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steatorrhea
Steatorrhea is the presence of undigested fat in stools.
Etiology:
- malabsorption
- inflammatory bowel disease
- celiac disease*
- tropical sprue
- abetalipoproteinemia
- exocrine pancreatic insufficiency*
- pancreatitis
- obstruction of the bile duct
- choledocholithiasis (gallstones)
- pancreatic cancer
- primary sclerosing cholangitis
- small intestinal bacterial overgrowth*
- short bowel syndrome*
- cystic fibrosis
- Zollinger-Ellison syndrome
- giardiasis
- Graves' disease / hyperthyroidism
- pharmaceutical agents
- Orlistat
- octreotide
- lanreotide
- whole nuts, especially cashews [3,4]
- oilfish (butterfish)
- jojoba oil
* 4 most common causes [5]
Clinical manifestations:
- by inspection, the stools are frothy, greasy & foul-smelling
- microscopically, fat globules may be seen with Sudan III stain
- abdominal pain or cramping
- diarrhea
- flatulence
- nausea with or without vomiting
- red flags
- bloody stool
- high fever
- severe abdominal pain or sudden onset of sharp pain
Laboratory:
- serum carotene: < 60 ug/dL with the patient on a diet of 100g fat/day for 72 hours
- fecal fat in 24 hour stool collection: > 7 g daily
Management:
- correct underlying cause
- pancreatic enzyme supplementation if indicated
- adequate amounts of fat-soluble vitamins
Related
fat in feces
General
malabsorption
References
- DeGowin & DeGowin's Diagnostic Examination, 6th edition,
RL DeGowin (ed), McGraw Hill, NY 1994, pg 522
- Wikipedia: Steatorrhea
http://en.wikipedia.org/wiki/Steatorrhea
- Better Medicine: Steatorrhea
http://www.localhealth.com/article/steatorrhea
- What could orange Oil-like droplets in stool be?
http://www.steadyhealth.com/What_could_orange_Oil_like_droplets_in_stool_be__t205343.html
- Medical Knowledge Self Assessment Program (MKSAP) 19
Board Basics. An Enhancement to MKSAP19.
American College of Physicians, Philadelphia 2022