Fat stool

Synonyms

Steatorrhea

definition

Fat stool is called in medical jargon Steatorrhea designated. Fat stool is created by one pathologically increased fat content in the stool caused by a fat digestion disorder. Fat stool is voluminous, bright shiny, frothy and foul smelling. The causal fat digestion disorder can have various causes. The therapy depends heavily on the disease causing it. Fatty stool is a symptom that can appear in various diseases, it is not a disease in itself.

causes

Fatty stools arise when the fats ingested with food are not sufficiently metabolized and absorbed into the bloodstream. Instead, they end up in the chair. A relatively typical cause of the occurrence of fatty stools is an impaired function of the pancreas. One speaks of exocrine pancreatic insufficiency. The exocrine part of the pancreas normally produces digestive enzymes such as lipase, which breaks down fats and makes them digestible.

Also read: Colors of stool and lipase in the blood - What does the value say?

With diseases like the chronic pancreatitis If the pancreas can no longer produce enough digestive enzymes sooner or later, pancreatic insufficiency occurs. The lack of the enzyme Lipase leads to the fact that the fats absorbed in the intestine are not broken down sufficiently, which means that they cannot be absorbed into the bloodstream. Instead, the Fats in the intestines and ultimately end up in the chair. Also cancer in the pancreas area, that is Pancreatic cancer, can lead to fatty stools in advanced stages.
Another possible cause of fatty stools is one Deficiency in bile acids. This is due to the fact that bile acids play an important role in the absorption of the split fat components into the bloodstream. A deficiency in bile acids occurs, for example, when the bile duct is blocked by one stone or one tumor.

Bile acid deficiency can also cause Crohn's disease occur. This is a chronic inflammatory bowel disease. If the inflammation mainly affects the ileum, a part of the large intestine, a deficiency of bile acids and thus fatty stools can occur.

Another cause of the development of fatty stools is that Celiac disease. This is a Gluten intolerance which must be treated with a strict diet. The chronic inflammation in the intestine leads to a loss of the surface of the mucous membrane, which plays an important role in the digestion of various food components. Among other things, the fats are affected by the indigestion, they end up in the stool and fatty stools develop.
Also in the context of Partial bowel removals (Bowel resections), for example after cancer in the bowel, fatty stools can occur.

Fat stool from stress

Stress is usually no trigger for the development of fatty stools. In order for fat stools to develop, fat digestion must be disturbed. However, stress does not have a significant impact on fat digestion.

Fatty stool from alcohol

Alcohol is no direct trigger for the development of fatty stools. A chronic excessive consumption of alcohol however, can become a chronic inflammation the pancreas. This in turn can lead to a for years Reduced function of the pancreas with a deficient production of digestive enzymes. This can cause fatty stools.

Fat stool in the context of irritable bowel syndrome

A Irritable bowel syndrome is a disease that is associated with abdominal discomfort. It is one of the psychosomatic diseases. In patients suffering from irritable bowel syndrome, no cause for the symptoms described can be found. The appearance of fatty stools is not a symptom that occurs in the context of irritable bowel syndrome. Common symptoms of irritable bowel syndrome, on the other hand, are flatulence, a flat stomach, bloating, loss of appetite, abdominal pain and diarrhea.

Diagnosis

In order to make the correct diagnosis in the presence of fatty stools, first of all the anamnese a crucial role. The attending physician may ask the following questions: How long is the fat stool already occurring? Is there other symptoms? Which Pre-existing illness consist? Exists a chronic alcohol consumption?
This is usually followed by a physical examination. Also one Inspection of the chair a stool sample may be necessary. Also one Blood test is part of the routine. Liver and pancreas values ​​can be determined here. Further possible investigations are then a Abdominal ultrasound, one X-ray examination, one Computed Tomography or ERCP (Examination of the bile ducts) and a Gastroscopy with examination of part of the small intestine. Samples are taken from the small intestine (Biopsies) taken. Function tests of the pancreas are also possible, but are not part of routine diagnostics.

