# Leaky gas-IAS



## MedStudSuf (Mar 21, 2016)

Hello everyone,

Sorry for bad language use but english is not my mother tongue.

I am a medical student and i realised that maybe something wrong with my body odors.I cannot smell by myself due to anosmia(unable to smell).I am 99% the problem exist but i think my friends hide the truth to protect my feelings.Everybody here knows the impact on our lifes,the hell we live. I cannot finish medical school(lost 5 years of my life),cannot have social life,cannot have girlfriend,cannot work.

I am sure for 3 things:

1)Not all of us has a real problem.I think a small percentage has ORS(olfactory reference syndrome-delusional disorder)

2)Not all of us has the same problem.Some people have systemic disease like TMAU,disulfidemia.Others have upper GI(GERD,esophagitis,zenker diverticulum,oral halitosis).Others have lower GI :gas incontinece ''

leaky gas''.I mention these because if you cannot smell you are not sure where the odor comes from.

3)Only people who suffer can understand you

I decided to write because i made two hypothesis for the aetiology of leaky gas and because i believe that if we collect information about symptoms and other parameters why may find a solution.For doctors is difficult to help because they examine you for 15 minutes and the odor may not appear and medical books dont mention that a problem.Only few of them(the real doctors) may think that something new is happening that is not in the book.

Whats the diference of gas(partial) incontinence and leaky gas? when you have leaky gas you dont feel the gas.you dont know when its happening unless you smell.In gas incontinence you feel the gas but cannot hold it in.

Because most of us visited GI doctor or colorectal surgeon and many people had examinations from rectal finger,manometry,colonoscopy and all came negative i strongly believe that the problem is not anatomical.the problem is pharmacological and has to do with hormones and neurotransmiters.At the end of anal canal we have two sphincters(internal and external).we can control external sphincter and we can do kegels to make it stronger but if internal is open we can do nothing.the problem is internal anal sphincter(IAS).

1st hypothesis

IAS is controlled by various neurotransmiters: NO,nicotine,epinephrine,opioids.Some of them constrict and others relax the sphincter.

A lot of people say that smoking make it worse.Of course, nicotine relax the sphincter.A lot of people say exercise helps.Of course exercise increases b-endorphins(opioids) and opioids contract the sphincter.So if someone has something like Endorphin Deficiency Syndrome plus some other factors may lead to relaxed IAS and leaky gas.

2nd hypothesis

RAIR stands for RectoAnal inhibitory Reflex and is a reflex that relaxes IAS if pressure in anus increases.This means that when gas reaches the sphincter relaxes.If this RAIR in some people is oversensitive then we have leaky gas.And if gas has low volume(small fart) and IAS is relaxed then you cannot sense anything(unfortunately people next to us will 'sense').But if the gas has high volume(big fart) then then the pressure in IAS is increased and you have the fart sensation.

I know that human body is much more complicate than this few paragraphs and everythng i wrote maybe ###### but i try to do my best because i want my life back

Some questions:

1)Is it worse when you are sitting?

2)When you have the fart sense and try to clench to hold,do you actually hold in?And how do you know that?you feel the pain in belly? personally when i clench i believe i cannot really hold in because try to hold in farts all day and never have pain...gas is going somewhere else than my intestines.

3)It happens before defecation? after meal? random?

4)what about sex? is everything normal?i ask because perineal muscles are all together.

As for hypothesis 1 i dont suggest opioid use because you will have longterm problems that need a lot of time to restore and make the problem much worse,its risky and of course it is just a hypothesis.we dont know..even if this is the problem the only safe way to increase endorphins is exercise and nutrition.

Thank you and i hope one day we help each other overcome this hell and live again


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## InvestigatorLG (Feb 23, 2016)

Hello Medstudsuf

I really like your 2 hypothesis, it can be a good guess

to answer your questions

1) Yes its little worse when I'm sitting

2) I can hold in or expel normal farts without problem. Leaky gas I can not hold in... Sometime I just don't feel a thing when it happens and sometime I feel a little hot sensation that tells me its happening

3) After meal or during and after digestion. Whatever makes thing moving in the bowels I thinks that makes it worse If I wake up in the morning and skip breakfast and have a good bowel movement. I will be smell free until lunch time.

4) All normal for sex, but smell may be worse after (but I'm really not sure), maybe because the muscle relax or something

Also 30 minutes after drinking coffee or alcohol, the smell is a lot worse.

For the opioid, there is a plant called Kratom, it's natural and legal but still addictive. It acts on the receptors the same way than opioid


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