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Discussion Starter · #1 ·
I posted this on another thread but I want to draw attention to this in case people haven't read the at thread.The three things which could lead to gas incontinence apart from the sphincters being weak are 1)"Laxity of the pelvic floor muscles keeps rectoanal angle open, preventing continence ", 2)"Scarring or deformity of air cushions prevents formation of an airtight and watertight seal" 3)"Internal anal sphincter inhibitory threshold may have decreased" I think the first two are especially important for leaky gas while if the last condition existed then there would be fecal incontinence too.
 

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Lack of a water-tight seal could also cause issues with fecal incontenance depending on the consistancy, so I do not know for certain if the three conditions necessarily divide out neatly into "also fecal" and not.It may also depend on severity of any of the three problems as well. I believe some of the fecally incontant people/treatments I have read about have been pelvic floor issues related rather than sphincter pressure related...but that is what I remember off the top of my head.This is still a separate issue from whether one smells or not (many of the intestinal gases are odorless), or whether one can smell oneself or not, as the smell mechanisms are independant of any leaking gas (the conditions under which one cannot smell oneself are independant of what odor you are not smelling whether it is perfume, farts, smoke, or other odors either from yourself or other sources), so care may need to be taken if the odor is only smelled by others as to tracking down the source of the odor. K.
 

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Discussion Starter · #4 ·
Well I read that there are three steps on the way to fecal incontinence, Gas, liquid, solid. And I also read that the sphicter or anus can theoretucally discriminate the difference between the three-gas, liquid, stool
 

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Discussion Starter · #6 ·
"The loss of control of stool, if gradual or incomplete, will nearly always first be noted with difficulties in controlling gas, then liquid stool, and finally solid stool. The importance of understanding this rests in the knowledge that a patient with incontinence to only gas or liquid stool may be corrected simply by effectively treating diarrhea.". Sensation is associated with the sampling reflex. This reflex results in the transient relaxation of the internal sphincter, with contraction of the distal external sphincter, theoretically allowing for discrimination of the contents of the upper anal canal and rectum as either gas or liquid or solid."vvSurgical Clinics of North AmericaVolume 82 � Number 6 � December 2002Copyright � 2002 W. B. Saunders CompanyReview articleAnorectal physiologyAlan G. Thorson, MD a,b, *
 

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Only that I have seen things that suggest that treatment for pelvic floor disfunction is one of the things used for treating fecal incontenance? I just can't seem to get the same very clear cut distinction you seem to be concluding from the information you posted. I do not know how much A is ONLY a cause for Gas incontenance and B is ONLY involved in fecal from what you posted, but I don't really want to get into an endless arguement with you over it, just was trying to figure out how you jumped from what you posted, to A is the cause of gas incontance and B and ONLY B is involved in fecal incontance, because it didn't make sense to me as you posted it.Guess all those doctors who ever even look at pelvic floor dysfunction when fecal incontanence is present are wrong and your interpretation of what you are posting is the only true and correct one. or something like that...can't really figure out how or if I should even reply. I think I may just completely and forever more leave bonnie completely alone on the board. If she posts I won't read or respond ever again because I just seem to be upsetting her way too much. Sorry about that.Shoulda stayed out of it...shoulda known better...FWIW...those who CAN smell the gas mostor at least much of the time when it happens are a separate category from those who believe they may have gas but can't smell it. And you may leak a lot of gas and not have any smell at all.The NOSE has certain ways it works and anal disfunction of any sort will not change that.If you MISSED my previous missives on this I end up in situations WHERE I KNOW I CANNOT SMELL MYSELF, BUT I KNOW EVERYONE ELSE CAN (that have nothing to do with gas, but does have to do with pig ****...so it is a close comparison).I would suspect that if you leak smelly gas and can't feel it most people most of the time unles you always walk fast and never sit a desk or in your car or in your house ever, would smell it when it happens unless there is something wrong with your nose. Some people can't smell anything at any time ever because the nose is screwed up, and they may smell to others, because they have a hard time noticing when they need to do something about odor whatever that may be. Congestion (which is a nose problem) can also reduce your ability to smell. But when my gas is smelly, trust me it cuts through even my worst congestion.I DO realize there are a couple of different GROUPS out there, heaven forbid I forget who exactly is what category or try to ever in any way at any time address things to a general audience.Sigh.I'm leaving the pain/gas part of the board...this just isn't worth it anymore.I'll be on the rest of the board, but I can't deal with the animosity I generate here...I do not know for certain why I have caused ya'll to hate me so intensely...but I'll leave just to make sure there is peace here.Bye.K.
 

