Feces are the waste product that appears as a result of digesting food consumed during the day. They usually have a precise appearance and composition based on the diet people follow. On some occasions it is possible to observe fat in the stoolwhich is a sign that something is not working right.
The presence of fat micelles or droplets in the stool is a clinical manifestation called steatorrhea. Education show that fat digestion and absorption is mediated by pancreatic lipases, bile acids and intestinal epithelium. Thus, the malfunction of any of these parts can lead to the appearance of the condition.
Unfortunately, the epidemiology of steatorrhea is difficult to determine, as it is usually not obvious at first. In these cases it is necessary to carry out some laboratory tests to confirm the presence of fat in the stool.
Symptoms of steatorrhea
The characteristics of fecal stools often change due to the presence of fat in them. In this sense, they can become bulkier, fetid and pale. This feces often floats in the toilet, making it harder to flush.
In some cases, the steatorrhea is usually more noticeable, so you may see fat micelles in the toilet, similar to what happens when oil and water are mixed. One of the main causes of this clinical manifestation is malabsorption syndrome, so people may have other general symptoms:
- Chronic diarrhea.
- Cramps and bloating.
- Flatulence.
- Weight loss.
Children may have more severe symptoms, including delayed growth and delayed puberty. It is important to remember that little ones need a certain amount of nutrients for their development.
Causes and risk factors
Fat in stool usually appears when there is a deficiency in the production of pancreatic lipases or bile acids. Also due to damage to the epithelium of the first portion of the small intestine. In this way, many pathologies affecting the liver, pancreas or intestines can cause the appearance of steatorrhea.
All conditions capable of causing exocrine pancreatic insufficiency (EPI) can be at the origin of the symptom, due to the lack of production of the enzyme. Some Education establish it chronic pancreatitis is the most common cause of PEI in adults.
A common condition that can cause fat in the stool is celiac disease. It is a pathology characterized by the involvement of the epithelium of the small intestine, which hinders the absorption of fats.
Other diseases in which steatorrhea can appear are the following:
- Cystic fibrosis.
- cholestasis
- Crohn’s disease.
- HIV enteropathy.
- Whipple’s disease.
- Parasitosis, such as giardiasis.
- Pancreatic or intestinal surgery.
How is fat in stool diagnosed?
The presence of fat in the stool can be diagnosed based on the clinical findings. However, confirmation is given by various laboratory tests. The specialist may first ask about the general characteristics of the stool. In addition, he will look for signs that indicate the presence of underlying conditions.
The necessary laboratory tests consist of a qualitative and quantitative analysis of fat in stool samples. The qualitative one will try to demonstrate the presence of macroscopic fat in the sample. It consists of adding a special dye that will change color in the presence of fat.
On the other hand, the quantitative analysis will try to determine the amount of fat expelled over a period of time. For this it will be necessary to collect several stool samples in 1, 2 or 3 days. The result will be positive when there is the expulsion of more than 7 grams of fat in the faeces in 24 hours.
How is the stool fat test done?
The preparation for the analysis of fat in feces is very thorough. People must maintain a diet in which 100 grams of fat is consumed per day for the previous 3 days to conduct the test. It can be an uncomfortable and cumbersome diet, but it’s the most accurate way to determine steatorrhea.
Likewise, the specialist usually indicates the suspension of the consumption of certain drugs and foods that could alter the test result. Sample collection depends on the age of the patient.. In adults, a plastic bag can be used to cover the toilet, while in children, the sample can be taken directly from the diaper.
The sample should be stored in a clean plastic container and delivered to the laboratory.. The latter will be in charge of using various dyes and special equipment to identify the fat micelles in the stool.
Treatments available for fat in stool
Treatment for the presence of fat in the stool will depend on the disease causing this manifestation. In general terms, It is recommended to maintain a balanced diet low in fat, as well as having adequate hydration. Foods that trigger symptoms should also be identified to avoid them.
General measures, such as rest and smoking cessation, can also help reduce symptoms. Reducing alcohol intake is also usually helpful, as are antiflatulent, antacid, and antidiarrheal medications.
Education affirm that the administration of exogenous pancreatic enzymes is useful in case of exocrine pancreatic insufficiency. On the other hand, the implementation of a celiac diet and education are essential for patients diagnosed with this pathology. Finally, the administration and surgery of ursodeoxycholic acid is the first-line treatment for cholangitis, for example.
When to see a doctor?
All people should see a specialist if they notice the presence of fat micelles or droplets in their stool. It is also important to seek professional help if you have an increased number of bowel movements per day, pale or very fetid stools.
The presence of fat in the stool may indicate the presence of a malabsorption syndrome. In this sense, sudden and involuntary weight loss and abdominal discomfort should be warning signs.
A problem not to be underestimated
The presence of fat in the stool can be a difficult manifestation to notice, because its symptoms are usually very nonspecific at first. It is characterized by sudden and subtle changes in stool, especially in smell, color and quantity. Furthermore, it can generate the appearance of general signs as the underlying disease progresses.
This clinical manifestation can be the product of multiple pathologies affecting the pancreas, the bile ducts or the intestinal epithelium. They can generate poor absorption of nutrients, which complicates the general condition. In this sense, it is vital to seek medical assistance in the presence of any abnormal symptoms.
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