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What is steatorrhea?

Steatorrhea is a condition that is characterized by having soft, watery, frothy, or greasy bowel movements with excessive amounts of fat in the stool. The more commonly-occurring condition, which is referred to as occult steatorrhea, produces stool containing high amounts of fat that may not be easily detectable. On the other hand, frank steatorrhea causes large amounts of fecal matter to become watery, oily, and extremely foul-smelling. Since the appearance of stool from frank steatorrhea is very similar to that of diarrhea, the two terms are often used interchangeably.

Possible Causes of Steatorrhea (Oily Stools)

There are a number of different factors that may cause oily stools. Diet factors, including eating fatty foods such as nuts, some fish, jojoba oil, olestra, and potato chips, may trigger the development of steatorrhea. Olestra is a substance used in packaged food items to minimize their fat and calorie content while still keeping their textures. This is possible because of its unique chemical structure, which, coincidentally, renders the body unable to digest it. Thus, olestra is excreted from the body in the stool, which will contain fat levels significantly higher than the upper limit of seven grams. Hence, the greasy appearance of feces from the consumption of olestra-containing foods may lead to an erroneous diagnosis of impaired fat absorption, or malabsorption.

Pancreatic disease, pancreatic tumors, and pancreatitis, which is the inflammation of the pancreas, may also cause steatorrhea. A small portion of the pancreas is responsible for housing digestive enzymes necessary in different bodily processes. In the occurrence of a leak, the pancreas may experience swelling. This can be very painful and damaging to its overall function, including its digestion of fat from food sources. This leads to malabsorption and causes stools to become oilier, increasing the risk of contracting steatorrhea.

Gallbladder disease, gallstones and malabsorption caused by various intestinal disorders like enteritis and Celiac disease can cause fatty stools. Celiac disease triggers digestive problems, particularly in the intestines, because it makes the body intolerant to dietary gluten. Consumption of gluten, which is found in wheat, barley, and rye, leads to abnormal alterations of the small intestine's mucous membrane. This affects its absorption of fats in the digestion process, causing the oil content of stool to increase.

Zollinger-Ellison syndrome, or ZES, causes tumors to develop in the pancreas and small intestines. These tumors elevate the gastrin levels in the body, triggering excess acid production in the stomach. This acid causes a wide range of problems, including peptic ulcers, which are characterized by thinning or eroded lining along the digestive tract. The digestion and absorption of numerous substances, including fats, is hence also impaired, making steatorrhea more likely to occur.

Certain medications and weight loss pills like orlistat and ezetimibe/simvastatin may also contribute to the development of steatorrhea.

When to See a Doctor

It is wise to consult a doctor when considering other causes of steatorrhea that are not directly related to medications or dietary issues. Symptoms such as prolonged diarrhea, vomiting and nausea, fever, severe pain in the abdomen, and drastic weight loss may be cause for alarm. In such cases, proper treatment and diagnosis from a professional is highly advisable. Tests may include stool exams, blood tests, imaging and endoscopic examinations to diagnose possible gastrointestinal disease.

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