Causes and risk factors
Deficiency of pancreatic enzymes leads to inadequate fat digestion causing excretion of fats through, i.e., steatorrhea. Temporary pancreatic steatorrhea may result from dietary changes or intestinal infections. Conditions that affect pancreas can also cause pancreatic steatorrhea. Causes include pancreatitis, congenital pancreatic lipase deficiency [abnormal lipase production in the pancreas by birth], pancreatic fibrosis, pancreatic cancer, malabsorption of fats, celiac disease, or sprue.
Clinical presentation
Steatorrhea is present with other signs and symptoms of underlying condition or disease, especially pancreatitis. Patient complains of abdominal pain or bloating. There is presence of foul smelling feces, pale and bulky stools, greasy stools, or bloody stools. Abdominal swelling, distention is seen. Nausea and vomiting can occur. Itchy skin, yellowing of the skin and whites whiting of the eyes occurs. There is considerable weight loss. In severe cases there can be chest pain, or difficulty in breathing and shortness of breath. Severe abdominal pain can occur. There can be anuria. Patient has high fever. Unconsciousness may occur.
Investigations
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Abdominal x x-ray is required. Blood test is done for complete blood count [CBC], pancreatic enzyme assays, and liver function tests [LFT]. Stool examination for detection of fats is done . Ultrasound is recommended. CT scan is advised.
Treatment
Treatment of the underlying cause is essential. Treatment involves limitation of fat intake, and nutritional support. Treatment of chronic disease includes pancreatic-enzyme replacement therapy.
Complications
Complications such as anemia, poor nutrition due to vomiting or diarrhea, intestinal obstruction and perforation, . Spread of infection may occur.
When to Contact a Doctor
One must consult a doctor if there is presence of bulky, foul smelling, greasy feces.
Prevention
Common cause of pancreatic steatorrhea is pancreatitis, so preventive guidelines for pancreatitis are – reducing alcohol consumption, limitation of fat intake, a diet low in carbohydrate and cholesterol, including fresh fruits, fresh vegetables, and protein rich diet in daily meal.
Systems involved
Digestive system
Organs involved
Pancreas, intestine
