What is Steatorrhea?
The human body is made up of wonderfully organized systems of organs that work together in a harmonious way. Each body part has a specific range of functions, and has definite ways of letting us know what condition our body is in. For example, a fever is a warning sign that tells us our body is fighting off an infection. In much the same way, we can learn to ‘read’ what our body is telling us through different bodily excretions, including the stool. Believe it or not, fecal matter can tell us a lot about our health, and what we can do to improve our current condition.
Stool testing and analysis
Stool examination is a common laboratory test that can be performed anytime during the course of a person’s life. It is usually done during annual check-ups, pre-employment examinations and such. This is done by collecting a small sample (usually pea-sized) and putting it through blood, microbial and chemical tests. Stool exams are used to determine is a person has issues in their digestive tract such as bacterial or viral infections, worms, lactose intolerance, and even colon cancer.
Stool exams are conducted in a hospital or clinic setting. However, even you can perform a kind of stool analysis of your own. The color, smell and texture of your stool, as well as the frequency of your bowel movements, can tell you a lot about your health. Today, we will focus on the condition known as steatorrhea.
What is steatorrhea, and how does it affect a person’s day-to-day life? Steatorrhea is defined as the presence of excess fat or oil in a person’s fecal matter. Some symptoms include stools that float or have an unusually foul smell. There is no standard level of fat or oil presence in feces that dictates whether a person is experiencing steatorrhea or not. In some cases, steatorrhea is the diagnosis when the stool contains more than 7 grams of fat or lipids within a 24 hour period when a person digests less than 100 grams of fat. In households, the common guideline is that if your bowel movement is unusually oily, then you may want to consult with your doctor.
Signs and symptoms
Fat in feces results from the body’s inability to absorb or digest it within the digestive tract. This will cause you to experience any of the following:
Stool that is bulky in appearance
Stool that floats and not easily flushed
Stool that leaves oily or greasy residue
Pale-colored stool (grey)
Abdominal pain or cramps
Causes for Steatorrhea
There are many possible causes for a person’s stool to turn oily or fatty. It may be because of an underlying condition, or brought about by taking certain drugs, in which case, the non-absorption of fat may be temporary.
Celiac disease – known as the body’s over-sensitivity to gluten (comes from wheat and similar grains).
Crohn’s disease and other inflammatory bowels diseases
Short bowel syndrome- shortening of the intestines caused by disease, surgery or congenital
Non-allergic intolerance to certain food types
Infection of the intestinal tract – can be bacterial, viral or parasitic
Biliary diseases such as atresia or stricture
Cancer such as cholangiocarcinoma
Pancreatitis – inflammation of the pancreas, usually due to excessive alcohol consumption
Cystic fibrosis – genetic disorder that affect the lungs and pancreas
Ingestion of weight loss drugs such as Orlistat
Graft versus Host Disease – post transplant condition
Categories of Steatorrhea
There are generally three categories for steatorrhea that is commonly diagnosed. These are:
Malabsorption – due to intestinal diseases, shortening of the gut, or certain medicinal intake
Bile salt deficiency – reduced levels of bile production and secretion
Pancreatic insufficiency or Acinar cell loss – destruction of pancreatic cells and loss of organ function
Complications that may arise
Steatorrhea, just like any unnatural bowel movement or occurrence, can lead to more serious conditions if not treated early and properly. Some of these conditions include:
Vitamins like A, D, K and E are fat-soluble, so if lipids are not absorbed or digested properly, there is possibility that it will result in vitamin deficiencies which can, in turn, lead to serious complications and imbalances as well.
How to diagnose or test for Steatorrhea
Tests to determine the cause of this condition are aimed at the possible source or underlying disease instead of the condition itself. For example, a bentiromide test can be done to see if the fatty bowel is caused by chronic pancreatitis. Bile acid breath tests can also be conducted to determine if the cause is malabsorption. In much the same way, abdominal x-rays, CT scans, ERCPs and ultrasounds may be performed to isolate the main problem within the digestive tract.
Food allergy tests can also be done to see if the condition is caused by your body’s inability to process of absorb certain food types. If there is significant weight loss, jaundice, muscle spasms or other symptoms experienced, it may be a sign of a more serious disease. For this reason, stool exams should be done as soon as possible. Patients should call ahead for instructions on how to prepare for the test and how to collect the specimen. They will usually be asked to abstain from alcohol72 hours prior extraction, and eating a high-fat diet during this three-day period.
If the reason for greasy bowels is still not determined, a biopsy may be performed in order to check for other gastrointestinal disorders, especially if the stool is bloody.
Treatments for Steatorrhea
Most physicians consider steatorrhea as a symptom in itself, and therefore, the treatment is usually targeted at the root cause of the bowel leakage. Medications may include antibacterial, antiviral or anti-parasitic drugs, change in diet (includes therapy), enzyme supplements and lifestyle changes.
Different treatments will be issued based on the actual cause of the steatorrhea. For example, pancreatic diseases will require different medication from liver diseases. The same applies when the cause is excessive alcohol consumption or abuse of drugs such as Orlistat. In these cases, discontinuance is the first step to achieving regular stool consistency and bowel normalization.
Always consult with your physician before undertaking any medical or therapeutic treatment for steatorrhea. There are various ways to resolve this condition, including natural (herbal) therapies. However, since this may come with an underlying cause, it is imperative to get the correct diagnosis in order to solve the root cause of loose and oily stool.
The safety of the weight-loss drug Orlistat has been in question since it was found to cause steatorrhea while claiming to treat obesity. It is true that users achieve weight loss when taking this medication, but the side effects have made controversial and notorious. Clinical trials have reported that users have achieved as much as 5% decrease in body mass or even more, although the ‘mass’ was not completely made up of fat. In this regard, doctors advise that the intake of Orlistat come with a strict compliance to a low-fat diet in order to reduce the side effects.
The safety of drugs, as well as their contraindications, must always be putin high consideration before intake. Weight loss can be achieved through safer and more natural means, and steatorrhea can be avoided.
Casio Wiser is a health advocate for MCATScores.net