What does steatorrhea look like? (+3 observations)

In this article, we will discuss the characteristics of steatorrhea and why it happens. Steatorrhea often goes unnoticed in the early stages.

What does steatorrhea look like?

Steatorrhea looks like a bulky, soft, sticky stool with a pale colour. Sometimes steatorrhea can be foamed, frothy, and filled with mucus. The colour of the faeces is often light-brown, but orange, green or yellow faeces may also seen.

These sticky faeces float in water and are often difficult to flush. The faeces are often foul-smelling. The sticky nature of the faeces may go unnoticed in the early stages of steatorrhea.

If you have steatorrhea then it means that food (especially fats) is moving through your gastrointestinal tract without properly getting absorbed. It can also happen if you have recently consumed high-fat food (1).

What are the characteristics of steatorrhea?

The characteristics of the faeces which can enable you to identify steatorrhea include:

  • Appearance and texture: The faeces will appear to have a thick, greasy surface. Sometimes foaming and frothing might also occur. 
  • Colour: The colour of faeces may vary if you have steatorrhea. Most of the time it is light brown. 
  • Consistency: The faeces will be bulkier, more massive, non-seedy, and wobbly in consistency.
  • Undigested fat: Excreting less than 7 grams of fats in 24 hours is considered normal. If the fat content is higher in faeces they will look sticky and the patient will defecate frequently.

How do you know if you have steatorrhea?

Observing the faeces after defecation is the first step to identifying steatorrhea. Other accompanying symptoms might include:

  • Stool sticking: If the stool sticks to the toilet bowl more than normal after flushing then it is an early sign of steatorrhea.
  • Floating: Due to the higher fat content in the faeces, steatorrhea tends to float on the water of the toilet bowl.
  • Loose stool: Although steatorrhea is different from diarrhoea, the patient might experience loose stools but they will be bulkier.
  • Weight loss: Due to the malabsorption of fats, the patient will begin to lose weight.
  • Bloating sensation: Abdominal discomfort and bloating sensations are common in steatorrhea.
  • Indigestion or heartburn: Due to food malabsorption, the patient might feel acid reflux and heartburn.

What medical conditions may cause steatorrhea?

Steatorrhea might occur due to malfunctioning of the pancreas, biliary tract, and intestinal abnormalities (2, 3, 4, 5, 6).

Disease Cause
Intestinal causes
Infection Intestinal infection caused by Clostridium difficile
Inflammatory bowel disease As Crohn’s disease affects the small intestine, it may cause malabsorption of fats 
Short bowel syndrome This occurs due to physical loss or decreased functioning of the small and/or large intestine. It leads to malabsorption of fats and other nutrients.
Biliary tract causes
Biliary atresia If refers to an impaired bile acid flow. Biliary atresia is a congenital disorder in which the tubes carrying bile from the liver to the gallbladder become obstructed.
Bile duct strictures It can cause gallbladder stones, secondary biliary cirrhosis, pyogenic liver abscesses, and fat-soluble vitamin deficiency. 
Tumor of the biliary tract Ampullary carcinomas may cause steatorrhea due to malabsorption.
Pancreatic causes
Inflammation Due to the loss of acinar cells and pancreatic inflammation the chances of steatorrhea increase.
Cystic fibrosis It is a genetic disease and causes impaired total bile salt secretion.
Congenital lipase enzyme deficiency It is due to a rare form of exocrine pancreatic failure that causes the deficiency of lipase enzymes. Lipase enzyme is required to break down triglycerides into free fatty acids.
Other causes
Diabetes Steorrhoae may occur in diabetes mellitus Type I.
Medication Certain cholesterol-lowering medicines like simvastatin can cause steatorrhea. Orlistat (slimming) pill is also known to cause steatorrhea. However, some medications like sucralfate (an antiulcer drug) might make the faeces look paler, but it does not mean that you have steatorrhea.

How to manage steatorrhea?

The treatment of steatorrhea is often dependent on the underlying cause and disease. It can be easily managed at home, however, your doctor would suggest clinical interventions for severe steatorrhea.

  • Hydration: Stay hydrated and drink plenty of water.
  • Diet: Take a diet that is not high in fibre and fats.
  • Fat-soluble vitamins: These include vitamins A, D, E, and K.
  • Antidiarrheal medication: To reduce the frequency of defecation, antidiarrheal drugs like loperamide and bismuth salicylate can be taken.
  • Pancreatic enzyme replacement therapy: These medications contain proteases, lipases, and amylases.
  • Omeprazole: It can be given to patients with cystic fibrosis. Omeprazole improves fat digestion and absorption (7).

As a pharmacist, I often observe my pee and faeces. The change in colour and consistency can lead to early detection of a more complicated disease. You should consult your doctor if you are defecating frequently as it may cause electrolyte imbalance and other complications.

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