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Steatorrhea
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Contributors
Steatorrhea
Classification and external resources
ICD-10 K90
ICD-9 579.8
MeSH D045602
Steatorrhea (or steatorrhoea) is the presence of excess fat in feces. Stools may also float due to
excess lipid, have an oily appearance and can be especially foul-smelling.
[1]
An oily anal leakage
or some level of fecal incontinence may occur. There is increased fat excretion, which can be
measured by determining the fecal fat level. The definition of how much fecal fat constitutes
steatorrhea has not been standardized.
Contents
1 Causes
o 1.1 Associated diseases
o 1.2 Medications
o 1.3 Excess whole nuts in diet
o 1.4 Natural fats
o 1.5 Artificial fats
2 Treatment
3 See also
4 References
Causes
Possible biological causes can be lack of bile acids (due to liver damage, hypolipidemic drugs, or
gallbladder removal (cholecystectomy)), defects in pancreatic enzymes, defective mucosal cells,
certain medicines that block fat absorption, or indigestible or excess oil/fat in diet. The absence
of bile acids will cause the feces to turn gray or pale. Another cause of steatorrhea is due to the
adverse effect of octreotide or lanreotide, which are analogs of somatostatin, used clinically to
treat acromegaly.
Associated diseases

This section does not cite any references or sources. Please help improve this section
by adding citations to reliable sources. Unsourced material may be challenged and
removed. (December 2010)
Malabsorption, e.g. in inflammatory bowel disease, celiac disease, and
abetalipoproteinemia
[2][3]

Exocrine pancreatic insufficiency
Pancreatitis
Choledocholithiasis (obstruction of the bile duct by a gallstone)
Pancreatic cancer (if it obstructs biliary outflow)
Primary sclerosing cholangitis
Bacterial overgrowth
Short bowel syndrome
Cystic fibrosis
Celiac Disease
Zollinger-Ellison syndrome
Giardiasis (a protozoan parasite infection)
Graves' disease / hyperthyroidism
Abuse or misuse of certain prescribed slimming pills (such as Orlistat)
Tropical sprue
In patients with steatorrhea, other associated symptoms may include reduced bone density,
difficulty with vision under low light levels, and slow blood clotting times.
Medications
Orlistat (also known by trade names Xenical and Alli) is a diet pill that works by blocking the
enzymes that digest fat. As a result, some fat cannot be absorbed from the gut and is excreted in
the feces instead of being metabolically digested, sometimes causing oily anal leakage.
[4][5][6]

VYTORIN (ezetimibe/simvastatin) tablets can cause Steatorrhea in some people.
[4][6]

Excess whole nuts in diet
There are anecdotal reports on the internet describing oily droplets in feces after eating large
amounts of cashews or other whole nuts.
[7][8]
They in agreement with studies showing that stool
lipids are greatest when whole nuts are eaten, compared to their nut butters, oils or flour
[9]
and
that lipids from whole nuts are significantly less well absorbed.
[10]

Natural fats
Consuming jojoba oil has been documented to cause steatorrhea and anal leakage because it is
indigestible.
[11]

Consuming escolar and oilfish (sometimes called butterfish) will often cause steatorrhea, also
referred to as Gempylotoxism or Gempylid Fish Poisoning or keriorrhea.
[12]
The fish is
commonly used in party catering due to its delicate flavor and because it is cheap and readily
available.
[citation needed]

Artificial fats
The fat substitute Olestra, used to reduce digestible fat in some foods, was reported to cause
leakage in some consumers during the test-marketing phase. As a result, the product was
reformulated before general release to a hydrogenated form that is not liquid at physiologic
temperature. The U.S. Food and Drug Administration warning indicated excessive consumption
of Olestra could result in "loose stools"; however, this warning has not been required since
2003.
[5][13]

Treatment
Treatments are mainly correction of the underlying cause, as well as digestive enzyme
supplements.
[14]

