to fluctuations in other symptoms. We can look at all the conditions that are linked SIBO, like fibromyalgia, rosacea. These are created by bacterial toxins flooding the body and causing havock.However, another thing that links your eye twitch and a reduction of sphincter tone at the same time is the central nervous system.Part of the neuro assessment is bowel function, since problems in the brain or the spinal cord can lead to the nerves that supply the sphincter (pudendal nerve) not sending the normal signal, and consequently there is degrees of incontinence. I am thinking about something wrong in the brain or nerves that is intermittently creating these 2 distant symptoms.


----------



## Alexl7

Hi, the leaky gas happens because the sphincter get too relaxed when it's in "relax mode"most of people here complaint from have mild sphincter weakness and leaky gas plus either clear or yellowish discharge.I believe that the valance of the intestinal flora plays an important roll on thisand as someone state before in this blog that the mind and the colon are somehow working togetheris completely true, so i strongly believe that the digestive tract while is unbalanced can cause any kind ofwrong message that relaxes the sphincter.In my personal case my stomach became a real mess after take antibiotics for long periods of timewith no probiotics while on them, so it killed all my intestinal flora and guess what?? All kind offweird symptoms start to happen, most of what people here complaint about... LG,discharge,yellow/green stools,noisy stomach,weak sphincter etc... Well as you can see just about everything.So does it happen why? it definitely happens cos the anal sphincter gets weak for the colon or whole system messor people here dont remember how it use to be when they were healthy? They could hold as much gas as they had and no matter how long you kept it inside no leakage, the healthy relief you got after yousit in the toilet after a bowel movement.For me if nothing is working as it use to work before there is something that gotta be fixed, the onlyway i can and people could take any kind of special trial cos of the thing going on it is while looking for the wayto fix it, i dont see for example why do people have to take 3 hours for emptying their bowels when they were healthy ittook them about 15 min maximum...? I dont take that as a solution, that just means that something is wrong and it's gotta be fixed.


----------



## drink32

westr said:


> i like that idea. if i stop taking probiotic i get LG, i get the impression the problem is physically based but the physical factor is created by bad bacteria. when my LG is non existant i get a good sound to my wind that i can control. when I have LG although I have wind I can control, when it comes out it has virtually no sound. I used to think it was due to the quality of the wind, as though wind created by bad bacteria just isnt explosive which is why our bodies has toruble sensing it. now I htink muscles/nerves are affected by bad bacteria. I get a twitchy eyelid when I had LG too. Lots of subtle clues we just need to be aware of I suppose.


Can you list what you do to help with the LG? I read your earlier post: "complete evacuation is not the only thing that works for lg, i heard it only stops it for a few hours whereas ive almost completely eliminated it through other mean." Are you only taking probiotic or are you doing more? Is this something you buy at the local safeway or a bit harder to find? And are your LG symptoms triggered by consumption of Alcohol? Alex17 talked about the "relax mode" of the sphincter and I think alcohol definitively triggers that for me. I was just wondering if it is the same for you. I've been going through this for 2 years and every once and a while trying to google anything that helps without much luck. I found the solesta surgery and searched that to see if it actually works and that's how I stumbled across this thread. I've found more here in this one thread than I have in those random google searches. Its hard when I hang around my friends when they all want to spend the night drinking either at the bars or at our fraternity, and I know alcohol worsens my LG. I fake taking shots and pretend to have mixed drinks to try and hide my LG symptoms. So if you could share how you help with your LG that would be greatly appreciated. Thank you for your earlier posts. Sincerly,1732


----------



## westr

drink32 said:


