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 … Fatty Stools (Steatorrhea): Causes
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 … Fatty Stools (Steatorrhea): Therapy
Medical history (history of illness) represents an important component in the diagnosis of steatorrhea (fatty stools). Family history What is the general health of your relatives? Are there any diseases in your family that are common? Social history Have you been abroad recently? If so, where? What were the hygienic circumstances? Current medical history/systemic history … Fatty Stools (Steatorrhea): Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Abetalipoproteinemia (synonym: homozygous familial hypobetalipoproteinemia, ABL/HoFHBL) – genetic disorder with autosomal recessive inheritance; severe form of familial hypobetalipoproteinemia characterized by deficiency of apolipoprotein B48 and B100; defect in the formation of chylomicrons leading to fat digestion disorders in children, resulting in malabsorption (disorder of food absorption). Endocrine, nutritional … Fatty Stools (Steatorrhea): Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by steatorrhea (fatty stools): Endocrine, nutritional, and metabolic diseases (E00-E90). Weight loss Malabsorption of fat, carbohydrates and protein, electrolytes (sodium, potassium, calcium), water and vitamins (fat-soluble vitamins A, D, E and K and water-soluble B vitamins).
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? Bowel movements? Visible vessels? Scars? … Fatty Stools (Steatorrhea): Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. Pancreatic parameters – amylase, lipase. Trypsin [hydrolase secreted by the exocrine pancreas, which can cleave proteins/proteins as a serine protease] Elastase in serum, elastase in stool [only meaningful in moderate or severe pancreatic insufficiency]. Fecal fat excretion [pathological: > 7 g/d; in stool collected for … Fatty Stools (Steatorrhea): Test and Diagnosis
Therapeutic target Improvement of maldigestion (poor digestion of fat). Therapy recommendations The therapy of steatorrhea depends on the etiology (causes). See “Pancreatic insufficiency (pancreatic weakness)/Medicinal therapy.” See also under “Other therapy.”
Obligatory medical device diagnostics. Abdominal sonography (ultrasound examination of abdominal organs) – for basic diagnostics. Computed tomography (CT) of the abdomen (abdominal CT). Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification. Endoscopic retrograde cholangiopancreaticography (ERCP; diagnostic method … Fatty Stools (Steatorrhea): Diagnostic Tests
The following symptoms and complaints may indicate steatorrhea (fatty stools): Shiny, foul-smelling stools [shiny and gray stools, clay-like; pungent odor].
