Fatty stool is medically described as steatorrhea. Getting oily stool once in a while is quite normal and can be caused by dietary changes or due to stomach infections. However if your stool contains oily or greasy substances floating in water it can be steatorrhea. The main cause for fatty stool is non absorption of fat particles in the food. Your digestive tract has failed to absorb fats pushing it through excretion. Any abnormality in the bile, pancreas or intestine can cause oily stool.
Absorption Of Fat :
Fats are also one of the essential nutrients for our body. Fat is a high calorie food and hence is considered as a bundle of energy. But fat take more time for getting absorbed in the blood passing through various steps. Bile, liver, gallbladder, pancreas and the intestine are involved in the absorption of fats.
Fat rich foods are sent from the stomach to the small intestine in semisolid form along with plenty of stomach acids which is known as chyme mixture. Gallbladder releases bile into the intestine which reacts with fat molecules breaking them into tiny droplets. The course of this action is called as emulsification and the fat in the form of droplets undergoes several changes by the action of enzymes and digestive fluids. Lipase is an enzyme that helps in breaking down fat droplets into monoglycerides and fatty acid which can be absorbed easily.
Now the fatty acids travels through the walls of the intestine wherein small sized fatty acids are directly absorbed. Large fatty acids undergo several changes to get transformed into lipid molecules. In this process triglycerides and cholesterol mix up with protein carriers to form chylomicrons. Lipids are not fully absorbed due to impaired action of gallbladder and pancreas. A variety of diseases and autoimmune disorders can affect the liver reducing the production of bile. In such cases the undigested fats are excreted in the stool causing oily greasy stool.
Absorption of fatty acids depends on bile release and digestive fluids and lipase enzyme. Any abnormality or reduction in the secretion of the above liquids can interrupt normal absorption of fat. Various factors can affect the absorption of fat like swelling of wall of the intestine and ulcerative colitis and any disease in the pancreas, bile and gallbladder. You should seek medical attention if there is constant oily greasy stool, since it can result in loss of weight. Normally steatorrhea is a short-term problem caused by eating wrong diet. Getting oily greasy stool along with other symptoms like blood leakage in the stool or pus with stool can be serious.
Symptoms Of Steatorrhea :
- Oily greasy stool
- Black colored stool or tarry stool
- Blood leakage with stool
- Stool mixed with pus
- Excess of gas
- Bloating sensation or feeling of fullness
- Sharp abdominal cramps
- High fever
If you have two or more of the above symptoms, it can be a matter of concern and you should consult your GP promptly.
Some Of The Major Causes Of Oily Stool (Steatorrhea) Are Discussed Here :
- Digestion Oriented Problems :
Any abnormality in the digestive system can drastically reduce the fat absorption. Acute pancreatitis or chronic pancreatitis (swelling or infection of pancreas), any tumor in the pancreas, deficiency of enzyme secretion of pancreas, gallstones, bile duct stones, and Zollinger Ellison syndrome are some of the problems in the digestive system that causes oily greasy stool.
- Eating Spicy Oily Foods :
Eating too much of oily and spicy foods can affect the pancreas or intestine causing oily greasy stool.
- Intestine Oriented Causes :
Any infection in the GI tract can reduce or abruptly stop the bile secretion causing poor absorption of fat. Bacteria, virus or other parasites can infect the gastrointestinal tract. People who have undergone recent surgery in the intestine can develop this problem. You can get oily greasy stool after bariatric surgery. Celiac disease and gluten intolerance can damage the intestine leading to oily greasy stool. Food allergy and food poisoning can cause oily stool. Conditions that irritate the intestine like inflammatory bowel disease and irritable bowel syndrome can affect the normal functioning of intestine leading to poor absorption of fat.
- Bile Related Problems :
Oily greasy stool can be the result of bile related conditions like poor development of bile (biliary atersia), narrowing of bile duct or any impairment in the bile and development of cancerous tumor in the gallbladder or biliary tract.
- Mal-Absorption :
Reduction in the normal absorption of protein, carbohydrate, vitamins, minerals or fat can cause oily stool or steatorrhea. If you have mal-absorption you may have other signs like diarrhea, loss of weight (without trying), bloating or fullness in the stomach, excess of gas formation and oily greasy stool. In some people it can also affect the tongue causing dryness and cracking of tongue and lips. If you observe the stool you can see a ring of oil floating in the toilet water. Further the stool may be frothy and foul smelling.
Other causes like Whipple’s disease, overgrowth of bacteria in the intestine, cystic fibrosis and use of weight loss pills like orlistat can cause steatorrhea. There should be enough time for the chyme (semisolid digested food) while passing through the gut. If it gets through the intestine quickly essential nutrients like fat, vitamins and proteins are not properly absorbed by the intestine. Short bowel syndrome, constant diarrhea and over use of laxatives can cause this condition resulting in oily greasy stool.
Stool Test :
Based on the symptoms your doctor may order for a stool test. If the fat content present in the stool is over 100g per day it indicates mal-absorption and poor absorption of fat.
Steatorrhea Treatment :
Your doctor would first identify the root cause of the problem of oily stool before attempting to treat it. People who have undergone colorectal surgery cannot get back to normal absorption as before. In such cases the doctor would recommend suitable dietary changes to avoid oily greasy stool. Low fat diet and oil free diet is often suggested. If you have poor absorption of carbohydrates like disaccharides or lactose should be avoided. In other words dairy products should not be taken. Lactase tablets can be given along with milk products for easy digestion of lactose. In such cases suitable vitamin supplements would be prescribed to the patients to maintain the basic requirements of nutrients. For those with problems in pancreas, oral pills that contain pancreatic enzymes are given. Even in such cases the person should remain on low fat diet.