In short, steatorrhea, also spelled steatorrhoea, is a medical condition in which the amount of fat present in feces is higher than normal. However, the amount of fecal fat that is sufficient for diagnosis of steatorrhea has not been standardized.

This severely changes the appearance of stools, which can be very difficult to flush, they look oily, the color is pale and the odor is worse than usual. Similarly, many patients experience some form of fecal incontinence.

However, the problems with steatorrhea do not end with bad stool. Fat is an integral part of a number of internal bodily processes and its malabsorption can lead to reduced bone density, hampered blood clotting, excessive bleeding, easy bruising and vision impairment during lower  levels of light.

What are the causes of steatorrhea?

Fatty stools are mostly caused by problems with irregular digestion or absorption processes. The most common one is EPI (exocrine pancreatic insufficiency), which is a condition due to which pancreas fails to produce enough of its digestive enzymes. Other causes can be deficiency in lipases and bile salts as well as numerous intestinal diseases all of which can lead to impaired absorption.

Steatorrhea can also be caused by medication whose purpose or side effects include reducing fat absorption. One example of this is orlistat whose purpose is to reduce fat intake by blocking the fat-digesting enzymes. Reduced absorption of fat means that it needs to be excreted anally and this causes steatorrhea.

Some patients reported oily stool after eating too much whole nuts. Eating oil or butter from the same nuts is not connected to developing steatorrhea, since those are well absorbed, unlike lipids from whole nuts.

causes steatorrhea
Causes Steatorrhea
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Jojoba oil is indigestible, so consuming it causes steatorrhea. Similarly, consuming escolar  and butterfish also leads to steatorrhea.

Many diseases are also related to developing steatorrhea. Aside from the already mentioned exocrine pancreatic insufficiency, many conditions related to pancreas can lead to steatorrhea. These include cystic fiborsis, pancreatitits (inflammation of the pancreas) and various forms of pancreatic cancer which affect bile.

Graves’ disease is also a condition followed by steatorrhea.

Steatorrhea also occurs with conditions such as gallstones, liver damage, gallbladder removal surgery, primary sclerosing cholangitis, which is another inflammatory condition. All of these conditions, and many more, obstruct bile ducts.

Aside from bile and pancreas issues, steatorrhea also comes from intestinal fat malabsorption. It comes from conditions such as protozoan parasite infection, bacterial overgrowth, celiac disease (a genetic autoimmune disorder affecting the small intestine), abetalipoproteinemia (Bassen-Korzweig syndrome which hampers fat absorption due to a mutation in microsomal triglyceride transfew protein), inflammatory bowel disease (which is an expression denoting several different conditions within the small intestine and colon – the most common include Crohn’s disease and ulcerative colitis), short bowel syndrome, Zollinger-Ellison syndrome (a condition when stomach produces too much acids which cause peptic ulcers), tropical sprue (another inflammatory condition, this time of the lining of the small intestine) and more.

Diagnosis of steatorrhea

The most reliable method is determining the levels of fat in feces, although increased amounts of fat in feces can be noticed through visual inspection.

Treatment of steatorrhea

Having in mind that steatorrhea is usually accompanied by some other condition, or is a symptom for it, treatment is usually turned towards dealing with the cause. This means that the treatment options vary greatly. One of the most common solutions is taking digestive enzyme supplements.

As we have already mentioned, various forms of inflammation are among the most present causes for steatorrhea. This is what put the spotlight on PEA as one of the most effective and safest solutions.

PEA helps relieve pain and inflammation and promotes cell recovery. It brings cells back to their natural healthy state and restores homeostasis.

This is so due to the only ingredient in PEA capsules – pharmaceutical grade palmitoylethanolamide. Palmitoylethanolamide is an endogenous fatty acid which the body produces when cells need help. It is completely safe and easily broken down by enzymes, which means there is no way to overdose on PEA. However, our bodies produce enough palmitoylethanolamide to deal with mild conditions. For chronic and more severe ones, we need supplementation.

Inflammation is dealt with through PEA’s effects on mast and glia cells, whose calming reduces inflammatory response (relieving inflammation does away with one of the most common causes of steatorrhea), as well as through its cooperation with anandamide, another endogenous substance also known as the “bliss molecule”. Through this cooperation, PEA affects receptor CB2 which is widely spread all over our immune system. It controls hematopoietic cells, B cells and macrophages all of which play an important role in protecting our immunity by cleaning microbes and cellular debris, or creating antibodies.

The primary target of PEA is the receptor called PPAR-alpha. It controls the metabolism of lipids (fat) in the liver and it is also present in the intestines and kidneys, where it normalizes their functions.

PEA also binds to GPR55 and GPR119, the first of which is present in ileum and jejunum, which are parts of the intestines, while the second is in pancreas and gastrointestinal tract. The latter is also known for regulating the feeling of hunger.

PEA addresses several different diseases associated with steatorrhea and it works against inflammation and within the liver, kidneys and gastrointestinal tract. Moreover, its complete safety and lack of side effects means that it is perfect for prolonged usage and combination with any other medicine you might be taking for treating the underlying cause.