Steatorrhea is the presence of excess fat in
fecesFeces, faeces, or fæces is a waste product from an animal's digestive tract expelled through the anus during defecation.-Etymology:...
. Stools may also float due to excess lipid, have an oily appearance and be especially foul smelling. An oily anal leakage or some level of
fecal incontinenceFecal incontinence is the loss of regular control of the bowels. Involuntary excretion and leaking are common occurrences for those affected.Subjects relating to defecation are often socially unacceptable, thus those affected may be beset by feelings of shame and humiliation. Some do not seek...
may occur. There is increased
fatFats consist of a wide group of compounds that are generally soluble in organic solvents and largely insoluble in water. Chemically, fats are generally triesters of glycerol and fatty acids. Fats may be either solid or liquid at normal room temperature, depending on their structure and composition...
excretion, which can be measured by determining the fecal fat level. While definitions have not been standardised, fat excretion in feces in excess of 0.3 (g/kg)/day is considered indicative of steatorrhea.
Possible biological causes can be lack of
bileBile or gall is a bitter yellowish, blue and green fluid secreted by hepatocytes from the liver of most vertebrates. In many species, bile is stored in the gallbladder between meals and upon eating is discharged into the duodenum where the bile aids the process of digestion of lipids by...
acids (due to liver damage or hypolipidemic drugs), defects in pancreatic juices (enzymes), and defective mucosal cells.
Steatorrhea is the presence of excess fat in
fecesFeces, faeces, or fæces is a waste product from an animal's digestive tract expelled through the anus during defecation.-Etymology:...
. Stools may also float due to excess lipid, have an oily appearance and be especially foul smelling. An oily anal leakage or some level of
fecal incontinenceFecal incontinence is the loss of regular control of the bowels. Involuntary excretion and leaking are common occurrences for those affected.Subjects relating to defecation are often socially unacceptable, thus those affected may be beset by feelings of shame and humiliation. Some do not seek...
may occur. There is increased
fatFats consist of a wide group of compounds that are generally soluble in organic solvents and largely insoluble in water. Chemically, fats are generally triesters of glycerol and fatty acids. Fats may be either solid or liquid at normal room temperature, depending on their structure and composition...
excretion, which can be measured by determining the fecal fat level. While definitions have not been standardised, fat excretion in feces in excess of 0.3 (g/kg)/day is considered indicative of steatorrhea.
Possible biological causes
Possible biological causes can be lack of
bileBile or gall is a bitter yellowish, blue and green fluid secreted by hepatocytes from the liver of most vertebrates. In many species, bile is stored in the gallbladder between meals and upon eating is discharged into the duodenum where the bile aids the process of digestion of lipids by...
acids (due to liver damage or hypolipidemic drugs), defects in pancreatic juices (enzymes), and defective mucosal cells. The absence of bile acids will cause the feces to turn gray or pale. Another cause of steatorrhea is due to the adverse effect of
OctreotideOctreotide is an octapeptide that mimics natural somatostatin pharmacologically, though it is a more potent inhibitor of growth hormone, glucagon, and insulin than the natural hormone...
which is an analog of somatostatin used clinically to treat
acromegalyAcromegaly is a syndrome that results when the pituitary gland produces excess growth hormone after epiphyseal plate closure at puberty...
.
Seen in
- malabsorption
Malabsorption is a state arising from abnormality in absorption of food nutrients across the gastrointestinal tract.Impairment can be of single or multiple nutrients depending on the abnormality...
, e.g. in inflammatory bowel diseaseIn medicine, inflammatory bowel disease is a group of inflammatory conditions of the colon and small intestine. The major types of IBD are Crohn's disease and ulcerative colitis..-Forms:...
, celiac disease, and abetalipoproteinaemia
- exocrine pancreatic insufficiency
Exocrine pancreatic insufficiency is the inability to properly digest food due to a lack of digestive enzymes made by the pancreas. This disease is found frequently in dogs. EPI is also found in humans afflicted with cystic fibrosis and Shwachman-Diamond Syndrome. EPI is caused by a progressive...
- pancreatitis
Pancreatitis is inflammation of the pancreas that can occur in two very different forms. Acute pancreatitis is sudden while chronic pancreatitis "is characterized by recurring or persistent abdominal pain with or without steatorrhea or diabetes mellitus."...
- choledocholithiasis
Choledocholithiasis is the presence of gallstones in the common bile duct. This condition causes jaundice and liver cell damage, and is a medical emergency, requiring the endoscopic retrograde cholangiopancreatography procedure or surgical treatment....
- (obstruction of the bile ductA bile duct is any of a number of long tube-like structures that carry bile.Bile, required for the digestion of food, is excreted by the liver into passages that carry bile toward the hepatic duct, which joins with the cystic duct to form the common bile duct, which opens into the intestine.The...
by a gallstoneIn medicine, gallstones are crystalline bodies formed within the body by accretion or concretion of normal or abnormal bile components.Gallstones can occur anywhere within the biliary tree, including the gallbladder and the common bile duct...
