Hello Dear. Feces normally have an unpleasant smell. Foul-smelling stools have an unusually strong, putrid smell. In many cases, foul-smelling stools occur due to the foods people eat and the bacteria present in their colon. However, foul-smelling stools can also indicate a serious health problem. Diarrhea, bloating, or flatulence may occur with foul-smelling stools. These stools are often soft or runny. What causes foul-smelling stool? Changes in diet are a common cause of foul-smelling stool. Additional causes include the following: I. Malabsorption Malabsorption is also a common cause of foul-smelling stool. Malabsorption occurs when your body is unable to absorb the proper amount of nutrients from the food you eat. This generally occurs when there’s an infection or disease that prevents your intestines from absorbing nutrients from your food. Common causes of malabsorption include: 1. celiac disease, which is a reaction to gluten that damages the lining of the small intestine and prevents proper absorption of nutrients 2. inflammatory bowel disease (IBD), such as Crohn’s disease or ulcerative colitis 3. carbohydrate intolerance, which is an inability to process sugars and starches completely 4. dairy protein intolerance 5. food allergies If you have IBD, eating certain foods will cause your intestines to become inflamed. People with IBD often complain of foul-smelling diarrhea or constipation. People with IBD also have flatulence after eating certain foods. This flatulence may have a foul smell. II. Infection Infections that affect the intestines may also cause foul-smelling stools. Gastroenteritis, an inflammation of the stomach and intestines, can occur after eating food contaminated with: 1. bacteria, such as Escherichia coli or Salmonella 2. viruses 3. parasites Soon after developing the infection, you may experience abdominal cramps and then have foul-smelling, runny stools. III. Medications and supplements Certain medications may cause gastrointestinal discomfort and diarrhea. Taking some over-the-counter multivitamins may also cause foul-smelling stools if you’re allergic to the supplements’ ingredients. After a course of antibiotics, you may have foul-smelling stools until your normal bacterial flora is restored. Foul-smelling diarrhea can be a side effect of taking more than the recommended daily allowance of a multivitamin or any single vitamin or mineral. Diarrhea associated with a multivitamin or medication overdose is the sign of a medical emergency. Getting too much of any of these vitamins can have life-threatening side effects: 1. vitamin A 2. vitamin D 3. vitamin E 4. vitamin K 5. Other conditions Other conditions that can cause foul-smelling stools include chronic pancreatitis, cystic fibrosis, and short bowel syndrome. How is foul-smelling stool diagnosed? During your appointment, your doctor will ask questions about your stools, including their consistency and when you first noticed the foul odor. If the consistency of your stools has recently changed, your doctor will want to know when the change occurred. Tell your doctor about any recent changes you’ve made to your diet. Your doctor may ask for a stool sample to check for bacterial, viral, or parasitic infections. They may also ask to take a blood sample for testing. Long-term outlook Your long-term outlook depends on what caused the foul-smelling stool. Most conditions that cause this symptom are treatable. However, diseases such as Crohn’s may require lifelong changes to your diet or medications to control bowel movements and pain. Prevention I. Make dietary changes Making dietary changes may help prevent foul-smelling stools. For example, you should avoid drinking raw, or unpasteurized, milk. If you have a disease that affects the way you absorb food or the way your body reacts to eating certain foods, your doctor can devise a diet plan that’s right for you. Following this diet plan can help reduce symptoms such as abdominal pain, abdominal bloating, and foul-smelling stools. II. Handle food properly Avoid bacterial infections from food by handling your food correctly. Cook raw foods such as the following thoroughly before eating: 1. beef 2. poultry 3. pork 4. eggs Cooking thoroughly means checking your food’s internal temperature with a thermometer before eating. Consult your local health department for the minimum internal temperature each type of food must reach before you eat it. Don’t prepare meat and vegetables on the same chopping board. Preparing them on the same board can spread Salmonella or other bacteria. You should also wash your hands thoroughly after handling raw meats or using the restroom. Now coming to your nasal bleed, it is called epistaxis. It is not related to diarrhoea. Most nosebleeds do not have an easily identifiable cause. However, trauma to the nose is a very common cause of nosebleeds. Nosebleeds can be caused by trauma to the outside of the nose from a blow to the face, or trauma to the inside of the nose from nose picking. Other conditions that predispose a person to nosebleeds include: 1. exposure to warm, dry air for prolonged periods of time, 2. nasal and sinus infections, 3. allergic rhinitis, 4. nasal foreign body (object stuck in the nose), 5. vigorous nose blowing, 6. nasal surgery, 7. deviated or perforated nasal septum, and 8. cocaine use. Less commonly, an underlying disease process or taking certain medications may cause a nosebleed or make it more difficult to control. 