Steatorröa

Steatorröa, also called steatorrhea, is the excretion of abnormally large amounts of fat in the feces, indicating impaired fat digestion or absorption. The stools are typically bulky, pale, greasy, float in water, and may have a foul odor. Patients may experience weight loss, abdominal bloating, and fatigue; fat-soluble vitamins (A, D, E, K) can become deficient if the condition persists.

Causes include pancreatic exocrine insufficiency (most notably chronic pancreatitis, cystic fibrosis, pancreatic cancer), diseases affecting the small intestine or its mucosa (celiac disease, Crohn's disease, short bowel syndrome), problems with bile acid production or flow (cholestasis, biliary obstruction), small intestinal bacterial overgrowth, after certain surgeries (ileal or gastric surgeries), parasitic infections (Giardia), and some medications (orlistat).

Diagnosis typically involves quantitative stool fat testing, such as a 72-hour fecal fat collection showing elevated fat excretion (commonly greater than 7 g/day). Additional tests may include fecal elastase to evaluate pancreatic function, stool fat staining, and investigations for underlying diseases (blood tests, endoscopy, imaging).

Treatment focuses on addressing the underlying cause and managing fat absorption. Pancreatic enzyme replacement therapy is effective for pancreatic insufficiency. Dietary management may include a normal to modest fat intake, the use of medium-chain triglycerides, and supplementation of fat-soluble vitamins. In children, nutritional support and growth monitoring are important. Regular follow-up aims to correct deficiencies and monitor response to therapy.