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Steatorrhea is a condition where a substantial amount of fat is found in the feces. The presence of excess fat in feces means that malabsorption is occurring, where food is not properly absorbed from the gut. Typically, the stools float and are bulky, foul-smelling and pale in color. Droplets of oil may be visible, remaining apparent even after the toilet has been flushed, leaving a greasy deposit around the bowl. Steatorrhea is indicative of certain diseases, such as chronic pancreatitis or celiac disease, and is often associated with anemia.
If steatorrhea occurs together with digestive problems and pain in the abdomen, this can signify chronic pancreatitis. In this disease, often caused by excessive alcohol consumption, the pancreas is inflamed over a long period of time, leading to tissue damage and subsequent scarring. The pancreas makes enzymes involved in digesting food, so its damage means fewer enzymes are produced. Since pancreatic enzymes are particularly responsible for digestion of fat, fewer enzymes means less fat is digested. Fat tends to remain in the stools, making them paler, more foul-smelling than usual and difficult to remove by flushing.
Over time, malabsorption leads to weight loss and fatigue, and since the pancreas also makes insulin, lack of this may lead to diabetes. Treatment involves abstinence from alcohol, pain relief, and medication to replace missing pancreatic enzymes with artificial versions. Occasionally, if there is severe pain unrelieved by medication, surgery may be required to remove part of the pancreas.
Steatorrhea may also occur in celiac disease, an autoimmune disease where the body attacks itself while making antibodies against gluten. This causes inflammation of the gut, damaging the lining so it is less able to absorb food. Poor absorption of vitamins and food causes steatorrhea, anemia, abdominal pain and diarrhea. The disease can occur at any age and may be diagnosed with a blood test. Treatment involves following a gluten-free diet.
Infection by a parasite known as giardia can also give rise to steatorrhea. In areas of the world where giardia is common, it infects the intestines of people who drink contaminated water or eat food washed in that water. The infection interferes with food absorption in the gut so that excess fat and vitamins are lost in the stools, causing steatorrhea. In chronic cases, diarrhea is present over several weeks and, if untreated, the disease can go on for months. It is generally treated with a combination of rehydration and antibiotics.
There are other important diseases where steatorrhea can occur. One example is cystic fibrosis, a genetic disorder mainly affecting the lungs and pancreas, and cancers of the liver and pancreas. Treatment varies depending on the specific illness.