Regular bowel movement can be a sign of a person having a healthy and functional bowel. It is difficult to define what is a regular bowel movement as this can vary from once a day to three or four times a week. Beside frequency of bowel movement, the shape and consistency of stool plays a role in a healthy bowel movement. A healthy stool is usually considered as soft, well-formed, brown to golden brown colour and easy to pass in one go. In this DoctorOnCall’s article, we will learn more about one of the changes leading to unhealthy stool; steatorrhea and what can cause such a condition.
Steatorrhea is defined as an increase of fat excretion in the stools. In other words, it is known as a fatty stool as the stool contains too much fats. It is difficult to estimate how many people are affected by steatorrhea as many go unrecognised due to minimal to nonspecific symptoms. One thing for sure, steatorrhea does affect all walks of life.
A person with steatorrhea can be suspected when the stool is bulky with fats and visible oil separation. The stool also usually seemed foamy or frothy, foul-smelling, appeared to be covered in thick greasy film, difficult to be flushed away and is in light-colour of light brown, green, orange or yellow. In severe case of steatorrhea, a person may experience muscle weakness, muscle pain, chronic fatigue, unexplained weight loss, fever, chronic diarrhoea, anaemia, malnutrition, dehydration skin issues such as dermatitis or pruritus, vision disturbances and nerve problems. Steatorrhea in children usually leads to growth problems when persisting or becoming chronic.
Just as the long list of symptoms associated with steatorrhea, there are many causes of steatorrhea. Below are among the common causes:
1) Chronic pancreatitis
2) Cystic fibrosis
3) Pancreatic tumours
4) Cholestasis
5) Crohn disease
6) Celiac disease
7) Giardiasis
8) Lymphoma
9) HIV
10) Medication such as orlistat use in weight loss therapy
11) Bacterial infections of the gastrointestinal tract such as Whipple disease
12) Gastric bypass surgery
13) Intestinal injury or resection
14) Graft-versus-host disease following surgery
Although in general steatorrhea may not be a great concern and not an emergency itself, when it is left untreated, it can lead to severe malnutrition as the gastrointestinal tract is unable to absorb fat that contains fat soluble vitamins and certain nutrients. This may result in severe weight loss. At times, steatorrhea can be a sign of an impending doom underlying serious life-threatening conditions. Life-threatening symptoms such as bloody stool, changes in consciousness, high fever, chest pain, breathing difficulty and severe abdominal pain should be a sign to seek immediate medical care by calling an ambulance or visiting the emergency room. Hence, it is best to get yourself or a person you know checked by doctors when experiencing symptoms relating to steatorrhea.
A person is diagnosed with steatorrhea after a series of questions and tests run by doctors. This includes medical history reviews, asking symptoms relating to steatorrhea and faecal fat test. A faecal fat test is a test used to evaluate stool’s fat content. If the causes of steatorrhea is inconclusive, doctors may run several laboratory tests such as complete blood count, liver profile and antibodies finding, imaging tests such as x-ray, ultrasounds, CT or MRI scan and endoscopy to help find exact causes and changes in the digestive tract. In certain cases, biopsy may be done.
Treatments depend on the cause and severity of the symptoms. In most mild cases, rest at home and home remedies should alleviate the symptoms. In chronic or severe cases of steatorrhea, medical intervention such as medications and hospitalisation is needed to treat steatorrhea.