# Detail about why there are 1000s of causes of fecal smell symptom



## JMH91 (Apr 16, 2014)

Fecal smell is made of sulfure, but also a few other chemical, less than sulfur, like "indole", "skatole". When people recognize fecal smell, they mainly recognize Hydrogen sulfide and some other sulfur chemical. This is why air smells fecal when you are near to a volcano (like Yellowstone). It is the sulfur in the air. Foods with many sulfur are usually high protein like egg, meats, but cannot avoid sulfur in diet since it is vital for life (some essential protein built with sulfur...to say rats in lab die when not feed any sulfur).

Here is list of some causes of fecal smell symptom, to show that one internet "cure" is very unlikely to work for more than one person I believe. Best thing, is to see best specialist doctors, like coloproctologist. As I said before, if doctors do not find any problem, then odor is probably here for as long as it wants to be, and nothing can change this. FIRST STEP, is to confirm odor is REAL and not imaginary (olfactory reference syndrome). This is by just ask many people, especially trusted people to you.

UPDATE= I added some "cures" so this posting was not so nasty to hear for people who suffer for many years, but they are realistic cure and try to show that different problem need different solution.


*Problem keeping gut contents inside.* This can be unaware leak of mucus, fecal, or gas. Such gas, mucus or even feces can be 100% normal and healthy in content, but it is 100% normal and healthy for gut contents to have fecal smell, because bacteria in everything. Impossible I believe to eliminate normal feces smell, maybe reduce slightly, but feces will always smell for all humans because it is waste... you cannot expect to smell it like flower. "Wet" sensation of anus. Maybe weak feeling, or feeling that anus has fallen down. Problems with sphincter, caused by some nerve damage (less sensation and/or less strength in sphincter muscles). Maybe burning pain, muscle twitching, or other nerve damage symptom. Other problem like hemorrhoids, fissure, etc stop sphincter closing properly. Need to think of this problems as fecal incontinence, because that is closest to what it is in science. Fecal incontinence causes- many, many, many.
Some "cures" might be like identifying problem like fissure or hemorrhoid. Easy for doctor to find, so people never have long term problem I believe. If "invisible" problem like nerve damage, much harder for doctor to see. Stopping progress of nerve damage by identifying cause (e.g. slipped disc in spine, sciatica, multiple sclerosis, etc etc). Residual nerve functioning can be stimulated with sacral nerve stimulation. Muscles can be trained to become stronger and more bulky, just like weight training in gym makes muscles bigger and stronger. Best is TENS for anus (option of vagina if preferred by women- will still contract pelvic floor and sphincter), but Kegel exercise does same job. Other surgery like PTQ implant/Solesta injection make more bulk in tissues around anus. 


*Problem not getting all feces out during bowel movement* ("incomplete evacuation"). Some people say, this is reason of fecal odor. I disagree. Why almost all people with IBS-C have no odor problem? It is not problem to incomplete evacuation ONLY if sphincter is doing job correctly and smell will not escape. BIG problem if combined with above sphincter not keeping in contents. Some contents is kept inside, and is released to outside constantly. Problem with incomplete evacuation is also called "obstructed defecation syndrome". Many, many, many causes.
Some "cures" might be to find cause of obstructed defecation. Some coloproctologist specialize in this. Other things like biofeedback, squatting on toilet, bulk forming laxative (only type of laxative that can be taken in long term without dependence), fiber. Smaller stools is harder for muscles to push out, need to make stools normal size, and stick together instead of messy. Water enema can be taken safely everyday, enema with laxative medications cannot be taken regularly because gut becomes dependent and "lazy". Some kits for home water enema, like this http://www.coloplast.co.uk/peristeen-anal-irrigation-system-en-gb.aspx (not the one i have, but it is close in appearance). This causes leaking of watery mucus for a few hours after use, but empty out colon very well. Best time to use is last thing at night, then when wake up just need to let last bit out before day is ready. Lie on back and raise pelvis so water runs inside with gravity. This prevents cramping pain from so much volume of water. This is very good for cleaning out all contents of colon for the next day (sometimes no normal bowel movement for next 2 days). Remember takes, from eating, sometimes 2-3 days for food to pass through whole gut and become feces. Some people think, that what meal is eaten night before is next morning bm. This is not true, unless severe diarrhea problem when things move much faster through. 


*Problem making gut contents smell more odor than is normal.* I don't understand well. Maybe bacteria imbalance making more odor. Maybe inflammation in gut or other diseases causing worse odor. Inflamed gut produces much more mucus, and can cause mucus leaking problem. Here i take from wikipedia (many are inflammations, but I think many others outside this list): Celiac disease, Crohn's disease, Ulcerative colitis.,Chronic pancreatitis,Cystic fibrosis,Intestinal infection, e.g. Clostridium difficile infection, Malabsorption, Short bowel syndrome
Maybe indirect benefit is to try reduce odor of gut contents, but this is not perfect or complete resolve smell, because gut contents ALWAYS SMELL to some level. Many, many diet "cures" posted on internet. I do not believe in many of them. Maybe is best to say, reduce gas (low FODMAP type diet), and make sure colon is empty of feces (see incomplete evacuation problem solution).

