Tag Archives: Food

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

FoulSmellingStool

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 SterlingMedicalAdvice.com 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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Straight, No Chaser: That Doesn't Belong There, Little Johnny

jingle bell

Let’s talk about our kids and the things they put inside themselves. Pediatric foreign body ingestion/insertion is a common emergency room presentation. Maybe it’s just part of them exploring their world. In fact, I recall getting a pearl in my ear and a dime in my nostril as a child; maybe I wanted to start saving at a young age… Bottom line: kids get in trouble. And it’s not always their fault. Families sometimes leave things lying around the house. Children may be fed something they can’t handle. Then there’s always the older sibling putting stuff in them…
More than 100,000 cases of accidental pediatric foreign body ingestion occur each year. I’m going to address the three main orifices where things are placed and let you know the dangers, potential solutions and what to expect if and when you show up in the emergency room. Yep, three different holes, because different types of insertions occur, each with their own risks. I guess they figure if there’s a hole, something needs to go in it.
Ears:
What Happens: Kids will put anything that will fit in their ears, but the problems arise when something either gets stuck or breaks off in an ear. This can include such things as a cotton swab, food, a toy (a bead, something waxy, or something pointy) or whatever else they get their hands on. This poses a significant risk of infection, bleeding and possible rupture of the eardrum, which can lead to an entirely new set of complications.
What You Need to Know: Regardless as to the nature of the item, removal of the item is going to be very dramatic. At home, you should be very conservative in your efforts to get anything out of a child’s ear. Blind efforts may lead to pushing the item further back on the eardrum, possibly rupturing it, or jabbing it into the ear canal, causing damage and potentially setting up an infection. Such efforts usually make it even more difficult for health professionals to get at it once you come to the ER or your doctor’s office.
What happens in the ER: Drama. Depending on the size, shape and depth of the object, tools to flush it out, suck it out, scoop it out or pick it out may be used. There is no guarantee of success, and if the object is unable to be easily retrieved (without an unacceptable risk of further ear damage), the child may either be put to sleep to make the process easier, or you may be referred to an ears, nose and throat specialist.
Nose:
What Happens: Somehow kids think that because of the shape of the nostrils, round things just belong in there. Those smooth pearls, beads, marbles and kernels fit just right.
What You Need to Know: The particular danger with items placed in the nose is they can become dislodged into the airway and choke the child. You should be mindful of this as you try to get that object out yourself. One strategy that you might safely try (assuming no blood or significant pain or other apparent injury exists) is to ‘blow your child a kiss’. Put your mouth around the kids mouth and give a big puff. Sometimes this will pop the object out of the nostril! More easily, if the child is big enough to blow his/her nose, try that while occluding the unaffected nostril.
What Will Happen in the ER: We may try the same things described above. We may also use a piece of equipment called an Ambu-bag to deliver that same type of puff. If that doesn’t work, we have additional means to enter the nose and try to remove the object. The most important consideration is to protect the child’s airway.
Throat to the Stomach or Lower Airway:
What Happens and What You Need to Know: More foreign object ingestions and aspirations (passage down the airway) occur in children younger than 3 years than in other age groups, although they do occur in all ages. Even relatively immobile infants may get something inappropriate in their mouths despite not being able crawl or pick up objects and put them in the mouth. Their relative inability to chew, coupled with faster breathing rates increases the odds of objects entering the windpipe instead of the food pipe. We see simple things such as nuts, raisins, coins, magnets, seeds, foods (e.g. hot dogs and grapes), as well as toys, pins, batteries, balloons, bones and many other items. Your pediatrician has likely advised you to avoid giving certain foods until the child is at least 5 years old.
Objects that have entered or passed through the throat will leave a sensation that something is still in the throat, particularly if it scratched something on the way down. Objects in the airways run the risk of partial or complete obstruction of different parts of the airway. This can be immediately life-threatening if severe enough obstruction has occurred. There’s no guesswork here; the child will be having difficulty breathing, coughing, gasping and likely turning blue.
What Will Happen in the ER:
Management of swallowed or aspirated foreign body depends on the size of both the object and child and the object’s location.
1) If it’s in the stomach or beyond: unless there are multiple sharp objects that suggest something’s been perforated, little will be done, and you’ll be instructed to wait and watch for it in the stool.
2) If it’s in the airway, this is an emergency, and a lung specialist will need to get the object out with a special scope.
3) If it’s in the food pipe but not yet in the stomach or beyond, what’s done will depend on the size and location. Esophageal foreign bodies (that is, those in the food pipe) generally require early removal by a specialist because of their potential to cause respiratory problems (by manual pressure onto the windpipe) and complications to the esophagus itself (scratches, burns or even rupture). Most notably, ingestion of those annoying button batteries, and their lodging in the esophagus require urgent removal even if no symptoms are present because of an unacceptably high risk of complications. Sharp foreign bodies (except for single straight pins) are especially dangerous and prone to complications and most likely will also need to be removed.
So, after all that, is there any wonder why we ask you to child-proof your home? The dangers are real, and the drama of an ER visit for these things is avoidable and worth being diligent at home. Have a great, safe, healthy and happy weekend.

From the Health Library of SterlingMedicalAdvice.com: “Is there really a way to eat what you want and still lose weight?”

calorie table
In all honesty, if you are staying within the daily calorie intake range, then yes, it’s possible. That said, foods that are bad for weight loss cause your blood sugar levels to rise and drop quickly, making you hungry. Of course, if you are craving more food, you are going to take in excessive calories and gain weight. That’s why eating nutritious foods will help you lose the weight and keep it off.
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