Stool is made up of many components including water, mucus, bacteria, fiber, various cell linings, salts, proteins, and fats. Having too much fat in stool is termed as steatorrhea and it can be a sign that there is malabsorption occurring in a person’s body. The body may not be absorbing nutrients as it is required or it may not be efficiently making enzymes or bile used to digest fat. If you are having too much fat in stool you may want to be examined to find out the cause. Sometimes, the cause can be a simple thing like taking a lot of fat in your diet to a serious problem like the liver being dysfunctional and not able to release bile.
What does fat in stool look like?
A person who has too much fat within stool (steatorrhea) has pale, bulkier, and foul-smelling stool. The stool tends to float since it has high gas content and is covered in some greasy film. You may notice drops of oil in the water within the toilet bowl. Having mild or short-lived cases of excess fat in stool may bring some discomfort.
Symptoms of fat in stool
Mild steatorrhea has symptoms that include:
- Stool that float
- Foul-smelling stool
- Stool difficult to flush
- Stool appearing to have a thick, greasy film
- Diarrhea or runny or loose stool that’s a bit bulky than usual
- Abdominal pain
- Bloating
- Cramping
- Gassiness
- Indigestion
- Heartburn
- Frothy, foamy, or mucous-filled stool
- Exhaustion
- Light brown, orange, green, yellow stool, or light colored stool
- Minor bone, joint, and muscle ache
If you have been having fat in stool for an extended period of time, it may be regarded as chronic or severe, and it could present with symptoms like dehydration and malnutrition. If the fat in stool is linked to some underlying condition, a person may have serious symptoms. Chronic steatorrhea symptoms include:
- Weight loss
- Vision problems
- Fever
- Chronic, fat-filled, foul-smelling, heavy, loose stool
- Chronic exhaustion
- Muscle weakness or pain
- Anemia
- Osteoporosis
- Neurological conditions
- Skin conditions
- Reduced rate of growth in kids
Causes of Too Much Fat In Stool
Fat in stool may be due to consumption of foods having high amounts of fat and fiber like nuts. Too much fat in a person’s stool may not be a serious health issue and it happens when a person has taken a lot of fat, potassium oxalate, or fiber. Certain foods may have fats that are difficult to digest or indigestible, and when this is coupled with fibers, it can bring about steatorrhea. The foods and drinks that will make stool to have high amount of fat are:
- Artificial fats
- Excessive alcohol
- Nuts like whole nuts having the shell or skin intact
- Coconut or palm kernel oil
- Naturopathic oils or essential oils
- Oily, high-fat fish like oilfish and escolar. These can be mislabeled as fatty tuna or butterfish
- Whole wheat products having lots of fiber
Having too much fat in stool for a long time or when it is severe, it may indicate an underlying medical condition like enzyme deficiency, malabsorption, or gastrointestinal disease. Some of the known medical causes of excess fat in stool are:
- Kidney damage
- Pancreatic diseases
- Celiac disease
- Gallstones or removal of gallbladder
- Gallbladder cancer
- Cystic fibrosis
- Liver damage or failure
- Diabetes
- Cholesterol medication
- Obesity medications like carb and fat-blockers
- Intestinal damage or injury
- Gastric bypass surgery
- Bacterial infections involving the gastrointestinal tract particularly Clostridium difficile
- Lipid or fat metabolism disorder like Tay-Sachs disease and Gaucher disease
- Crohn’s disease
- Hypoparathyroidism or having very little parathyroid hormone
- Congenital heart failure
- Tropical sprue
- HIV
- Parasitic infection like Giardia
- Lymph damage or lymphoma
- Amyloidosis
- Diabetic medications
- Whipple disease – a bacterial infection involving the digestive system that interferes with the way an individual’s body breaks down carbohydrates and fats.
Your body may fail to absorb useful components of food that you eat like dietary fat. It also fails to adequately break down food, especially fat. Cystic fibrosis is a common condition that causes malabsorption. It’s an inherited disorder affecting mucus and sweat glands, and other organs in an individual’s body. Chronic pancreatitis is another condition that causes malabsorption leading to too much presence of fat in stool.
Diagnosing Fat In Stool
You want to consult a doctor when you notice that your stool is floating, appearing greasy, abnormally foul-smelling, and pale. You may also notice that you have other symptoms related to malabsorption like cramps and weight loss. A doctor will examine your symptoms and medical history. He or she may consider qualitative test and quantitative tests of your fecal fat.
Quantitative test: You will need to collect stool samples for about 4 or so days and the specimens are studied to establish the total fat amount for each day. Normal results for the test would show about 2 g to 7 g of fecal fat for 24 hours in adults. In adults fat should account for not more than 20 percent of solid matter. In infants, it’s less one gram for a period of 24 hours. In case of babies that are bottle-fed, fat needs to account for 30 to 50 percent of fecal solid matter. In breastfed babies, fat should be about 10 to 40 percent to be regarded as normal result.
Qualitative test: It is used to measure fat globules present in a single stool sample. The levels regarded as normal are those having no more than 50 neutral fat-globules as well as those having no more than 100 fat-globules of fatty acid. These can be seen under the microscope.
D-Xylose absorption test: This is done when it is suspected that too much stool fat is being caused by malabsorption. D-Xylose is a type of sugar and the test measures the levels of this sugar in urine or blood.
When preparing for the fecal fat tests, a person is asked to consume about 100 g of fat every day for three days before the test. The individual is also asked to fast for about 5 hours on the day of test just before they are tested. When taking 100 g of fat in a day, an individual considered healthy should be able to excrete about 7 g or less of fat in a day. Steatorrhea is clinically defined as passing excess of 7 g of fat in fecal matter or stool within a period of 24 hours after you have consumed 100 g of fat in a day.
Treatment of Excess Fat In Stool
Doctors will have to find out what is causing the fat in stool and device a treatment plan based on the cause. If fat in stool is related to diet, you may just need to avoid consuming foods that could trigger the symptoms. People who are lactose intolerant should avoid taking milk products or have them is small doses. People with celiac disease should avoid taking wheat or foods that comprise gluten. Medication and lifestyle changes can help with chronic pancreatitis and cystic fibrosis.
Medications that can treat and prevent steatorrhea are:
- Anti-diarrheal medications
- Intravenous fluids (IV) done to help restore electrolytes and prevent dehydration
- MHC oils
- Proton-pump inhibitors (PPIs)
- Pancreatic-enzyme replacement therapy or PERT
Home remedies that may help when you have excess fat in stool are:
- Using OTC gas, anti-bloating, and antacid medications
- Using OTC anti-diarrheal medications like bismuth subsalicylate and loperamide
- Staying hydrated
- Reducing fat intake in diet
- Reducing or quitting smoking
- Reducing dietary fiber
- Taking more of folic acid, vitamin B12, calcium, iron, and magnesium
- Taking more of fat-soluble vitamins
- Limiting potassium oxalate
- Reducing alcohol intake
- Take healthy fat and steer clear of processed fat. Good fat is obtained from avocados, coconut oil, fish, and eggs
