The so-called fatty stool (medically: steatorrhea or steatorrhea) always occurs when there is a lack of absorption of fats supplied through food in the digestive tract. This can be caused by food intolerance or by a more serious disease such as pancreatic cancer.
What is fatty stool?
By fatty stools, also called steatorrhea in technical language, physicians understand a reduced absorption of food fats, which are subsequently excreted again via the stool. The stool accordingly takes on a foamy and sticky consistency, accompanied by a pungent odor. The affected person also suffers from symptoms such as abdominal pain, flatulence or diarrhea. Often, the reduced fat intake is also accompanied by a lack of protein intake, which can also lead to symptoms. Up to 10 g of fat can thus be excreted daily via bowel movements. Experts then speak of pathological fatty stools. Steatorrhea is a symptom of a disease or food intolerance and should therefore always be medically clarified or treated accordingly.
Causes
The causes of steatorrhea (fatty stools) lie in an abnormally reduced ability to absorb the fats supplied in the diet, which are subsequently excreted in the stool. A possible reason for this could be gluten intolerance, which leads to inflammation of the mucous membrane of the small intestine and thus to a disturbance in fat absorption. Diseases of the pancreas can also cause steatorrhea, for example inflammation or cancer. Gallstones or inflammation of the bile ducts can also be responsible for the occurrence of fatty stools. Under certain circumstances, certain medications may also impair fat absorption in the digestive tract. Particularly medications used to treat obesity not infrequently result in fatty stools, as do some antibiotics.
Symptoms, complaints and signs
In steatorrhea, the excreted stool contains a lot of fat. The consistency of the stool is often soft or sticky. Its volume may be unusually large. It is also possible for foam to form or for the stool to have an oily sheen. In addition, the stool may have an unpleasant odor. A clearly visible sign of steatorrhea is the excretion of fat that is not bound in the stool. The stool may have small eyes of fat that may be visible in the water closet after toileting. The stool may also contain larger amounts of liquid fat that form small puddles after excretion. However, the evidence of steatorrhea is not so clear in every case. Steatorrhea can occur as a symptom of various diseases. Therefore, fatty stools are often accompanied by other symptoms that vary depending on the underlying disease. The symptoms that often occur together with steatorrhea include, above all, gastrointestinal complaints such as flatulence, abdominal pain and diarrhea (diarrhea). It is possible that those affected lose weight when large amounts of fat are excreted undigested, since the body does not absorb the energy contained in it in this case. Any weight loss may likewise be only indirectly related to steatorrhea, which in turn depends on the underlying disease that also causes the fatty stools.
Diagnosis and course
Fatty stools can often already be recognized by the affected person himself. During the subsequent visit to the doctor, a detailed conversation first takes place to ask about the patient’s circumstances and medical history. A stool examination provides information about the actual fat content. Blood tests can help to detect inflammation or gluten intolerance. Cancer can also be detected in this way. Ultrasound and X-ray examinations or a computer tomography allow further conclusions to be drawn about the condition of the organs. If steatorrhea remains untreated, the disease responsible for it can spread unhindered and possibly cause severe damage to the affected organs. Some diseases, such as pancreatic cancer, may even lead to the death of the patient if left untreated.
Complications
Whether steatorrhea causes complications, and if so, what they are, depends primarily on the cause.If the fatty stool is based on gluten intolerance, deficiency symptoms and chronic infectious diseases can occur if it is not treated. Since celiac disease weakens the entire organism, late effects such as cardiovascular diseases and allergies are also conceivable. If, on the other hand, a disease of the pancreas is responsible for fatty stools, this can lead to inflammation or even cancer. A tumor disease can even lead to the death of the patient if left untreated. In the case of gallstones, steatorrhea is usually followed by an infection of the gallbladder, which can develop into a so-called porcelain gallbladder. This increases the risk of developing gallbladder cancer. Apart from the accompanying gastrointestinal complaints, fatty stools themselves do not have any serious consequences. Occasionally, however, it can cause constipation or even intestinal obstruction. Treatment of steatorrhea also addresses the causes. If, for example, there is an inflammation of the pancreas, side effects may occur as a result of prescribed medication. The same applies to celiac disease therapy. In the case of gallstones, surgery is required, which carries known risks such as infection, bleeding or injury.
When should you see a doctor?