> Can you list what you do to help with the LG? I read your earlier post: "complete evacuation is not the only thing that works for lg, i heard it only stops it for a few hours whereas ive almost completely eliminated it through other mean." Are you only taking probiotic or are you doing more? Is this something you buy at the local safeway or a bit harder to find? And are your LG symptoms triggered by consumption of Alcohol? Alex17 talked about the "relax mode" of the sphincter and I think alcohol definitively triggers that for me. I was just wondering if it is the same for you. I've been going through this for 2 years and every once and a while trying to google anything that helps without much luck. I found the solesta surgery and searched that to see if it actually works and that's how I stumbled across this thread. I've found more here in this one thread than I have in those random google searches. Its hard when I hang around my friends when they all want to spend the night drinking either at the bars or at our fraternity, and I know alcohol worsens my LG. I fake taking shots and pretend to have mixed drinks to try and hide my LG symptoms. So if you could share how you help with your LG that would be greatly appreciated. Thank you for your earlier posts. Sincerly,1732


welcome to the site, first 2 things to understand about LG is that it come sin different forms, some can smell it, some cant, some can feel a gas movement they cant control, some cant. I have/had the kind where only i could smell it and it didnt come with a gas movement, i have gas movements i can control (however when things were bad I could tell I could only just stop them from coming out. the 2nd thing to understand is most people on this site will swear blind they have some kind of intuition about what it is and will debunk any others theory, it soudns rough to say it but it is the truth.i once had a 100% cure, then stopped everything i did, then it came back, then i went back on what i was doing, then it went, then i ate whatever i wanted but carried on the self medication and it kind of came back. bare in mind noones ever said they can smell anything to me, and i used to live with 6 other people.there is a thread containing what i did, basically an extreme diet with some supplements. although most of what i did probably didnt help I think its telling that noone replied to my thread saying they were following what i did step by step...in a nutshell you need to get some acidophilus probiotic, get tablets containing 3 billion cultures, take 2 in the morning with a cold breakfast, then one in the evening. i think thats what sorted it for me. i got mine from a shop called holland and barret in the UK, make sure to refrigerate then after opening.re: alcohol, i get the impression when things are bad it does aggrevate it, but i have had untold pints since i told my mates i was leaving newcastle, im now in antwerp in belgium and have been abusing local belgium beer with not much issue. i can only smell anything when im in the car after ive been sitting down for a while, and yet a few minutes later i can go back to the car and theres no trace of a stink.


----------



## ileo

Update:wikipedia is full of content nazis that deleted this article. The article can temporarily be found here: http://ddxfetor.wikinet.org/wiki/Rectal_malodor(I will work on supplying the evidence that this is a real problem to the content nazis when I am less depressed by their obstinacy)


----------



## Allen.tannenbaum

I'm spreading my thread around this website for others to see because its a simple solution and it worked for me. If your symptoms do not improve in 4-5 months then I'm sorry! Either way this worked for me and i hope it does for you too.

-Take 1 MAGNESIUM CITRATE supplement (150mg or 200MG) three times a week (Monday/Wednesday/ Friday) after a full meal (after dinner).

-If you begin to experience diarrhea, then reduce the amount of Magnesium citrate to twice a week or even once a week. Make sure to take it with food! Not on an empty stomach!

It took about 4 months for things to get completely back to normal though&#8230; it did take a while&#8230;

-this is optional, instead of sitting on the toilet; you could instead place three strips of toilet paper on the group to make a tray and SQUAT, using the toilet paper as a collector. I know it sounds ridiculous, but that's how we humans defecated before the invention of what we now know as a toilet. Obviously, you will only be able to do this at home! But it should help your pelvic floor muscles to relax.

The MAGNESIUM CITRATE (150MG) mixed with the SQUATTING, should help you pelvic floor relax and your anal sphincter to heal.

-Magnesium is essential for MUSCLE RELAXATION and FUNCTION. When I was going through this, I tried everything, and I was just lucky to have tried this and it worked for me.

If this does work for anyone else, please spread this, if this simple solution helps someone else, like it has helped me, that's amazing!


----------



## Candide

Can't find the article anymore. I think it would be right to unpin this thread, unless the article is still saved somewhere.


----------

