Steatorrhea

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is steatorrhea?

Steatorrhea is the medical term for fat in stool. Fat in the stool can cause bulky stool that floats, has an oily or greasy appearance, and smells foul. Fat in the stool is fat that the digestive tract was unable to absorb. Temporary steatorrhea may result from dietary changes or intestinal infections. Steatorrhea that is persistent may result from diseases of the biliary tract, pancreas, or intestines.

Fat absorption is dependent upon bile (which is produced in the liver and stored in the gallbladder), pancreatic lipases (enzymes that break down fat), and normal intestine function. Absence of bile is often due to blockage of the biliary tract and can result in pale colored fatty stool and jaundice. Absence of pancreatic lipases is uncommon, but can occur as a result of a diseased pancreas, cystic fibrosis, or an abnormality that is present at birth.

Inflammation of the lining of the intestines, which may occur with conditions such as ulcerative colitis (inflammation of the colon and rectum), Crohn’s disease (inflammation of the bowels), and celiac disease (a severe sensitivity to gluten in the diet), can interfere with absorption of fats. Also, fat absorption may be affected by surgical removal of a portion of the intestines.

Often, steatorrhea is a short-lived problem related to diet or infection; however, if it lasts for more than a couple of weeks, becomes more severe, or is accompanied by other symptoms, it may be due to a more serious condition. Seek immediate medical care (call 911) if you have bloody stool, black or tarry stool, stool with pus, severe abdominal pain or cramping, or high fever (higher than 101 degrees Fahrenheit).

If your steatorrhea is persistent or causes you concern, seek prompt medical care.

What other symptoms might occur with steatorrhea?

Steatorrhea may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Conditions that affect the digestive tract may also involve other body systems.

Digestive tract symptoms that may occur along with steatorrhea

Steatorrhea may accompany other symptoms affecting the digestive tract including:

  • Abdominal pain or cramping
  • Abdominal swelling, distension or bloating
  • Abnormally foul-smelling stools
  • Bloody stool (the blood may be red, black or tarry in texture)
  • Diarrhea
  • Gas
  • Nausea with or without vomiting
  • Pale feces

Other symptoms that may occur along with steatorrhea

Steatorrhea may accompany symptoms related to other body systems including:

Serious symptoms that might indicate a life-threatening condition

In some cases, steatorrhea may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bloody stool (blood may be red, black, or tarry in texture)
  • Change in level of consciousness or alertness, such as passing out or unresponsiveness
  • Chest pain, chest tightness, chest pressure, or palpitations
  • High fever (higher than 101 degrees Fahrenheit)
  • Not producing any urine, or an infant who does not produce the usual amount of wet diapers
  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, or labored breathing
  • Rigidity of the abdomen
  • Severe abdominal pain or sharp pain that comes on suddenly

What causes steatorrhea?

Temporary steatorrhea may result from dietary changes or intestinal infections. Steatorrhea that is persistent may result from diseases affecting the biliary tract, pancreas, or intestines.

Intestinal causes of steatorrhea

Steatorrhea may be caused by conditions affecting the intestines including:

  • Bacterial, parasitic or viral infection of the gastrointestinal tract

  • Bariatric (weight-loss) surgery

  • Celiac disease (severe sensitivity to gluten from wheat and other grains that causes intestinal damage)

  • Food intolerances (difficulty digesting certain foods without the symptoms of a food allergy)

  • Inflammatory bowel disease (including Crohn’s disease and ulcerative colitis)

  • Short-bowel syndrome (shortening of the intestine)

Biliary tract causes of steatorrhea

Steatorrhea can also be caused by diseases of the biliary tract including:

  • Biliary atresia (condition present at birth that involves failure of development of the bile ducts)

  • Biliary stricture (narrowing of the common bile duct, the tube that carries bile from the liver and gallbladder to the intestines)

  • Cholangiocarcinoma (cancer of the biliary tracts or gallbladder)

  • Gallstones

Causes of steatorrhea related to the pancreas

Steatorrhea can also be caused by conditions that affect the pancreas including:

  • Congenital pancreatic lipase deficiency (an abnormality of lipase production in the pancreas that is present at birth)

  • Cystic fibrosis (genetic disorder that interferes with lung and pancreatic function)

  • Pancreatic cancer

  • Pancreatitis (inflammation of the pancreas)

Questions for diagnosing the cause of steatorrhea

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your steatorrhea including:

  • When did you first notice steatorrhea?

  • Have you noticed any blood, mucus or pus in your stool?

  • Have you noticed a change in the color of your stool?

  • Do you have any other symptoms?

  • Have you recently made any changes to your diet?

  • Does anything make your symptoms go away or make it worse?

  • Have you had symptoms like this before?

  • Have you had surgery to remove part of your intestines?

  • What medications are you taking?

What are the potential complications of steatorrhea?

Because steatorrhea can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Anemia (low red blood cell count)

  • Failure to thrive in infants and children

  • Frequent serious or opportunistic infections

  • Growth problems in children

  • Intestinal obstruction and rupture of the intestinal wall

  • Poor nutrition due to vomiting, diarrhea, or a decreased desire to eat

  • Spread of cancer

  • Spread of infection

  • Surgery to remove parts of the digestive tract due to a serious infection or malignant condition

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 8
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Stools - floating. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003128.htm.
  2. Fecal fat. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004055/.