How can I recognize fatty stool myself?

Fat stool can be identified by the stool more volume than usual. The chair is also relative bright and glittering. He smells very strong.

Color of the fatty stool

Fat stool is mostly of a relative light clay colored brown, the surface is shiny.

Concomitant symptoms

The accompanying symptoms that can occur with fatty stools vary depending on the triggering cause. It can lead to upper abdominal pain and a feeling of fullness as well as a decrease in appetite. A bloated stomach and increased flatulence can also occur. Itching and yellowing of the skin are also possible. Weight loss and heavy night sweats can also occur. Which accompanying symptoms occur can be decisive for the diagnosis.

The next topic is about another possible symptom of fatty stool. Read more about this under: Yellow bowel movements - what do I have?

Fat stool with flatulence

Flatulence can occur as an accompanying symptom in the context of fatty stools. They can provide an indication of the presence of a Indigestion be in the sense of a lack of absorption of the food components in the bloodstream. This can occur if the clinical picture of Celiac disease or Sprue be the case. This is a gluten intolerance. Gluten is a component of grain. As long as none gluten free diet If there is recurring inflammation in the intestine, the intestinal villi, which play an essential role in the absorption of food components into the bloodstream, wither and digestion is considerably disturbed. Fatty stools, flatulence, abdominal pain with a flat stomach and a feeling of fullness can occur.

Fat stool with diarrhea

In addition to fatty stools, diarrhea can occur in some of the diseases mentioned above. For example with the Pancreatic insufficiency or the Celiac disease. In general, a digestive disorder can lead to diarrhea.

treatment

Treatment depends heavily on the underlying cause. The fatty stool itself cannot be treated; the underlying disease must be addressed therapeutically. Is a Pancreatic insufficiency The cause of the symptoms can be taken with the meals tablets that contain the digestive enzymes that the pancreas can no longer produce sufficiently in the person affected. If these tablets are taken regularly, the symptoms will usually go away completely.
Is a Deficiency in bile acids cause of the complaints, the cause of the bile acid deficiency must be found out. At a Gallstone this must be removed as the cause. Lies a tumor before, the therapy depends on what type of tumor it is, where it is located and how far advanced it is.
At a Crohn's disease the cause of the bile acid deficiency must be a change in diet.
Is there a Celiac disease Before, the diet needs to be complete gluten-free food be changed. This requires a lot of patience and discipline, but if the diet is strictly followed, the symptoms usually recede (almost) completely.

Duration

The duration of fatty stools depends largely on the triggering cause and its treatment. If a gallstone is the cause, in some cases it can spontaneously loosen and come off, but usually there is one Treatment necessary. For the other causes mentioned, treatment is usually first necessary until the symptoms disappear.

anatomy

pancreas

Chronic inflammation of the pancreas is the most common cause of the appearance of fatty stools. The pancreas is called a gland because it produces different substances. In the endocrine part of the gland arises insulin, a hormone that uses sugar. In the exocrine part, digestive enzymes are produced. Chronic inflammation can slowly develop over the years Reduced function of the pancreas come, the so-called Pancreatic insufficiency. If this affects the exocrine part, not enough digestive enzymes are produced. These enzymes include the Lipasewhich is necessary for fat digestion. If there is a deficiency in lipase, the dietary fats can no longer be sufficiently broken down and absorbed into the bloodstream so that they have to be excreted in the stool. Fatty stools develop.

bile

Bile acids are essential for fat digestion. They have a fatty and a water-containing part and can thus emulsify, i.e. enclose, the split dietary fats. This allows the fats to get into the bloodstream. A deficiency in bile acids leads to a reduced absorption of fats, the fats no longer get into the blood sufficiently but are excreted with the stool. A deficiency in bile acids occurs, for example, in the context of a bile congestion, as can occur with gallstones or a tumor of the bile ducts. Bile acid deficiency can also occur in Crohn's disease.