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Discussion Starter · #8 ·
quote: think I may just completely and forever more leave bonnie completely alone on the board. If she posts I won't read or respond ever again because I just seem to be upsetting her way too much
How did you jump to the conclusion I ws upset- Just because I asked you to back your statements up?
I am not upset and was in fact quite happy you posted because I can always learnn a thing or teo from you and flux.
 

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Discussion Starter · #10 ·
No i am not upset. I went back to the way I asked the question and I guess this was the second time I was asking you to back your statements up of and I wanted to emphasize it. I really would like a reference for the statement you keep making that the body can't distinguish between stool and gas. I have backed my statenments up with a reference so it is only fair that you back your statements up.Looking at your analysis, I do think it is more likely that people with pelvic floor dysfunctions suffer from stool incontinence but there are so many other issues connected with the three types of incontinence as I have pointed out that I read it as more likely that people with the air cushons not making an air proof junction could lead to the leakage of gas. We may have a difference of opinion about it but that doesn't mean I am upset. Once again however, it would still be nice for you to back your statenment that the body can't discriminate betweenm stool and gas while passing them.
 

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kmottus, I hope you hang around. You have a lot to contribute. I really don't believe that bonniei was taking offence.Our previous discussion on not being aware of passing odorous gas came to a deadlock, but I wanted to bring something else up which I didn't mention then.Throughout the day I often (and especially when in the company of others) feel extreme discomfort in my lower bowel/rectal area. Involuntary rumblings and spasms are commonplace. When I am by myself I expel the gas, which is often quite odorous. However, when I'm with others I clench my buttocks, hoping to prevent the gas from escaping, and not knowing whether or not it smells.So, kmottus and flux, can you see why I (and other posters) claim to have this problem? It could be body odour...it could be other things.... but, because of the comments I hear from others and the association of the feeling that I assume to be gas building up and trying to escape, it's easy to assume that I am involuntarily farting. I would welcome comments from you both and from anyone of the others who understand where I'm coming from, having the some problem.Please respond....anybody.
 

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Discussion Starter · #12 ·
kmottus I hope you hang around too. If you left wwe would suffer from a great loss.Arnie, I would only give one bit of advice; Clenching of buttocks will not prevent gas from exscaping. As Joyce's post said that you have to feel like you are "pulling" something and my nurse says that you have to feel like you are sucking a straw in- so try to pull upwards and you might have better results.
 

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I really don't remember saying that the sphincter cannot ever tell gas from stool. I've usually been one to buy into the "sphincter is smart enough to know gas from liquid from solid" but maybe I mis-spoke something.I do wonder how much it is possible to be gas incontinant, and gas incontinant ONLY, without having enought issues with pelvic floor, sphincters, etc that could be causing additional problems.Assuming this is a "I can never ever tell when I pass gas (no noise, no sensation of it) but I never have other soiling issues even when I have diarrhea" type of scenario.Because I assume the "I leak gas but do not know it" means no noises associated with the passing rather than can't keep it in even when I want to sort of issues.From www.med.unc.edu/wrkunits/2dept/medicine/fgidc/incontinence.htm Dr. Whitehead is the author and *ASSUMING MY MEMORY IS CORRECT* he does a fair amount of work with biofeedback, etc and anal/pelvic floor disfunction sorts of thing."Accidently passing gas: Is that fecal incontinence?Most people pass rectal gas every day, up to 20 times per day. This can be very embarrassing, but it happens so frequently that most doctors would not call it fecal incontinence. However, your docotor can sometimes help you reduce the odor or the amount of gas you pass."But other articles mention loss of control of gas as one of the PARTS of fecal incontinence, so it is hard to know from what I have read if there is a "gas only" incontinence issue that has been well-documented or how they determine that vs normal person passing gas sorts of things.Most of the articles I look up on Medline about gas incontinence seemed to be fecal incontinence papers where people also pass gas.But I do not ever recall believing that the body doesn't know the difference between stool and gas, but I do wonder how likely it is that someone could have gas and only gas issues (can't feel it build up, can't feel it pass, can't hear it pass, and in some cases can't smell it pass) and be 100% totally normal when it comes to other things.Noting that even normal people with normal rectums and normal sphinceters, etc will sometimes soil themselves if the diarrhea is hitting hard enough, so there is a point where anyone can lose control.K.
 

