Steatorrhea (or steatorrhoea) is the existence of surplus fat in stool. Stools can be bulky and hard to flush out, possess a pale and greasy look and may be particularly foul-smelling. An oily rectal blockage or any amount of fecal incontinence might happen. There's increased fat excretion, which may be quantified by determining the fecal fat amount. The definition of just how much fecal fat represents steatorrhea hasn't been standardized.




Steatorrhea Causes

Impaired absorption or digestion could lead to fatty stools. Potential triggers include exocrine pancreatic insufficiency, with inadequate digestion in deficiency of lipases, reduction of bile salts, which reduces micelle formation, and small intestinal disease generating malabsorption. Several other causes include specific medications that block fat loss, or indigestible or surplus oil/fat in diet.

Not having bile secretion may cause the stool to turn grey or pale. Other characteristics of fat malabsorption can also occur such as decreased bone density, difficulty with vision under low light levels, swelling, bleeding and slow blood clotting times.

Associated diseases

Conditions producing intestinal malabsorption. These include celiac disease, bacterial overgrowth, tropical sprue, Giardiasis (a protozoan parasite infection), Zollinger-Ellison syndrome, short bowel syndrome, inflammatory bowel disease and abetalipoproteinemia.
Other causes. Drugs that can produce steatorrhea include orlistat, a slimming pill, or as adverse effect of octreotide or lanreotide, used to treat acromegaly or neuroendocrine tumors/carcinoid syndrome . It can be found in Graves' disease / hyperthyroidism.
Conditions affecting the pancreas. Exocrine pancreatic insufficiency can be caused by chronic pancreatitis, cystic fibrosis and pancreatic cancer (if it obstructs biliary outflow).
Conditions affecting bile salts. Obstruction of the bile ducts by gallstones (choledocholithiasis), primary sclerosing cholangitis, liver damage (intrahepatic cholestasis), hypolipidemic drugs, or changes following gallbladder removal (cholecystectomy).
Medications

Orlistat (also called trade names Xenical and Alli) is a diet pill which works by blocking the enzymes that digest fat. Because of this, some fat can't be absorbed by the gut and is excreted in the stool rather than being metabolically digested, occasionally resulting in fatty an*l leakage. Vytorin (ezetimibe/simvastatin) pills can lead to steatorrhea in certain individuals.

Treatment

Treatments are mainly correction of the underlying cause, as well as digestive enzyme supplements.



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