)
- pancreatic cancer
Pancreatic cancer is a malignant neoplasm of the pancreas. Each year in the United States, about 42,470 individuals are diagnosed with this condition and 35,240 die from the disease. The prognosis is generally poor; less than 5 percent of those diagnosed are still alive five years after diagnosis...
- (if it obstructs biliary outflow)
- primary sclerosing cholangitis
Primary sclerosing cholangitis is a chronic liver disease caused by progressive inflammation and scarring of the bile ducts of the liver. The inflammation impedes the flow of bile to the gut, which can ultimately lead to liver cirrhosis and liver failure. The underlying cause of the...
- bacterial overgrowth
- short bowel syndrome
Short bowel syndrome is a malabsorption disorder caused by the surgical removal of the small intestine, or rarely due to the complete dysfunction of a large segment of bowel. Most cases are acquired, although some children are born with a congenital short bowel...
- cystic fibrosis
Cystic fibrosis is a genetic disorder known to be an inherited disease of the secretory glands, including the glands that make mucus and sweat....
- Zollinger-Ellison syndrome
Zollinger-Ellison syndrome is a disorder where increased levels of the hormone gastrin are produced, causing the stomach to produce excess hydrochloric acid. Often the cause is a tumor of the duodenum or pancreas producing the hormone gastrin...
- Giardiasis
Giardiasis in humans is caused by the infection of the small intestine by a single-celled organism called Giardia lamblia. Giardiasis occurs worldwide with a prevalence of 20–30% in developing countries. Additionally, Giardia has a wide range of human and other mammalian hosts, thus making it very...
- a protozoan parasite infection
- Abuse or misuse of certain prescribed slimming pills.
As a side effect
Steatorrhea can also be due to eating non-digestible oils or fats such as
OlestraOlestra is a fat substitute that adds no fat, calories, or cholesterol to products. It has been used in the preparation of traditionally high-fat foods such as potato chips, thereby lowering or eliminating their fat content.- Commercialization :Olestra was accidentally discovered by Procter &...
, and a side-effect of medicines that prevent the absorption of dietary fats such as
OrlistatOrlistat , also known as tetrahydrolipstatin, is a drug designed to treat obesity. Its primary function is preventing the absorption of fats from the human diet, thereby reducing caloric intake...
.
Artificial fats
The fat substitute
OlestraOlestra is a fat substitute that adds no fat, calories, or cholesterol to products. It has been used in the preparation of traditionally high-fat foods such as potato chips, thereby lowering or eliminating their fat content.- Commercialization :Olestra was accidentally discovered by Procter &...
, used in some reduced-fat foods, was reported to cause leakage in some consumers during the test-marketing phase. As a result, the product was reformulated before general release to a hydrogenated form that is not liquid at physiologic temperature. The
United StatesThe United States of America is a federal constitutional republic comprising fifty states and a federal district...
Food and Drug AdministrationThe Food and Drug Administration is a Government agency of the United States Department of Health and Human Services and is responsible for regulating and supervising the safety of foods, tobacco products, dietary supplements, Medication drugs, vaccines, Biopharmaceutical, blood transfusion,...
warning indicated that excessive consumption of Olestra could result in "loose stools"; this warning has not been required since 2003.
Medications
OrlistatOrlistat , also known as tetrahydrolipstatin, is a drug designed to treat obesity. Its primary function is preventing the absorption of fats from the human diet, thereby reducing caloric intake...
(Xenical) is a diet pill that works by blocking the enzymes that digest fat. As a result fat cannot be absorbed from the gut and some fat is excreted in the feces instead of being metabolically digested, sometimes causing oily anal leakage.
Natural fats
Consuming
jojoba oilJojoba oil is the liquid wax produced in the seed of the jojoba plant, a shrub native to southern Arizona, southern California and northwestern Mexico. The oil makes up approximately 50% of the jojoba seed by weight.- Composition :Jojoba oil is a mixture of wax esters, 36 to 46 carbon atoms in...
has been documented to cause steatorrhea and anal leakage because it is indigestible.
Consuming
escolarThe escolar, Lepidocybium flavobrunneum, is a species of fish in the family Gempylidae, the only species in the genus Lepidocybium. It is found in deep tropical and temperate waters around the world. It is also marketed as "butterfish". -Biology:The escolar is dark brown in colour, growing darker...
and
oilfishThe oilfish, Ruvettus pretiosus, is a species of snake mackerel in the family Gempylidae, and the only species in the genus Ruvettus. It is found in the Mediterranean, middle Atlantic and throughout the southern seas, at depths of between 100 and 800 m...
(sometimes called butterfish) will often cause steatorrhea. The fish is commonly used in party catering due to its delicate flavor and the fact that it is cheap and readily available.
Treatment
Treatments are mainly correction of the underlying cause, as well as digestive enzyme supplements.