Irregularities in toileting should be observed and followed up. If abnormalities occur during bowel evacuation, special care should be taken. This is often the first sign of an existing disease. If the observations are unique, there is usually no cause for concern. Often the food intake was not optimal or harmful substances such as alcohol were consumed. In case of repeated or increasing changes, consultation with a physician is advisable. This is especially true if the peculiarities persist for several days or weeks as well as show an increasing character. Soft or sticky stools indicate disorders of the organism. If the volume of the excretions is unusually large compared to the food ingested, this is an indication of an existing disease. In case of general complaints of the gastrointestinal tract, a control visit to a doctor should take place. An unpleasant odor of the excretions, flatulence or changes in weight are to be understood as warning signals of the body. A general malaise, pain, diarrhea or constipation must be investigated. If small puddles of fat are noticed being excreted from the intestines during a toilet visit, a physician should be consulted immediately and informed of the observations.
Treatment and therapy
Once steatorrhea has been clearly diagnosed and the cause of the disorder determined, appropriate therapy can then be initiated. This depends on the particular disorder. Gluten intolerance often does not require special treatment; however, the affected person must avoid foods containing gluten to remain symptom-free. Inflammation of the pancreas should be treated immediately, otherwise it can become life-threatening. This involves the administration of various medications and, in some circumstances, surgery to remove the affected parts of the organ. The same applies to pancreatic carcinoma: surgical removal of the tumor in combination with chemotherapy promises good treatment success. Gallstones should definitely be removed if they cause symptoms such as fatty stools. In many cases, they can be crushed, which is effective and less stressful for the patient. Adherence to a diet can also be useful in many cases, in order to support the respective therapy and not put additional strain on the digestive tract. Basically, the earlier the disease is detected and treated, the higher the probability of a problem-free therapy and complete healing.
Prevention
Basically, the occurrence of fatty stools cannot be directly prevented. However, a healthy lifestyle with a balanced diet and sufficient exercise, as well as abstaining from alcohol and nicotine, can help prevent the development of the diseases responsible for fatty stools. If the first signs of fatty stools appear, it is advisable to consult a doctor if in doubt. He can clarify the causes and, if necessary, initiate appropriate therapy.
Aftercare
After successful treatment of steatorrhea, follow-up care may be essential, depending on the cause. If celiac disease was the trigger of steatorrhea, it is unavoidable to avoid foods containing gluten even after treatment. In the case of diseases of the pancreas (pancreatitis, pancreatic cancer) or the gastrointestinal tract (Crohn’s disease and other chronic inflammatory bowel diseases), regular blood tests as well as gastroscopy and colonoscopy and, if necessary, ultrasound examinations of the organs are necessary even after steatorrhea has been corrected. If gallstones were the cause of steatorrhea, no follow-up is required if they have been removed. If the cause was inflammation of the bile ducts, regular check-ups of the bile ducts should be performed even after successful treatment of this inflammation, since the likelihood of recurrence of bile duct inflammation is increased in people who have already had one. If the use of certain medications such as antibiotics was causative for the development of steatorrhea, these should be avoided in the future. In addition, regular observation of the stool can often detect a recurrence of steatorrhea at an early stage. Here, patients are required to pay attention to changes in their stool (in particular, a loamy color and an acidic odor, but also diarrhea and unusually high stool volume) and should consult their physician at an early stage if they suspect a recurrence of steatorrhea.
What you can do yourself
Self-treatment of steatorrhea is based on medical therapy. If gluten intolerance is the underlying cause, the doctor will recommend a diet. If gallstones are the cause, they must be operated out. After surgery, the patient must take it easy. Bowel movements should return to normal within a few days of the operation. If the fatty stools are caused by pancreatitis, the most important measure is to take the prescribed painkillers correctly. In addition, plenty of fluids must be taken in so that digestion can regulate itself quickly. As soon as the symptoms subside, light food can be taken again. The symptoms should have completely subsided after one to two weeks at the latest. A healthy lifestyle with plenty of exercise contributes to recovery and prevents recurrence of steatorrhea. The diet must be changed after fatty stools. Patients pay attention to a low-fat diet composed of proteins and low-fiber foods. In particular, trans fats, i.e. industrially hydrogenated fats, which are mainly present in frozen foods and pasta, should be avoided. Alcohol should be avoided as far as possible. In addition, small meals that supply the body with little but high-quality protein are recommended In children, further medical clarification is necessary to rule out metabolic diseases as a cause.
