odor problem

[danryan]

Hello Doctor,

I am a twenty year old healthy male and have had an anal odor for as long as I can remember, regardless of what I eat, the consistency of my bowel movements, how much I cleanse, how much cologne I wear, the internal deodorant pills I take, etc. School, to help illustrate, was a nightmare when I sat in front of someone as he/she incessantly kicked my desk. Gas, diarrhea, and perspiration seem to exacerbate the problem, but as I said, my anus is redolent all the time. I have seen three doctors, including a gastroenterologist who gave me a sigmoidoscopy—all of them were bemused. For the last ten years I have ruminated on what engenders this problem, and I only surmise that my anal sphincter is loose, for as a child I was sometimes constipated. I would appreciate any information on anything I can do to deal with this problem so I can lead a normal social life.  
Regards,

Dan

[Kevin Pho, MD]

Hello - thanks for asking your question.

This is a more common problem than you imagine.

Typically the causes for fecal odor is constipation or fecal incontinence.  I would consider increasing fiber in your diet, taking fiber supplements or taking laxatives that can improve constipation.

Fecal incontinence is another possibility.  The flexible sigmoidoscopy is a good start for evaluation.  Other tests to consider would be nerve conduction studies, ultrasound or anorectal manometry can all be used to determine if there are any problems with the anal sphincter.  

Testing the stool itself for infection or malabsorption can also be considered in conjunction with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.