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What is Steatorrhea?
Steatorrhea is an absorptive or digestive symptom characterized by passage of fatty components in feces over and above 6 gm in 24 hours for no less than three successive days. This occurs usually because of decreased bile delivered to the intestine. Indicative of its occurrence is the presence of a large, foamy, greasy and offensive-smelling stool.
Signs and Symptoms
- Abdominal pain
- Abdominal distention
- Foul smelling feces with pale color
- Stools become bulkier than usual
- Floating stools
- Diarrhea
- Oily anal leakage
- Rapid, severe weight loss in recent months
- Nausea with or without vomiting
- Jaundice or the yellowing of the skin and whites of the eyes
- Pruritus
Causes
Maldigestion
Bile salt deficiency may later result to Maldigestion of fats. This problem arises when there is biliary cirrhosis due to cholestasis; obstruction, deconjugation of bile salts due to bacterial overgrowth, and diminished reabsorption brought by congenital ilial disease, surgical resection or bypass. It is not an uncommon occurrence to notice steatorrhea in post cholecystectomy patients.
Cystic fibrosis
This causes the formation of mucus plugs in the pancreatic ducts, hence, blocking the release of pancreatic juices.
Malabsorption
Malabsorption of fats may be a problem in patients diagnosed with Crohn’s disease, Celiac disease, Whipple’s disease, intestinal Lymphangiectasia, and intestinal ischemia.
Pancreatic Insufficiency
Absence or major reduction of enzymes such as amylase, lipase, Trypsin and chymotrypsin curbs fat digestion. This problem may arise secondary to chronic pancreatitis and pancreatic cancer.
Indigestible fats
Jojoba oil use has always been demonstrated to start out steatorrhea and oily anal leakage because of its indigestible nature. Often prepared are in parties because of its delicate taste, escolar, oil fish and butterfish, however, may cause temporary steatorrhea.
Drugs
Slimming medications such as Xenical works by blocking digestive enzymes, therefore, disrupting the digestion of fats. Most fats from the alimentary canal are not metabolically absorbed; as a result, these undigested components are expelled together with stools.
Artificial fats
An artificial fat substitute known as Olestra is accounted by some consumers to cause an oily anal leakage.
Excessive alcohol consumption
Excessive alcohol intake may damage the pancreatic tissues, resulting to the formation of scars and inflammation.
Treatment
- To begin with, the primary cause must be corrected, followed by the administration of 30,000 U of potent lipase enzymes with each and every meal. The therapy is expected to result significant weight gain as the digestive system recovers its potential to dissolve fats.
- Failure of the above treatment may be due to the destruction of the digestive enzymes by gastric acid. The use of H2 blockers will provide protection by reducing hydrogen ion release. The second approach involves the use of pH-sensitive enteric coated enzymes by which, enzymes are not delivered until the duodenal environment alkalizes.
- In some situations, the second option may fail due to either the premature gastric alkalinity allowing precipitate release of pancreatic enzymes or by excessively large microspheres that cannot be well-timely emptied. If any of these occur, limit everyday consumption of fatty foods to 50 mg or free of fat as possible.
- Strictly lower intake of alcohol.