See also
Rectal discharge
Keriorrhea
Fecal leakage
References
1. Adam S Cheifetz, Alphonso Brown, Michael Curry, Alan C Moss (10 Mar 2011). Oxford
American Handbook of Gastroenterology and Hepatology. Oxford University Press.
p. 234.
2. Moutzouri, E; Elisaf, M; Liberopoulos, EN (March 2011). "Hypocholesterolemia.".
Current vascular pharmacology 9 (2): 20012. doi:10.2174/157016111794519354.
PMID 20626336.
3. Hasosah, MY; Shesha, SJ; Sukkar, GA; Bassuni, WY (2010). "Rickets and dysmorphic
findings in a child with abetalipoproteinemia". Saudi medical journal 31 (10): 116971.
PMID 20953537.
4. Squires, Sally (2006-01-24). "Weighing a Pill For Weight Loss". Washington Post.
Retrieved 2007-07-06. "While the Food and Drug Administration (FDA) still must
approve the switch, the agency often follows the advice of its experts. If it does, Orlistat
(xenical) -- currently sold only by prescription -- could be available over-the-counter
(OTC) later this year. But it's important to know that the weight loss that's typical for
users of the drug -- 5 to 10 percent of total weight -- will be less than many dieters
expect. And many consumers may be put off by the drug's significant gastrointestinal
side effects, including flatulence, diarrhea and anal leakage."
5. "Frito-Lay Study: Olestra Causes "Anal Oil Leakage"". Center for Science in the Public
Interest. February 13, 1997. Retrieved 2007-07-07. "The Frito-Lay report states: "The
anal oil leakage symptoms were observed in this study (3 to 9% incidence range above
background), as well as other changes in elimination. ... Underwear spotting was
statistically significant in one of two low level consumer groups at a 5% incidence above
background." Despite those problems, the authors of the report concluded that olestra-
containing snacks "should have a high potential for acceptance in the marketplace.""
6. "The Word Is 'Leakage'. Accidents may happen with a new OTC diet drug.". Newsweek.
June 25, 2007. Archived from the original on 2007-06-18. Retrieved 2007-06-21.
"GlaxoSmithKline has a tip for people who decide to try Alli, the over-the-counter
weight-loss drug it is launching with a multimillion-dollar advertising blitzkeep an
extra pair of pants handy. That's because Alli, a lower-dose version of the prescription
drug Xenical, could (cue the late-night talk-show hosts) make you soil your pants. But
while Alli's most troublesome side effect, anal leakage, is sure to be good for a few
laughs, millions of people who are desperate to take off weight may still decide the threat
of an accident is worth it."
7. http://www.ask.com/question/oily-orange-stool
8. http://www.steadyhealth.com/What_could_orange_Oil_like_droplets_in_stool_be__t205
343.html
9. Int J Obes (Lond). 2008 Feb;32(2):322-8. Epub 2007 Oct 2.Peanut digestion and energy
balance. Traoret CJ1, Lokko P, Cruz AC, Oliveira CG, Costa NM, Bressan J, Alfenas
RC, Mattes RD. http://www.ncbi.nlm.nih.gov/pubmed/17912269
10. Hollis, J., & Mattes, R. (2007). Effect of chronic consumption of almonds on body
weight in healthy humans. British Journal of Nutrition, 98(03), 651-656.
11. Comparative aspects of lipid digestion and absorption: physiological correlates of wax
ester digestion
12. Bad Bug Book - Foodborne Pathogenic Microorganisms and Natural Toxins Handbook:
Gempylotoxin, FDA
13. "Reported medical side-effects of Olestra according to Procter and Gamble studies".
Center for Science in the Public Interest. Retrieved 2007-06-21. "Olestra sometimes
causes underwear staining associated with "anal leakage." Olestra sometimes causes
underwear staining. That phenomenon may be caused most commonly by greasy, hard-
to-wipe-off fecal matter, but occasionally also from anal leakage (leakage of liquid
olestra through the anal sphincter)."
14. WrongDiagnosis >Treatments for Steatorrhea Retrieved on 20 Mars, 2009
[dead link]

[show]
v
t
e
Digestive system, Digestive disease, Gastroenterology (primarily K20K93, 530
579)
Categories:
Feces
Diarrhea
GI tract disorders
Diseases of intestines
Conditions diagnosed by stool test
Symptoms and signs: Digestive system and abdomen
Proctology
Steatorrhea-related diseases
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