# how does LG physically happen



## LeakyGasLeaker (Jan 14, 2018)

There are two types of people that have the LG issue, one with a physical disorder such as Pelvic Floor Dysfunction, and the other with potential bacterial issues or something related to carb malabsorption. Or both I dunno.

I'm just curious about the second cause for leaky gas, or the internal issue related to digestion. How does that physically make someone emit putrid smelling gas? As in, how does that cause the anus to involuntarily open and leak gas? Is it related to incomplete evacuation?


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## CalmWaters (Mar 31, 2017)

Well, from how I see it, everyone sort of experienced a foul, unrelenting smell that filled a room within minutes, some smelling fecal, some like farts, and the other God knows what. Some people could feel the bubbles, and some people feel warm leakage.

From the looks of other people's tests including my own, there's a miscoordination of the anal sphincter muscle when not in use. Maybe there's a sort of thing such as patulous anus from constipation or nerve damage. Either way, the inner sphincter and pelvic floor muscles are the ones related to holding gas, so if there's any anatomical or nerve issue, it would be one of those two or both. The thing is that the gut is always filled with gas, but there's no way it would be leaking if it weren't for the anatomical defects or the inability to relax, and therefore have the inner sphincter contract. And if you do have pelvic floor or inner sphincter dysfunction, you will have incomplete evacuation. Moreover, I realized that holding gas makes stool harder and compact, so it could be that not being able to hold gas may also create cases of incomplete evacuation. Some of us noticed that working out the pelvic floor has helped us evacuate better.

Malabsorption, on the other hand, allows fermentation of carbs and breakdown of other nutrients that the bacteria feed off. It's also more so that your food will rot in your intestines more, allowing gases from sulfuric compounds from meat, and other gases created from bacterial decomposition in your gut to mix and create heavy volumes, which may escape involuntarily when your intestines are full. In other cases, the putrid smell can come from pathogenic bacteria such as c. Diff, which includes inflammation, ulcers, and the smell of horse dung.


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## PokerFace (Jan 13, 2017)

Very well put, Calm


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## Optimistical (Jan 7, 2018)

I found a great article on Wikipedia that summarizes the issues we are experiencing under "Obstructed Defecation"

The wikipedia article contains multiple citations to medical studies, which you find at least the abstracts for to validate the information listed on the wiki article.

Here;s a little bit of the article...I bolded the part that seems very relevant to our issue:

Signs and symptoms[edit]

incomplete or unsuccessful attempts to evacuate,
prolonged episodes on the toilet,
rectal pain,
posturing,
digitations or perineal massage to aid defecation
enema dependency

*Fecal incontinence to gas, liquid, solid stool, or mucus in the presence of obstructed defecation symptoms may indicate occult rectal prolapse (i.e. rectal intussusception), internal/external anal sphincterdysfunction, or descending perineum syndrome.[1]*

Causes[edit]

One review stated that the most common causes of disruption to the defecation cycle are associated with pregnancy and childbirth, gynaecological descent or neurogenic disturbances of the brain-bowel axis.[4]Patients with obstructed defecation appear to have impaired pelvic floor function.[5]

Specific causes include:


Anismus[4] and pelvic floor dysfunction[6]
Rectocele[6][4]
"Rectal invagination" (likely refers to rectal intussusception)[4]
Internal anal sphincter hypertonia[3]
Anal stenosis[6]
Fecal impaction[6]
Rectal or anal cancer[6]
Descending perineum syndrome[6]
 Incomplete evacuation[edit]

Obstructed defecation may be a cause of incomplete evacuation of stool.[7] Normal emptying of rectal contents is 90-100%. <90% evacuation could be defined as incomplete evacuation. Incomplete evacuation is also one of the factors implicated in the cause of fecal leakage.

Diagnosis[edit]

The two key features of obstructed defecation are:


An inability to voluntarily evacuate rectal contents[6]
Normal colonic transit time[6]

A 5 item questionnaire was validated for diagnosis and grading of obstructed defecation syndrome.[7] The parameters were:


Excessive straining
Incomplete rectal evacuation
Use of enemas and/or laxatives
Vaginal-anal-perineal digitations (needing to press in the back wall of the vagina or on the perineum to aid defecation)
Abdominal discomfort and/or pain
 Classification[edit]

Obstructed defecation is one of the causes of chronic constipation.[5] Obstructed defecation could be considered to be a type of bowel obstruction, where it may be classified under large bowel obstruction. Obstructed defecation frequently gives rise to a symptom called tenesmus. Constipation, bowel obstruction and tenesmus are therefore all closely related topics.

Outlet obstruction can be classified into 4 groups.[8]


Functional outlet obstruction
 
Inefficient inhibition of the internal anal sphincter
 
Short-segment Hirschsprung's disease
Chagas disease
Hereditary internal sphincter myopathy
 
Inefficient relaxation of the striated pelvic floor muscles
 
Anismus (pelvic floor dyssynergia)
Multiple sclerosis
Spinal cord lesions


Mechanical outlet obstruction


Internal intussusception
Enterocele


Dissipation of force vector


Rectocele
Descending perineum
Rectal prolapse


Impaired rectal sensitivity


Megarectum
Rectal hyposensitivity

Treatment[edit]

Obstructed defecation has many causes, so the management in any individual case is specific to the cause of the symptom. For rectal internal intususception treatment is surgical, either STARR or rectopexy. For rectocele STARR or mesh implantation. For anismus/ pelvic floor dessynergia: biofeedback exercise.

Here;s the actual link if you want to look: https://en.wikipedia.org/wiki/Obstructed_defecation#cite_note-Obstructed_Defaecation_Web-2


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## LittleSteps (Nov 23, 2017)

Here in France, we call it anisme(if you want to look for it) and it is basically the dysfunction of the muscles that control the anus. It is treated with perineal and pelvic floor rehabilitation as well as medication that empties the rectum every single day.It doesn't get rid of all the symptoms though so there is probably another issue that we don't know.


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## Optimistical (Jan 7, 2018)

Yes, I agree - it has to be more than just one of these issues since people have resolved anismus but not resolved the incontinence issue..

Here's the list the previous article included as possible causes/....I'm sure we have several of the issues listed, most likely anismis/PFD, Intussecption, and descending perineum syndrome:

Specific causes include:


Anismus[4] and pelvic floor dysfunction[6]
Rectocele[6][4]
"Rectal invagination" (likely refers to rectal intussusception)[4]
Internal anal sphincter hypertonia[3]
Anal stenosis[6]
Fecal impaction[6]
Rectal or anal cancer[6]
Descending perineum syndrome[6]


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