### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
What could be the cause of a 7year old boy to have foul smelling stools? He was born fine. growth has always been below 5%. He suffers from severe constipation so takes miralx daily. aside from growth and asthma he apears normal and healthy. his apgar score was slightly low when he was born , he had rsv within the first month and followed it with pnemeonia, he also had several ear infections ending in surgery for ear tubes. Please help the doctors cant seem to figure out why?? important to note- he has had the salt/sweat test for cycstic fibrosis whicChatDoctore back neg. and growth hormone test also came back fine. with the exception of his last cbc which showed he was low in vitamen D nothing else has been found. More about the stools- they r dark brown in color w/an orange tint, they stick to bottom of stool and are difficult to get flushed also the closest related smell to his stools would be vomit. the smell is so strong it can be smelt in the rooms surrounding the restroom even and remains pressent for at least 30minutes following the stool.

### output:

The bad smell of the stool is because of the sever constipation, the stool which is stuck at the colon starts to be fermented by bacteria and cause this bad smell the regular use of laxatives and evacuation of the bowel can help with this problem a boy who has a growth below 5th gentile and has some constipation should raise the suspicion of celiac disease I recommend doing total serum IGA level, anti tissue trasglutminase IGA level to exclude celiac disease I hope this helps