Straight, No Chaser: "Abnormally" Foul-Smelling Stools


Obligatory disclaimer: this blog is in response to a reader request (Thank you?), not a commentary on the quality of your Thanksgiving cuisine… and we’re off…
There’s an obvious joke here about the native smell of stools, but that’s not what we’ll be discussing today. Most people are aware of how their stools normally smell. How should you react when your stools are abnormally foul-smelling?
Let’s address this conversation by understanding what normally produces the smell and consistency, what causes changes in the smell and what should prompt you to get evaluated.
Normally your stools smell the way they do because of a combination of them being waste products of certain food (which once digested and impacted by resident bacteria in your lower intestines release foul-smelling by-products) and releasing flatulence (gas).
It should stand to reason that conditions that change either the composition of your stools (e.g. a change in your diet), the presence of bacteria in your lower intestines (e.g. taking antibiotics) or conditions changing the production of gas or absorption of your food would lead to foul-smelling stools, and indeed these are common causes.
There are significant medical conditions associated with the above, including the following:

  • Celiac disease – Gluten foods damage the part of the small intestine that absorbs nutrients; this malabsorption leads to abnormal stools.
  • Cystic fibrosis
  • Food allergies/Lactose and other carbohydrate intolerance (or allergies) – These conditions also leads to malabsorption.
  • Inflammatory bowel disease (e.g. Crohn’s disease, ulcerative colitis) – Among other things, these conditions inflame the intestines, limiting absorption and leading to diarrhea and foul-smelling stools.
  • Medication/multivitamin overdose
  • Pancreatitis

Foul-smelling stools should always warrant concern and reflection on whether any dietary changes might have caused the change. Here are some signs that, if present should prompt a visit to the ER or a conversation with your expert.

  • Abdominal pain
  • Black, bloody or pale stools
  • Fever and/or chills
  • Unintended weight loss

Finally, as long as I have your attention, remember to wash your hands and fully cook your meats. These simple preventable steps can ward off many conditions that affect your digestive tract.
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