*Problem of fecal smell not coming from anus.* This is called "fecal body odor" sometimes. Can be "surface" problem caused by unbalance of skin bacteria living on sweat (bromhidrosis), or can be "insider" problem caused by many things. Actual chemicals secreted in sweat from body are causing odor. Liver problems, kidney problems, pancreas problems, overgrowth of gut bacteria problems, many other causes of fecal body odor coming from sweat. But very rare I think.
For surface problem, Bromhidrosis, can try specialist dermatologist, I have no experience of this, I think it is washing with special soaps, changing clothes often, special antiperspirants, some bromhidrosis even take surgery (sympathectomy). For inside odor problem, most doctor do not know of these problems. It is curse for life if it is genetic disease, most likely will never be diagnosed. For bacteria overgrowth cause of inside problem, maybe one day, doctors learn how to stop bacteria overgrowth, but not currently reliable. People like Dr Pimmentel say, they can cure overgrowth with antibiotic. Same, with probiotics. Not true that gut overgrowth can be easily altered, can just temporarily alter and then it will just go back. Gut bacteria make up is very STABLE, and RESISTS ANY CHANGE. Maybe, fecal transplant will be normal one day. Difficult and expensive to find currently. I think, long term diet to starve bacteria like low FODMAP will eventually alter overgrowth, but probably needs to be permanent diet change for rest of life.


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## tummyrumbles (Aug 14, 2005)

This is a very well thought out post. Do you have Leaky Gas yourself?

Incomplete evacuation is the main cause of Leaky Gas. The reason why some IBS-C people don't complain of gas is possibly because they don't experience malabsorption. I personally know of someone who openly admits to being chronically constipated but there's no IBS symptoms. I'm guessing they have no pain from gas either. Maybe they digest all of their food efficiently and their problem is simply that they're constipated. Not all constipated people have IBS.

Leaky Gas is from retained gassy stool and/or gas which wasn't completely evacuated. Excess gas is likely to be from malabsorption. Gas is painful to hold in and the sphincter naturally partially opens in response to this. I don't think any of us deliberately open the sphincter so it might be an involuntary reflex due to the build up of stool or gas as it gradually descends in the colon. Gas seems to be more painful for IBS sufferers but maybe also we just have more of it.

This is just my view and I can't find any information about Leaky Gas on the web. I know this is true because complete evacuation completely cures Leaky Gas, at least until more stool / gas works its way down from higher up.

Most people with Leaky Gas are well aware of the problem coming from the anus, because they're consciously trying to hold the gas in. But some Leaky Gassers don't seem to be aware of any gas pressure. The only way they know they've got LG is because of comments people make.

Re: your comment: "Gut bacteria make up is very STABLE, and RESISTS ANY CHANGE."

Not true! See this link:

http://www.sciencemag.org/content/334/6052/105.full

"Linking Long-Term Dietary Patterns with Gut Microbial Enterotypes"

A more healthy long-term diet can change bacteria type. Exclude all refined flour, sugars, alcohol and high FODMAPs. Also some low FODMAP raw salad foods can also cause gas so be wary of these. Some of us are methane producers and methane can be a direct cause of constipation (which underlies LG).

Family doctors can't help and I'm not even sure about specialists. They don't seem to understand IBS. Researchers have better knowledge about IBS but then we don't see them.

Fissures and hemorrhoids aren't the cause; they're a symptom and caused by straining.

Operations like the solesta implant don't cure IBS. The underlying cause still remains. The sphincter opens because it's painful holding gas in.

Fibre is tricky because it can be inflammatory for IBS-C people as well. About 50% of people produce methane which causes constipation. It's best to try gentle, lower-fibre veges like mashed potatoes & pumpkin, well cooked green beans or bok choi etc.

Fecal transplant can be dangerous because of foreign toxins and it's not needed anyway. The best cure for bacterial dysbiosis is long-term change in diet.

Exclude all alcohol, refined sugars (flours and sugar itself). For the first few days just eat protein (meat, fish, eggs & hard cheese) and yoghurt (lactose-free might be best) with low residue, non-gassy low FODMAP vegetables. Keep the fruit down to a banana and orange a day. This reduces a lot of the harmful bacterial gases that cause IBS symptoms.

Try to gradually introduce more fibre as this is what changes the bacterial enterotype over time. Most humans have all the basic types of bacteria, but in IBS there could be an overbalance of harmful bacteria. Gradual dietary change is probably the best way to restore the balance of good bacteria. The good populations need to be there to absorb the gasses and this can't be rushed.

