Therapy for steatorrhea depends on the exact cause. The following recommendations apply to steatorrhea due to exocrine pancreatic insufficiency (EPI; inability of the pancreas to produce enough digestive enzymes).
General measures
- Alcohol restriction (abstaining from alcohol), for life!
- Nicotine restriction (abstaining from tobacco use).
- Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised program for the underweight.
- Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
- Review of permanent medication due topossible effect on the existing disease.
Regular check-ups
- Regular medical checkups
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Observance of the following special dietary recommendations in exocrine pancreatic insufficiency:
- If steatorrhea (fatty stools) is present, it must be taken into account that patients with chronic pancreatitis (inflammation of the pancreas) and exocrine pancreatic insufficiency in the advanced stage often have malnutrition (malnutrition) and thus cannot do without the energy source fat. Therefore, a substitution of digestive enzymes (“ferment substitution”) should be carried out first and only then a reduction of fat consumption to 50-75 g/day should be considered. In the selection of dietary fats must be considered that the lower the melting point, the better the digestion (eg, vegetable oils; butter has a higher melting point).
- In rare cases, steatorrhea does not improve sufficiently with reduction of fat in combination with pancreatic ferment substitution. Then, partial replacement of dietary fat (LCT fats = fats with long-chain fatty acids) with MCT fats (fats with medium-chain fatty acids) should be performed:
- The transition to MCT fats should be gradual, otherwise abdominal (stomach) pain, vomiting and headaches may occur.
- MCT margarine – as a spread or after cooking add to the still warm food; is not suitable for frying, stewing, braising, grilling, etc.
- MCT cooking oils – can be used as cooking fat; however, they can not be heated as high as usual vegetable oils (do not heat too long and never above 70 ° C, at temperatures above 120-130 ° C smoke development occurs).
- Long keep warm or reheat the food prepared with MCT should be avoided, because a bitter aftertaste can arise.
- If there is a risk of insufficient energy and nutrient supply, the additional administration of a chemical-defined formula diet is indicated. A deficiency supply mainly affects the fat-soluble vitamins (especially vitamin A and E) and vitamin B12.
- Other measures are:
- Distribute food evenly throughout the day.
- Consume small portions.
- Gentle preparation of food (steaming, cooking).
- Avoid: foods that are difficult to digest, high in fiber.
- Prefer: carbohydrate-rich food with adequate protein content.
- Selection of appropriate food based on the nutritional analysis
- See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
- Detailed information on nutritional medicine you will receive from us.
