Steatorrhea is a medical term used to indicate the excessive presence of fat in the stool. It manifests itself with an abundant emission of pasty droppings, with a shiny and brilliant appearance.
With a balanced diet, between 60 and 100 g of lipids are introduced daily; we speak of steatorrhea when the fat content of feces exceeds 6-7 grams (depending on the authors).
Steatorrhea is therefore frequent in the presence of pancreatic insufficiency, pancreatitis, severe deficiency of bile salts or extensive intestinal resections. Although the stomach is poorly involved in lipid digestion, patients who have had gastric resection are more likely to experience steatorrhea. When the problem is pancreatic, the lipid quota in the diet is reduced and medium chain fatty acids (MCT) are prescribed, which can be well absorbed even without the intervention of lipase.
Due to the complexity of the digestive systems involved, there is also a physiological malabsorption of lipids, normally between 4 and 6 grams per day. A diet rich in long-chain saturated fatty acids, which are difficult for the body to digest, can contribute to accentuating absorption difficulties and with them the appearance of steatorrhea.
Infants fed with cow's milk are more likely to experience the disorder, since this food is free of lipase (a digestive enzyme) that we find in breast milk instead.
Steatorrhea is a side effect of many weight -loss drugs based on the inhibition of lipases and others, such as cholestyramine, which sequester bile acids to lower blood cholesterol levels. In this regard it is worth remembering that steatorrhea involves not only energy loss, but also essential fatty acids and fat-soluble vitamins (substances essential for our well-being).
