Do you have an abnormally oily stool? Let's talk about this (Steatorrhea)

It's normal for our bowel movements to change a bit depending on what we eat. But have you ever noticed that your stools have a strange oily or greasy texture? Do they float in water, are pale in color, and have an unbearable bad smell? If this doesn't happen for a day or two, but continues, it could be a sign that there is something wrong with our body. Today we are talking about this condition called 'oily stools' or 'steatorrhea' in medical terms.

Simply put, what is Steatorrhea?

Steatorrhea is when your stool contains too much fat. Simply put, when the fat in the food you eat is not properly digested and absorbed by the body, the unabsorbed fat is passed out in the stool. This condition is called fat malabsorption .

The following are the common features of this type of stool:

• Increasing in size .
• To have a loose, liquid nature.
• Having an oily or greasy appearance.
• Maybe foamy.
• Becoming pale like clay.
• Having a very bad, unbearable odor .
• Floating in the toilet bowl water .
• Difficulty flushing (sticky nature of the toilet bowl).

This may happen if you eat an occasional fatty meal. But if these symptoms persist, it's not a good idea to ignore them.

Why does fat appear in our stool? What happens during digestion?

Think of fat digestion as a team sport. There are three main players in this game: the liver, the pancreas, and the small intestine.

1. Liver: The liver produces a fluid called "bile." This bile breaks down large fat particles into smaller ones.

2. Pancreas: The pancreas produces special enzymes needed to digest fat.

3. Small intestine: Bile from the liver and enzymes from the pancreas collect in the small intestine. This is where fat is completely broken down and absorbed into the body.

Steatorrhea occurs if something goes wrong in this process.

• If the pancreas cannot make enough enzymes .
• If the liver cannot make enough bile .
• Even if these are made, if they cannot be sent to the small intestine due to blockages in the ducts.
• Or, if there is some damage to the small intestine itself and it is unable to absorb fat .

What are the main causes of steatorrhea?

There are several medical conditions that can cause this condition. It is easier to understand them by categorizing them according to the organ involved.

How does a doctor find the cause of this?

If you have these symptoms, be sure to see a doctor. He or she will ask you about your symptoms and examine you. They may also run some tests to determine the exact cause.

• Fecal fat analysis: This involves collecting a sample of your stool over a period of one to three days and measuring the amount of fat in it. This can help determine how much fat you have absorbed from the foods you have eaten and how much is excreted in your stool.
• D-xylose test: This can help determine whether the problem is in the small intestine or the pancreas/liver. You drink a liquid containing a sugar called D-xylose, and then a sample of your urine (or possibly blood) is tested a few hours later. If this sugar is present in the urine, it means that it has been absorbed well by the intestines. So the problem could be in the pancreas or liver. But if there is no sugar in the urine, the doctor can figure out that the problem is due to poor absorption in the intestines.

Additionally, endoscopy, scans, or other blood tests may be ordered depending on the cause.

How is the treatment and diet?

Treating steatorrhea actually means treating the underlying condition that is causing it. For example:

• If pancreatic enzymes are insufficient, enzymes called Pancreatic Enzyme Replacement Therapy (PERT) are given in the form of pills.
• If there is a problem with bile production, appropriate medications (e.g. Ursodeoxycholic acid) are given.

In addition, complications that arise from fat malabsorption also need to be treated. The main one is vitamin deficiencies . When fat is malabsorbed, fat-soluble vitamins such as vitamins A, D, E, and K are not absorbed. Therefore, the doctor may recommend taking these vitamins as supplements.

How should you take care of food?

The exact dietary changes you need to make will depend on the cause of your steatorrhea. It's best to discuss this with your doctor.

• If it occurs occasionally (due to eating too much fatty food): Reduce things like butter, heavy oils, coconut oil, palm oil, red meat, and processed foods.
• If it is due to a problem with fat absorption (Malabsorption): Here the story is a little different. The body needs fat to get the energy it needs. Therefore, the doctor may advise you to add more foods containing healthy fats (unsaturated fats) instead of bad fats. Examples:
• Oily fish like salmon, tuna, and mackerel
• Avocados
• Olive oil
• Nut butters
• Foods rich in fat-soluble vitamins:
• Vitamin A: fish oil, butter, eggs, carrots
• Vitamin D: oily fish, mushrooms, sun exposure
• Vitamin E: Sunflower seeds, almonds
• Vitamin K: Dark green vegetables like spinach and kale

Steatorrhea, oily stools, fatty stools, fat malabsorption, pancreas, liver, digestive system