Some of us have a genetic inclination to a long-drawn out bowel evacuation. I've had gas issues since I was 15 so I could have a gene that disrupts the colonic signalling in some way. I take just over an hour now, on average. A couple of days I got this down to about 15 or 20 minutes but this was after a very busy and physically active day. I'm an office worker and don't usually have days like this. I guess sitting there for a long time evacuating isn't popular with people here. I don't know why. It's not that bad and it does work after all.


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## JMH91 (Apr 16, 2014)

tummyrumbles said:


> This is a very well thought out post. Do you have Leaky Gas yourself?
> 
> Incomplete evacuation is the main cause of Leaky Gas. The reason why some IBS-C people don't complain of gas is possibly because they don't experience malabsorption. I personally know of someone who openly admits to being chronically constipated but there's no IBS symptoms. I'm guessing they have no pain from gas either. Maybe they digest all of their food efficiently and their problem is simply that they're constipated. Not all constipated people have IBS.
> 
> ...


Hi Tummyrumbles,

I would say, you miss prime message of this post, that there are 1000s of different causes of fecal smell symptom.

Reason I think that you can find no informations for "leaky gas"... if gas leaks all the time with no awareness, doctors would call this a type of fecal incontinence, maybe sometimes "minor incontinence" (i.e. no solid). No such word as leaky gas as far as doctors would say. Yes agree complete evacuation is very important for me too (i am not sure for all). BIG difference between being empty and not finishing bm in morning and having to go back to toilet in middle of morning or lunch. I also hate sitting for long time... so boring and then try to rush things by straining which is a waste of time. If I have ot wait more than about 15 mins I just leave it till after breakfast ;-) ... since no job all I do is stay in my home. But job starts again soon and I will probably get back into habit of water enema each night and just letting last residues of it out in the next morning. If water enema the night before, no natural bm for 24-48 hours. There is not really any gas if nothing in colon, no matter what diet is like (for me anyway).

The link you made, I cannot access in full, but yes I agree long term diet (probably needs to be life long diet) slowly change bacteria overgrowth. Taking antibiotics or probiotics is only small short term change with no long lasting effect. Probably, poor diet is reason for overgrowth in first place, and it took many years of poor diet to happen. Fecal transplant, sounds sometimes like doctors laughing at public and telling them to "go away and eat shit". But the stories about people who have had it for problems like severe D are very interesting. I have heard nothing of person with odor trying fecal transplant, but maybe would have impact in some cases since stories of smell of gas changing to donor's gas smell. It is just easier for people to think there is magic overnight cure than thinking they need diet for years.

Fissures and hemorrhoids, yes usually caused by straining, but can also be cause of odor by themselves since they stop sphincter closing fully. Also, surgery to hemorrhoids can be long term damage to sphincter.

Yes PTQ/SOLESTA etc do not cure IBS. They passively make sphincter's job easier by bulking out tissues around anus. They will not change anything else, but they can have good effect in some cases. I had much mucus leak a long time ago, to make stains in underwear of mucus. After PTQ "implant", cured 95% mucus leak, although sometimes wet sensation, when I go to wipe it away in toilet, nothing is on the paper (weird.. maybe is partial leak into anal canal which cannot escape last bit to outside... or maybe just more confused nerves from damage). NEVER again do I get stain in underwear. Such treatments make incomplete evacuation more likely however, so not good in that respect if person thinks this is main cause of smell. For me, PTQ made smell comments go from strangers SHOUTING in my face that I "smell of shit" ... to barely ever any definite comment. PTQ had bigger effect for me on odor than anything else, especially any of internet "cures" I tried over years. Now, PTQ has been replaced more by Solesta, but it is same operation, just different materials.


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## tummyrumbles (Aug 14, 2005)

Apparently a lady who used to post here a long time ago coined the phrase "leaky gas". What we call Leaky Gas is more properly referred to as "gas incontinence" and it's a recognised subtype of anal incontinence.

*Community-Based Prevalence of Anal Incontinence*

http://jama.jamanetwork.com/article.aspx?articleid=389439

"...Of those with anal incontinence, 36% were incontinent to solid feces, 54% to liquid feces, and 60% to gas."

But no, there's not much information about gas incontinence and I'm not aware of any studies on it but there's very few studies which seem to really understand IBS. Sue Shepherd who founded the FODMAP theory is an exception but then she has Celiac disease.

We had a few people here on the forum who had the solesta procedure but they never came back to advise how it went. I'm sure they would have let us know if it had been successful on a long-term basis. I don't think it was originally designed for gas incontinence, mainly for stool incontinence but the companies offering this will accept anyone for a price.

Staying there longer in the toilet really does make a huge difference and it doesn't have to be an hour. For me, most of is is done at least in the first half hour, it's only the last smaller bits usually towards the end. The more you evacuate the less leaky gas you get.

Do you like puzzles? Something to concentrate on makes it a lot easier. Good luck anyway.


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