Steatorrhea / Fat Malabsorption

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	Steatorrhea / Fat Malabsorption

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Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Other conditions that may be present | Recommendations


	Excessive excretion of fecal fat is called steatorrhea, a condition that is suspected when the patient has large, greasy, and foul-smelling stools. Such stools often float on top of the toilet water and are difficult to flush. Also, patients may find floating oil droplets in the toilet following defecation. Both digestive and absorptive disorders can cause steatorrhea. Digestive disorders affect the production and release of the enzyme lipase from the pancreas, or bile from the liver, which are substances that aid digestion of fats; absorptive disorders disturb the absorptive and enzyme functions of the intestine. Any condition that causes malabsorption or maldigestion is also associated with increased fecal fat.

Signs, symptoms & indicators of Steatorrhea / Fat Malabsorption:

Symptoms - Bowel Movements	Undigested fat in stools Offensive stool Greasy/shiny stools Pale stools
Symptoms - Food - General	Having severe/having moderate/having mild steatorrhea

Conditions that suggest Steatorrhea / Fat Malabsorption:

Vitamin A Requirement

Vitamin D Requirement

Vitamin K Requirement

Vitamin E Requirement

Risk factors for Steatorrhea / Fat Malabsorption:

Cystic Fibrosis

Children with cystic fibrosis have mucous plugs that block the pancreatic ducts. The absence or significant decrease of the pancreatic enzymes, amylase, lipase, trypsin, and chymotrypsin limits fat protein and carbohydrate digestion, resulting in steatorrhea due to fat malabsorption.

Organ Health

Pancreatitis

In chronic pancreatitis, episodes of acute pancreatitis recur until the pain becomes persistent and severe. The pain is brought on by eating, so that sufferers often avoid food and may lose much weight. Eventually, symptoms develop that are related to the failure of normal pancreatic function. Steatorrhoea are bowel motions that are pale, loose, fatty, and offensive, caused by the lack of lipase with subsequent malabsorption of fat.

Symptoms - Food - General

Counter-indicators:

Absence of steatorrhea

Steatorrhea / Fat Malabsorption suggests the following may be present:

Digestive Enzyme Need

Cystic Fibrosis

Children with cystic fibrosis have mucous plugs that block the pancreatic ducts. The absence or significant decrease of the pancreatic enzymes, amylase, lipase, trypsin, and chymotrypsin limits fat protein and carbohydrate digestion, resulting in steatorrhea due to fat malabsorption.

Recommendations for Steatorrhea / Fat Malabsorption:

Lab Tests/Rule-Outs

Test for Fecal Fat

Digestive Enzymes / (Trial)

A digestive enzyme preparation (high in lipase) can help breakdown fats and prepare them for absorption. These can be taken while ruling out underlying causes of fat in the stool.

KEY

		Weak or unproven link
		Strong or generally accepted link
		Proven definite or direct link
		Very strongly or absolutely counter-indicative
		Highly recommended

GLOSSARY

Acute: An illness or symptom of sudden onset, which generally has a short duration.

Bile: A bitter, yellow-green secretion of the liver. Bile is stored in the gallbladder and is released when fat enters the first part of the small intestine (duodenum) in order to aid digestion.

Carbohydrates: The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.

Chronic: Usually Chronic illness: Illness extending over a long period of time.

Chymotrypsin: An enzyme secreted by the pancreas into the small intestine to assist in protein breakdown.

Cystic Fibrosis: (CF) An incurable genetic disease involving a sticky buildup of mucus in the lungs (which makes breathing difficult and leads to infections), as well as pancreatic insufficiency (which leads to digestive problems). Symptoms include chronic cough producing thick mucus, excessive appetite combined with weight loss, intestinal disorders, salty sweat/skin and pneumonia. Lung-related problems are the most frequent cause of death. CF is a recessive disease, occurring only when a person inherits two mutated copies of the CF gene - one from each parent. Individuals with CF generally have a life expectancy of about 30 years.

Enzymes: Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.

Lipase: An enzyme secreted by the pancreas to assist in fat breakdown.

Pancreatitis: Inflammation of the pancreas. Symptoms begin as those of acute pancreatitis: a gradual or sudden severe pain in the center part of the upper abdomen goes through to the back, perhaps becoming worse when eating and building to a persistent pain; nausea and vomiting; fever; jaundice (yellowing of the skin); shock; weight loss; symptoms of diabetes mellitus. Chronic pancreatitis occurs when the symptoms of acute pancreatitis continue to recur.

Protein: Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.