Oily stool appears when there is excess fat in feces. It is also known as Steatorrhea. In this condition, stools may also float and gives an oily appearance and also gives foul smell. In few cases, fecal incontinence or oil leakage from anus can also occur. The increased fat secretion can be assessed by determination of fat level in feces. Temporary steatorrhea occurs due to dietary changes or intestinal infections, while the long term steatorrhea may be due to biliary, pancreatic or intestinal pathology.
Causes of oily stool
The main two reasons of steatorrhea are decreased absorption of fat and impaired digestion of fats, which can further be attributed to many other reasons. Some general reasons include:
- Impaired digestion: The primary enzymes responsible for fat digestion are bile and pancreatic lipase, which are secreted from the liver and pancreas respectively. Also, a few other enzymes also play some role in fat digestion.
Absence of bile generally occurs due to blockage in the biliary tract and results in pale fatty stool alongwith jaundice. Absence of pancreatic lipases is not generally seen, but may be present due to cystic fibrosis of the pancreas or diseased pancreas.
Therefore, majority of reasons of impaired fat digestion include some pancreatic pathology and impaired bile production or flow. Few reasons for impaired fat metabolism include:
- Pancreatic ulcer
- Pancreatic enzyme deficiency
- Pancreatitis, which may be acute or chronic
- Zollinger-Elison Syndrome
- Bile duct stones
- Primary sclerosing cholangitis
- Improper absorption: Another main reason for fat in stools is the impaired absorption of fat molecules through the gut and the transport of these molecules throughout the cells of the gut, the lacteals. For the proper absorption of these molecules from the gut, it is necessary that these form a micelle first, which is then absorbed by the gut cells. But in case of bacterial overgrowth in the gut wall, the formation of micelle is impaired and therefore absorption is poor. Few reasons contributing to malabsorption include:
- Inflammatory bowel disease, like Crohn’s disease
- Whipple’s disease
- Small bowel bacterial overgrowth
- Celiac disease
- Excessive usage of orlistat, which is generally present in slimming tablets
- Fast travel time from gut: The food substances, mixed with digestive enzymes of saliva and stomach passes slowly through the gut to ensure proper time for the enzymes to act and absorption of the fat molecules. However, in few conditions, this movement of chime is faster in some individuals, causing improper absorption and metabolism. Such conditions include:
- Short bowel syndrome
- over use of laxatives
- Dietary habits: Many dietary habits can also lead to steatorrhea which include the following:
- Excessive consumption of whole nuts: Various studies have shown association between excessive consumption of whole nuts like cashew nuts, groundnuts etc, with steatorrhea.
- Natural fats: Natural oil like jojoba oil is indigestible and causes leakage of oil from anus and steatorrhea.
Symptoms: Many symptoms can be associated with steatorrhea, depending upon the underlying cause of the condition. These symptoms can involve only the digestive tract or it can also show some systemic symptoms.
Symptoms associated with the digestive tract:
- bloody stool
- abnormally bad odour in the stool
- abdominal swelling
- abdominal pain
- nausea which may or may not be associated with vomiting
Systemic symptoms associated with steatorrhea:
- itchy skin
- recurrent infections
- jaundice, which appears as yellowish discolouration of the eye and the skin
- dark urine
Serious systemic symptoms which may be associated with life threatening conditions:
In case of any such condition contact your doctor immediately and seek advanced medical care. Such life-threatening symptoms include:
- chest tightness, chest pain and palpitations
- absent or minimal urination
- severe or sharp abdominal pain occurring suddenly
- respiratory problems like shortness of breath or difficulty in breathing
- very high fever
Treatment for oily stool
The treatment of this condition depends on the underlying cause. Temporary steatorrhea can occur due to dietary changes or intestinal infections. In case of intestinal infections, antibiotic therapy is helpful while the steatorrhea occurring due to dietary changes gets reversed by itself after correction of dietary habit. In case of improper supply of enzymes due to obstruction or impaired formation, dietary enzyme supplements can be given.
Steatorrhea itself is not a serious health problem, but if not treated properly, the underlying cause may produce serious permanent damages to the body. Some such complications include:
- frequent and opportunistic infections
- improper nutrition due to recurrent diarrhoea and vomiting
- intestinal obstruction which may further cause intestinal rupture
- spread of existing infection or cancer, if any
Steatorrhea is a commonly occurring condition but if it exists for a long period of time then you must consult your physician or nearest gastroenterologist.
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