I am a 20-year-old man. My problem is regarding unusually strong and foul smelling stool. I have been suffering from this problem for quite some time. It feels really awkward to state my problem. I have been worried due to complaints from every member of my family about stinking defecation. I have a normal food habit, I am not a vegetarian. I had problem of gastritis in the past. I’d really appreciate any medical solution to my problem.

— Anonymous

You have clearly stated that you are not a vegetarian. Now the question arises like in most Nepalis eating habits — how much meat products do you consume on a regular basis? Eating meat on regular basis does produce foul smelling stool. Are you taking enough water and green vegetables? Secondly, having any sort of gastritis also contributes to your problem. Acidity or peptic ulcerative disease are basically of two different types. The first is caused by our eating habits — if one keeps an empty stomach for more than six hours than the gastric juice which also constitutes an acid, namely, peptic acid gnaws at our stomach or intestinal lining in the absence of food causing gastritis or duodenitis in almost 60 per cent of the cases. Do remember, fasting so prevalent in our society, is a contributing factor.

Secondly, in the minority cases, one can harbour a bacteria namely, H. Pylori (acquired from our eating habits from catering outlets and unhygienic eateries) which causes acidity. In this latter case, as long as one is taking anti acidity medication one is relieved but the symptom resurfaces on stopping medication because the bacteria is still there. Before one had to do a endoscopy biopsy to rule out this cause, fortunately these days one can rule out this cause by a simple blood test called “H. Pylori antibody” test. If positive, one has to take a three pronged medication for two weeks to wipe out the bacteria. Of course, there might be other causes like digestive disorders when one’s body is not producing adequate digestive enzymes to break down food intake causing your symptoms.

Lastly, there is the question of some sort of pathology regarding your gastrointestinal system like ulcerative colitis or Crohn’s disease, celiac disease, pancreatitis, cystic fibrosis, malabsorption syndrome, short bowel syndrome, lactose intolerance among others where your large colon has some sort of anomaly where investigations like colonoscopy, endoscopy, abdominal CT scan maybe warranted. Thus, the bottom line would be — is it a question of your eating habits or some inherent pathology of your alimentary canal. Do have an appointment with a gastro-enterologist who would be best suited to rule out the above stated causes and accordingly solve your issue.