Steatorrhea natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]Sunny Kumar MD [3]
Overview
Steatorrhea on long term basis leads to deficiency of important nutrients. These deficiency ultimately effect body functions.
Natural History
The importance for the parthenogenesis of steatorrhea is deficiency of enzymes required for digestion of fatty food, or absorption of digested fatty food. The mechanism may be different for patients having steatorrhea and the microscopic picture of every pathology may be different but the effect of loosing fat in stool is similar in all patients. Steatorrhea was caused by the decreased enzymatic function of the pancreas, asynchronism of the food and bile supply to the intestinal lumen, disorders of absorption of lipolysis products.
These are the main causes that can lead to the appearance of steatorrhea:[1][2][3][4][5]
Inadequate production of bile (bile acids lacking)
Liver damage
Medication to reduce the level of lipids in the blood (hypolipidemic)
Surgical removal of gallbladder (cholecystectomy)
Pancreatic enzyme defect
Defect at the level of the mucosal cells
Medication that has as purpose the blockage of fat absorption
Fat rich diet (indigestible or excess oils in the diet might cause similar problems)
Acromegaly treatment as Somatostatin analogues – octreotide, lanreotide (adverse effect)
Eating nuts in large quantities (such as cashews)
Jojoba oil (indigestible oil)
Escolar/oilfish consumption
Consumption of artificial fats.
Complications
The outcomes of steatorrhea are explained as below:
Adults:
Anemia,
Intestinal obstruction
Weight loss.
Children:
Failure to thrive
Anemia
Weight loss
Prognosis
Prognosis generaly is good once the cause are treated and if replacement therapy is started . Most of the time it depend on the the cause of loosing fat in stool.
References
- ↑ Scarpignato C, Gatta L, Zullo A, Blandizzi C, SIF-AIGO-FIMMG Group. Italian Society of Pharmacology, the Italian Association of Hospital Gastroenterologists, and the Italian Federation of General Practitioners (2016). "Effective and safe proton pump inhibitor therapy in acid-related diseases - A position paper addressing benefits and potential harms of acid suppression". BMC Med. 14 (1): 179. doi:10.1186/s12916-016-0718-z. PMC 5101793. PMID 27825371.
- ↑ Podboy A, Anderson BW, Sweetser S (2016). "61-Year-Old Man With Chronic Diarrhea". Mayo Clin Proc. 91 (2): e23–8. doi:10.1016/j.mayocp.2015.07.033. PMID 26769182.
- ↑ Burnett JR, Hooper AJ (2015). "Vitamin E and oxidative stress in abetalipoproteinemia and familial hypobetalipoproteinemia". Free Radic Biol Med. 88 (Pt A): 59–62. doi:10.1016/j.freeradbiomed.2015.05.044. PMID 26086616.
- ↑ Valenzise M, Alessi L, Bruno E, Cama V, Costanzo D, Genovese C; et al. (2016). "APECED syndrome in childhood: clinical spectrum is enlarging". Minerva Pediatr. 68 (3): 226–9. PMID 25502918.
- ↑ Wilcox C, Turner J, Green J (2014). "Systematic review: the management of chronic diarrhoea due to bile acid malabsorption". Aliment Pharmacol Ther. 39 (9): 923–39. doi:10.1111/apt.12684. PMID 24602022.