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Some medical conditions can cause very foul smelling gas, such as irritable bowel syndrome and inflammatory bowel disease. However, these conditions bring with them other symptoms that are difficult to ignore, such as diarrhea, change in appearance of stools, abdominal cramps and sometimes abdominal pain.
Molds and mildew cause that familiar old smell because they release a gas that gets into fabric, carpet, curtains and furniture. Once the smell has permeated the area it can be difficult (but not impossible!) to remove.