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Arnie.I get the whole holding in gas can be problematic (I tend to rectal hypersensitivity so anything that inflates down near the sphincter can be hard to hold and gets painful).But are you saying that in situations where you are actively trying to keep from farting, clenching your butt, for some reason everyone around you starts trying to figure out where the terrible smell is coming from but when you clench your but you cannot ever smell it? BUt when you fart privately and loudly (fart proudly
) you CAN smell it???I do not see how clenching your butt vs letting it fly would change how well your nose is working ??????????That is why this is confusing to me. Some of what gets said about these things seem to be very contridictory. And I hold that some people can have several odor problems. The odor problem that you cannot smell at all, but others can, in generally HAVE to be from something that is around you and around your face area most of the time. So this scenario makes it sound like clenching your butt increases the miasma of gas smell around you so that you can't smell it, basically forcing a continual jet of smell to eminate from your butt and surround your person (like when my hair, skin, clothes, all are permeated with hog farm odor). But when you fart proudly the gas is periodic enough you can smell it??That is why I think there are such problems with this. Some of the "how a nose works" and "what people describe as symptoms" do not add up for me anyway that is logically consistant.And any attempt to try to question to find out what is really going on, or discuss the "how a nose works" and tell someone that A and B do not add up well, seems to upset everyone.And I wonder to what extent with some people they are searching for lack of smelliness in all the wrong places....It gets frustrating for me trying to understand or even come up with logical/biologically plausible reasons for what people are experiencing that the interpretation of what is going on is 100% the TRUTH LIGHT AND WAY is something that no person on earth should ever dare to do. We KNOW we are right about what is wrong with us so shut the frick up seems to be an attitude I have run into just a few too many times over this issue. K.
 

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Discussion Starter · #18 ·
quote:so it is hard to know from what I have read if there is a "gas only" incontinence issue that has been well-documented or how they determine that vs normal person passing gas sorts of things.
Yes. I have only my personal story to offer as far as that is co ncerned. My sphincters are weak based on control issues as well as resting and squeeze pressures. Most people 's resting pressure is pushing 60 according to my nurse while mine day before yesterday was 20 (I forget the units). I remember atleast flux saying that if the pressures were not normal there would be stool incontinence issues. Well I am living proof that there s not. That is because my sensation for stool is intact. I don't think my sensation for gas is that great.Besides the other reason I put up these factors is to give people some ideas of how they can proceed to find out what is wrong. I am not saying necessarily the factors I put up for gas incontinence exclude stool incontince. But gas incontinence is the first stepo for stool incontinence so these are viable options to explore edit in italics
 

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B.So let me ask a couple of questions to clarify for me what the sphincter issues and gas incontinence you experience actually mean, if you will ask some pretty detailed questions.So is it you can't hold gas in when you feel it?You fart (either detected by smell or by sound) when you don't think you have to?You don't feel the farts leave the body, but you hear or smell them, basically it happens but you didn't think you were ready to fart?I know with me and rectal hypersensitivity the ability to hold it in once there was any gas pressure was pretty minimal. Basically if the rectum said "gas is here" the mechanism to release it triggered without much concious control. Control over stool/liquid was a little better, but they may strech the rectum in different ways (how else can you tell them apart???) But holding anything in would generate a lot of pain until I let it out.I know when I had before/after anal manometery (I think that was what it was...ballon in the butt inflated different amounts, and you say how painful/urgent you feel) that when the IBS was worse (before) I couldn't complete a 10 minute constant pressure, but afterwards I could.I tend to not be that able to hold the fart in, but I do feel it is there very well (no suprises when it comes out) and when there is more hypersensitivity the ability to hold it basically disappears.K.
 

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Discussion Starter · #20 ·
quote:So is it you can't hold gas in when you feel it?
Generally I feel it too late. It is called urge incontinence.
quote:You fart (either detected by smell or by sound) when you don't think you have to?
This really depends on my meds. It variies. But yes I used to have gas which was detected only by smell and occasionally do if I don't watch my diet.
quote:You don't feel the farts leave the body, but you hear or smell them, basically it happens but you didn't think you were ready to fart?
Yes I have had that ( it really is not a fart as the buildup is not there so Iprefer to call it Leqaky gas) but not these days as I have elimminated fructose and so there is no gas to leak out. Occasionally if I am constipated this still happens so I take care of the constipation(done easily by drinking juice) and so I don't have the problem.
 
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