1. Inability of the blood to clot is most often due to blood-thinning medications such as warfarin (Coumadin), clopidogrel bisulfate (Plavix), nonsteroidal anti-inflammatory drugs (NSAIDs), or aspirin. 2. Topical nasal medications, such as corticosteroids and antihistamines, may sometimes lead to nosebleeds. 3. Liver disease, chronic alcohol abuse, kidney disease, platelet disorders, and inherited blood clotting disorders can also interfere with blood clotting and predispose to nosebleeds. 4. Vascular malformations in the nose and nasal tumors are rare causes of nosebleeds. 5. High blood pressure may contribute to bleeding, but is rarely the sole reason for a nosebleed. It is often the anxiety associated with the nosebleed that leads to the elevation in blood pressure Nosebleed Self-Care at Home: A small amount of bleeding from a nosebleed requires little intervention. For example, if a person with a cold or a sinus infection blows his or her nose vigorously and notices some blood in the tissue, one should avoid forceful nose blowing, sneezing, and nose picking. This is usually enough to keep the bleeding from getting worse. How to stop a nosebleed? 1. Remain calm. 2. Sit up straight and lean slightly forward. 3. Lean your head forward. Tilting your head back will only cause you to swallow the blood. 4. Pinch the nostrils together and apply direct pressure with the thumb and index finger for approximately 10 minutes. Time it to make sure the nostrils are not released earlier. 5. Spit out any blood in the mouth. Swallowing blood may make the affected individual vomit. This technique will stop the majority of simple nosebleeds. What to do after the bleeding has stopped Once the bleeding has stopped, try to prevent any further irritation to the nose, such as sneezing, nose blowing, or straining for 24 hours. Ice packs do not help nosebleeds. Exposure to dry air, such as in a heated home in the winter, can contribute to the problem. Adding moisture to the air with a humidifier or vaporizer will help keep the nose from drying out and triggering more bleeding. Another option is to place a pan filled with water near a heat source, such as a radiator, which allows the water to evaporate and adds moisture to the air. Nasal saline sprays or other lubricating ointments or gels also may be useful to promote tissue healing and keeps the nasal passages moist. Nosebleed Medical Treatment Anterior nosebleed: A minor nosebleed that has stopped may require no treatment at all. Frequently, the body will form a clot at the site of the bleeding that stops any further bleeding. If the source of the bleeding is from a blood vessel that is easily seen, a health care practitioner may cauterize it (seal the blood vessel) with a chemical called silver nitrate after applying a local topical anesthetic inside the nose. Chemical cauterization is most effective when the visible bleeding originates from the very front part of the nose. In more complicated cases, a nasal packing may be required to stop the bleeding. Nasal packings apply direct pressure inside the nostril to promote clotting and stop the bleeding. Many different types of nasal packings are available, including petroleum (Vaseline) gauze, balloon nasal packs, and synthetic sponge packs that expand when moistened. The decision as to which one to use is made by the health care practitioner. Most people who receive an anterior nasal packing go home with it in place. Because these packings block the drainage pathways of the sinuses, antibiotics may be started to prevent a sinus infection. The packing is usually left in place for 48 to 72 hours. Posterior nosebleed: A posterior nosebleed that does not stop bleeding on its own requires admission to the hospital, as these types of nosebleeds can be very serious. In order to control the bleeding, a posterior nasal packing will be inserted by your health care practitioner. While different types of packings are available, a balloon nasal pack is most commonly used. Unlike anterior nasal packings, posterior nasal packings are much more uncomfortable and frequently require sedatives and pain medications. Furthermore, potential complications such as infection and blockage of the breathing passages may be encountered with posterior nasal packings. Consequently, admission to the hospital, close monitoring and consultation with an otolaryngologist are required. Posterior packings are usually left in place for 48 to 72 hours. If this does not control the bleeding, arterial embolization or certain surgical procedures may be required. Hope i have answered your question. Feel free to contact me if you have any more questions. I ll be glad to help you. All the best With warm regards Dr Sanjay Kini