Treatment
The treatment depends strongly on the triggering cause. The fatty stool itself cannot be treated but the underlying disease must be treated therapeutically. If pancreatic insufficiency is the cause of the symptoms, tablets containing the digestive enzymes that the pancreas can no longer produce sufficiently can be taken with meals.
If these tablets are taken regularly, the symptoms usually disappear completely. If a lack of bile acids is the cause of the symptoms, the cause of the bile acid deficiency must be found. If the cause is a gallstone, it must be removed.
If there is a tumor, the therapy depends on the type of tumor, where it is located and how advanced it is. If Crohn’s disease is the cause of the bile acid deficiency, a change in diet must be made. If celiac disease is present, the diet must be changed to a completely gluten-free diet.
This requires a lot of patience and discipline, but if the diet is strictly adhered to, the symptoms usually disappear (almost) completely. The duration of fatty stools depends largely on the cause and treatment of the problem. If a gallstone is the cause, in some cases it can spontaneously dissolve and disappear, but in most cases treatment is necessary. Treatment is also usually necessary for the other causes mentioned until the symptoms disappear.
Anatomy
Chronic inflammation of the pancreas is the most common cause of fatty stools. The pancreas is called a gland because it produces various substances. The endocrine part of the gland produces insulin, a hormone for the utilization of sugar.
The exocrine part produces digestive enzymes. In the case of chronic inflammation, the pancreas can slowly lose its function over the years, the so-called pancreatic insufficiency. If the exocrine part is affected, not enough digestive enzymes are produced.
These enzymes include lipase, which is necessary for the digestion of fat. If there is a deficiency of lipase, the dietary fats can no longer be sufficiently broken down and absorbed into the bloodstream so that they must be excreted in the stool. Fat stools are the result.
Bile acids are essential for the digestion of fat.They have a fatty and a hydrous part and can emulsify the split food fats, i.e. enclose them. In this way the fats can then enter the bloodstream. A lack of bile acids thus leads to a reduced absorption of fats, the fats no longer reach the bloodstream sufficiently but are excreted with the stool.
A deficiency of bile acids occurs, for example, in the context of a bile stasis such as can occur with gallstones or a tumor of the bile ducts. A deficiency of bile acids can also occur in Crohn’s disease.
