
OP: “I work retail — Why do some people genuinely smell like feces?”
Recently someone asked why, as a retail worker, they regularly encounter people who smell like feces. This is a sensitive topic, but it shouldn’t be ignored. It’s important for there to be awareness and understanding. Here was my reply:
Well, at least Reddit gives people a place to ask awkward questions without getting side-eyed.
One thing to keep in mind is that people with health conditions still have to go grocery shopping, work, and live their lives like everyone else. Some people are very self-conscious about symptoms, some may not realize they have an issue, and some may simply have limited control over it.
A strong odor around someone does not automatically mean poor hygiene. There are a lot of possibilities.
Some causes can be practical: farm work, animal exposure, sewage work, garbage collection, industrial jobs, getting something on clothing, pet accidents, or even odors trapped in shoes or fabrics.
There are also medical possibilities. People with things like fecal incontinence, digestive disorders, ostomy bags, severe constipation, chronic diarrhea, malabsorption problems, or certain metabolic disorders can sometimes have noticeable odors despite being clean.
There are also rare medical conditions such as Trimethylaminuria (sometimes called “fish odor syndrome”), where the body has trouble breaking down certain compounds and unusual odors can come out through sweat and breath.
Certain illnesses can also affect body odor or breath, but those are usually accompanied by other symptoms and aren’t the most common explanation.
The main thing is that if someone looks clean and normal but has a noticeable smell, it’s probably safer not to jump straight to “that person doesn’t wash.” Sometimes you’re smelling a health issue, a work environment, or something going on that you can’t see.
——-Deep Dive——-
Here are some health disorders that might cause odors that aren’t anyone’s fault, despite the fact they might be very clean otherwise. Health disorders that cause someone to smell like feces primarily fall into metabolic, digestive, gastrointestinal, and bowel management and incontinence categories. The underlying issue often involves the body's inability to break down specific compounds or the presence of a severe blockage or digestive dysfunction:
- Metabolic Disorders
Trimethylaminuria (TMAU): Also known as "fish odor syndrome," this metabolic disorder occurs when the body cannot properly break down trimethylamine, a pungent chemical. As it builds up, it is released in sweat, urine, and breath, and is frequently described as smelling like rotting fish, garbage, or feces.
Fetor Hepaticus: This is a distinct, musty, and occasionally fecal-smelling breath condition caused by severe liver disease. It happens when a damaged liver can no longer filter toxins, which then circulate and escape through the lungs.
- Gastrointestinal and Digestive Disorders
Bowel Obstruction: A physical blockage in the intestines prevents the normal passage of waste. The trapped, fermented food and waste cause gases to travel upward, leading to severe fecal breath.
Gastroesophageal Reflux Disease (GERD): Chronic acid reflux allows stomach acid and undigested food particles to flow backward into the esophagus, bringing foul, potentially fecal-like odors to the breath.
- Severe Digestive Malabsorption
When the gut cannot properly digest and absorb nutrients (such as fats and proteins), the resulting bacterial fermentation produces highly volatile, foul-smelling gases.
Celiac Disease: An autoimmune reaction to gluten that damages the small intestine and leads to poorly absorbed nutrients and putrid, fatty stools.
Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis alter the gut microbiome and cause malabsorption, frequently resulting in extremely foul-smelling stool.
Small Intestinal Bacterial Overgrowth (SIBO): An excess of bacteria in the small intestine leads to intense fermentation, altering bowel habits and producing unusually strong-smelling gas and stool.
In addition to the above disorders:
- Bowel Management & Incontinence
Fecal Incontinence: The involuntary leakage of stool—often caused by nerve damage, weakened pelvic floor muscles, or chronic conditions like IBS—leads to soiling. Wearing adult diapers can trap these odors, making the smell noticeable to others if the garments are not changed frequently or if there is leakage.
Ostomies (Colostomy/Ileostomy): When a section of the intestine is diverted to an artificial opening (stoma) in the abdominal wall, a colostomy bag is worn to collect waste. While modern odor-filtering bags are generally very effective, leaks, gas venting, or changing the pouch can cause localized fecal odors. For example, if a person has colon cancer, some people might have to have the sphincter relocated to the front of the abdomen and waste comes out that exit into a sealed colostomy bag. (Other people might wear similar bags for urinary incontinence).
——-It’s usually nobody’s fault——-
People who emit a fecal odor can be meticulously clean because internal medical conditions bypass external hygiene.
- Gaseous Leaks and Air Exchange
Ostomy Venting: Colostomy bags must release built-up gas to prevent bursting. The charcoal filters designed to deodorize this gas can fail, releasing odor directly into the air.
Micro-Leakage: Microscopic amounts of gas or liquid stool can escape diaper seals. This happens despite thorough, frequent skin washing and immediate garment changes.
