Steatorrhea (or steatorrhoea) is the presence of excess fat in feces. Stools may be bulky and difficult to flush, have a pale and oily appearance and can be especially foul-smelling. 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.
CausesImpaired digestion or absorption can result in fatty stools. Possible causes include exocrine pancreatic insufficiency, with poor digestion from lack of lipases, loss of bile salts, which reduces micelle formation, and small intestinal disease producing malabsorption. Various other causes include certain medicines that block fat absorption, or indigestible or excess oil/fat in diet. The absence of bile secretion can cause the feces to turn gray or pale. Other features of fat malabsorption may also occur such as reduced bone density, difficulty with vision under low light levels, bleeding, bruising and slow blood clotting times.
- Conditions affecting the pancreas. Exocrine pancreatic insufficiency can be caused by chronic pancreatitis, cystic fibrosis and pancreatic cancer (if it obstructs biliary outflow).
- Conditions affecting bile salts. Obstruction of the bile ducts by gallstones ( choledocholithiasis), primary sclerosing cholangitis, liver damage (intrahepatic cholestasis), hypolipidemic drugs, or changes following gallbladder removal ( cholecystectomy).
- Conditions producing intestinal malabsorption. These include celiac disease, bacterial overgrowth, tropical sprue, Giardiasis (a protozoan parasite infection), Zollinger-Ellison syndrome, short bowel syndrome, inflammatory bowel disease and abetalipoproteinemia.
- Other causes. Drugs that can produce steatorrhea include orlistat, a slimming pill, or as adverse effect of octreotide or lanreotide, used to treat acromegaly or neuroendocrine tumors/carcinoid syndrome https://www.us.sandostatin.com /. It can be found in Graves' disease / hyperthyroidism.