Fatty Stools (Steatorrhea): Causes

Pathogenesis (development of disease)

• Maldigestion (poor digestion of fat) wg ;
  • Defect of synthesis* : Deficiency of pancreatic secretion (pancreatic fluid) due toex:
    • Chronic pancreatitis (inflammation of the pancreas), cystic fibrosis (genetic disease characterized by the production of too tame mucus in various organs).
  • Defect of secretion wg :
    • Deficiency of pancreatic secretion due to obstruction of the ductus pancreaticus (pancreatic duct) (e.g. due to stone, tumor, etc.)
    • Deficiency of bile acids due tobile duct obstruction (gallstone, tumor, etc.).
• Malabsorption (disorder of food absorption; in this case: poor absorption of the fat).
  • Intestinal absorption disorder, for example, because of severe diarrhea (diarrhea), scleroderma (collagenosis associated with hardening of the connective tissue of the skin alone or the skin and internal organs, especially digestive tract, lungs, heart and kidneys) of the intestine, etc..
  • Drainage disorder of the lymphatic vessels of the intestine.

* Note: Steatorrhea is not apparent until approximately 90% of the exocrine pancreatic tissue has been destroyed.

Etiology (Causes)

Biographic causes

• Genetic burden
  • Genetic diseases
    • Abetalipoproteinemia (synonym: homozygous familial hypobetalipoproteinemia, ABL/HoFHBL) – genetic disorder with autosomal recessive inheritance; severe form of familial hypobetalipoproteinemia; defect in the image of chylomicrons leading to fat digestion disorders in children.
    • Cystic Fibrosis (ZF) – genetic disease with autosomal recessive inheritance, characterized by the production of secretions in various organs to be tamed.

Disease-related risk factors

Infectious and parasitic diseases (A00-B99).

• Giardiasis – small intestinal infection caused by Giardia lamblia (Giardia duodenalis).
• Whipple’s disease – a chronic relapsing disease caused by the gram-positive rod bacterium Tropheryma whippelii that can affect the entire body (symptoms: Fever, joint pain, brain dysfunction, weight loss, diarrhea, abdominal pain and more).
• Mycobacterium avium intracellulare infection in AIDS patients.

Liver, gallbladder, and biliary tract – Pancreas (pancreas) (K70-K77; K80-K87).

• Chronic pancreatitis (inflammation of the pancreas).
• Pancreatic duct obstruction – obstruction of a duct of the pancreas.
• Exocrine pancreatic insufficiency (EPI) – inability of the pancreas to produce sufficient digestive enzymes.
• Occlusion of the bile ducts, v.a. by stone, tumor.

Mouth, esophagus (esophagus), stomach and intestine (K00-K67; K90-K93).

• Chronic ischemia of the small intestine – reduced blood supply to the small intestine.
• Impaired intestinal lymphatic drainage after congenital intestinal lymphangiectasia.
• Short bowel syndrome – problems with absorption of nutrients due to extensive surgical removal of small bowel.
• Malassimilation – disturbance of pre-digestion in the stomach, enzymatic breakdown of food components (exocrine pancreatic insufficiency / disease of the pancreas associated with insufficient production of enzymes), fat emulsification (eg, bile acid deficiency in cholestasis / biliary obstruction) and absorption or removal of absorbed food.
• Tropical sprue – diarrheal disease occurring in the tropics due to folic acid and vitamin B12 deficiency.
• Celiac disease (gluten-induced enteropathy) – chronic disease of the mucosa of the small intestine (small intestinal mucosa), which is based on hypersensitivity to the cereal protein gluten.

Neoplasms – tumor diseases (C00-D48).

• Somatostatinoma – neuroendocrine tumor that produces somatostatin.
• Obstruction of the bile ducts by tumor, unspecified.

Other causes

• Acquired lymphatic drainage disorder after trauma (injuries), etc.

Medication

• Colchicine (alkaloid of autumn crocus (Colchicum autumnale)) – drug used for gout attacks.
• Colestyramine (strong base anion exchanger) – drug, which is an absorption inhibitor of cholesterol.
• Neomycin (antibiotic)