Lung Exhalation: Severe digestive or metabolic conditions cause volatile compounds to absorb into the bloodstream. These compounds travel to the lungs and are exhaled through the breath, making skin scrubbing useless.
- Metabolic Sweat and Sebum
Continuous Excretion: Conditions like Trimethylaminuria (TMAU) force the body to sweat out pungent compounds constantly. A person will smell again minutes after leaving a shower because the sweat production never stops.
Fabric Trapping: Pungent metabolic chemicals bond tightly to clothing fibers. Normal laundering often fails to remove these trapped compounds, causing clean clothes to smell when body heat warms them up.
- Skin Barrier Limitations
Porative Release: Odor compounds exit through every pore on the skin surface. Soap and water only remove surface bacteria, not the systemic chemicals pushing out from underneath.
Over-Washing Risks: Excessive scrubbing destroys the skin's natural moisture barrier. This causes inflammation, breaks down tissue, and can actually worsen body odor by allowing opportunistic bacteria to thrive. Sometimes people are overly conscientious about their disorder and might overdo scrubbing in an attempt to remove odors they can’t control; this can actually make the problem worse in some situations.
——-Understanding and Tolerance——-
Try to remember that these kinds of odors can come from medical conditions people didn’t choose and often can’t fully control.
Compassion matters because you’re not looking at a failure of personal responsibility — you’re looking at someone dealing with something difficult that may be completely invisible to you.
You might not be aware of the emotional pain this person lives with daily. You may never know what someone is carrying around behind the scenes. Some health conditions aren’t obvious, but they can affect nearly every part of a person’s life.
You also might not realize the emotional side of it. Living with a chronic odor issue can make you constantly worry about what other people are thinking. It can lead to embarrassment, anxiety, isolation, and avoiding social situations altogether. But those same people need things and have to go shop like anyone else.
You may also assume the person isn’t trying, when in reality they could be spending a huge amount of time, effort, and money trying to manage symptoms that are still difficult to control. Some people reach a wall and that they do their best, but can only do so much. They deserve to be kind to themselves, and are already considerate of managing symptoms and how people feel.
And when a person is dealing with things like incontinence or ostomy care, parts of daily life that most people take for granted — privacy, confidence, spontaneity, independence — can suddenly become much harder. Some people can become depressed, socially isolated, or feel trapped inside their home if they don’t get out sometimes.
If you want to practice tolerance, treat the person the same way you would anyone else. Don’t make a scene, whisper, stare, or react dramatically if you notice an odor. If it’s too much, then it’s better to maintain distance than be cruel.
If something unexpected happens, understand that what may be an uncomfortable moment for you is probably much more stressful for the person experiencing it. They’re probably already hyperaware of people’s reactions.
And if someone trusts you enough to tell you about a medical condition, listen without judgment. Sometimes people need understanding more than they need advice.
——-Let’s flip the table——-
The problem could be “you” and not “them”.
If certain smells are being perceived incorrectly, the condition is called parosmia.
With parosmia, your brain can essentially “rewire” the way a smell is interpreted, causing something normal to suddenly smell unpleasant or completely different than it should.
With parosmia, you might notice smells turning into things like:
-feces or sewage
-rotting garbage
-something burning
-chemicals
-smoke
-spoiled food
For example, with parosmia, you may notice that coffee, onions, eggs, meat, perfume, shampoo, or even freshly washed laundry suddenly smells like poop.
A related condition is phantosmia, where you smell things such as feces, smoke, or chemicals even when no actual odor source is present. Things that can contribute to parosmia include:
-viral illness, especially after COVID-19
-sinus infections or chronic nasal inflammation
-nasal polyps
-head injury or concussion
-migraine
-certain medications
-neurologic conditions
-less commonly, seizures or growths affecting smell pathways
If you’re noticing that certain smells specifically get interpreted as a poop smell, that pattern tends to fit parosmia more than phantosmia because a real smell is present, but your brain may be assigning the wrong odor quality.
One useful clue is identifying which smells are changing. Is it coffee, meat, perfume, body odor, candles, smoke, or something else? The pattern itself can sometimes help narrow down the cause.
——-Conclusion——
Whether it’s them or you, sometimes the story behind a smell is more complicated than it first appears. A noticeable fecal odor around someone does not automatically mean poor hygiene; it can sometimes come from work environments, clothing, digestive problems, metabolic disorders, incontinence, ostomy care, or other medical conditions that may be difficult or impossible for a person to fully control. People dealing with these issues are often already putting significant effort into managing symptoms and may be carrying emotional burdens such as embarrassment, anxiety, or isolation. It is also possible that odor perception itself can be altered by conditions like parosmia, meaning the issue may sometimes involve how smells are being interpreted rather than the person being smelled.