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Family Medicine  (Expert Forum)
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another mysterious orange oily substance with bowel movement
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
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MedHelp Member's Question

another mysterious orange oily substance with bowel movement

by tulanebill, Dec 24, 2003 12:00AM
I had a triple by pass some three months ago, and for the past six weeks have observed an orange oily discharge with most of my bowel movements.  I took a digital picture of it in the commode this morning, and wonder if I could email it to you for your opinion.  I had a colonoscopy a few weeks ago, and they found no polyps at all, and they checked for blood in my stule and it was negative.



This oily orange substance floats on the top of the water in the commode, and seems to be mystifying every doctor that I have spoken with.....no one seems to have a clue, and I am afraid something may be wrong with my liver, not creating the proper bile to break down my food in the digestive process.....



Help!....Tulanebill



There does no appear to be any connection between the substance and my diet....for example, last night I drank a couple of old fashioned's, but this has happened in the past where I had not consumed any alcohol.....
Doctor's Answer

by Kevin Pho, MD, Dec 24, 2003 12:00AM
Oily or floating stools (steatorrhea) suggests malabsorption or chronic pancreatitis.  I would suggest tests to look for this.



For chronic pancreatitis, one can obtain a plain abdominal film to look for any calcifications.  Serum amylase and lipase levels can also be obtained.  If this is the case, pancreatic enzyme supplementation (using medication) is indicated.



For malabsorption, it would be a good idea to send the stool off for analysis.  A fecal fat test can be done to evaluate for fat malabsorption.  You can also test for celiac disease via a blood test.



You may want to discuss these possibilities with your personal physician.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



***I will be away and have limited internet access from December 26th to January 4th. I wish everyone a safe and happy holiday season.***



Take care,

Kevin, M.D.
Member Comments (10)

by farscape66, Dec 24, 2003 12:00AM
This is most like a gallbladder problem.  This happens to me on occasion. I have a large gallstone.  Stagnat bile backs up in the gallbladder. Then sometimes it's release can be triggered. It looks like an orange cowpile and floats.  Usually triggered by a meal especially high in fat.  Have your gallbladder scnned with ultrasound.  You got it right it is a bile related problem.  I am not a doctor but I know this one.  I have lots of info on this subject if you want it.

by kevinmd, Dec 24, 2003 12:00AM
To: *** Away from Dec. 26th to Jan. 4th ***
***I will be away and have limited internet access from December 26th to January 4th. I wish everyone a safe and happy holiday season.***



Take care,

Kevin, M.D.

by surgeon, Dec 25, 2003 12:00AM
I'd say the comment above about it being gallbladder related is very likely wrong: the statements of how bile flow behaves in relation to stones is not correct. One thing to consider is any medication or vitamins you might be taking now that you weren't before your bypass. One might also wonder if you are seeing increased mucus; that can be due to inflammation or infection of the colon, or polyps. If no other explanation is forthcoming, a scope exam of your colon might be indicated.

by Micha88, Jan 02, 2004 12:00AM
Hi,



I am a 35 yr old male.I have exactly the same symptom. The oil are droplets floating on the water and they are orange in color. I just had it day before yesterday. Yesterday, I inspected my stool again but the oil droplets are no longer there. However, today, there is blood in my stool which makes the whole toilet bowl red in color but there is no oil droplets. I do have piles and every once in a while there is bleeding but never before does it make the whole toilet bowl redI have mild pain in the lower abdomen. I went to my GP who said I might have Irritable Bowel Syndrome or it could be a viral infection. He just prescribe me some tablets to expel air from my stomach. What should I do? Any further suggestion or info is very much appreciated.



Is it really very abnormal to find oil droplets in stools? What should I do if I have chronic pancreatitis or bacteria infection as suggested?



Thanks a lot.



M.A

by Skylark, Jan 12, 2004 12:00AM
I have this "Oily Orange Bowel". Been having this for about one week now. Also, my other symptoms, are that it seemed like I had the flu. I have a pain in my chest (heartburn?), and imediate urge to take a bowel movement.



I had a surgery last year, a "Whipple Procedure", and was wondering if this is related. For those who do not know, the Whipple Procedure, is where the doctors think you have cancer. Usualy of the pancreas. So they go in, remove parts of your stomach, the head of the pancreas, part of your small bowel, and part of your liver. They remove the whole gall bladder, and then "re-connect" everything.



I have been taking "Nexium" ever since.



Anyone have any idea what is wrong ?

by marchienne, Feb 02, 2004 12:00AM
I am not a doctor, or even close, but i have been experiencing a similar problem. I am in perfect health other than this odd phenomenon of oil in the toilet.  after doing some research i found out that Olestra or Olean (fat substitute/fat blocker) that is used in some low-cal processed foods can cause this effect.



since i have be eating a lot of low-cal ruffles WOW! potato chips, i have noticed this effect.



I just wanted to bring this up in case any of you have been eating something with Olean or Olestra in it.



i also read that it blocks the absorption of beta kerotene, which is in in a lot of orange vegetables, so maybe that's making the oil turn orangey?







by SASSY-30, Feb 03, 2004 12:00AM
This is probably not very helpful but I too suffered this orange oil. 2 years in trying to explain this to my GI Doc I finally took a sample to him. Apart from the panic look on his face I new I wasn't a normal thing they see.  They sent it off to the lab but said it was contaminated "need another sample".  Three times I did this, all came back "for a re-test".  For three years I suffered this then it just stopped, I never found out what this was and don't think I ever will.  I don't think Doc's know the source of the oil and Malabsortion was ruled out, I've had so many tests all come back normal, the only thing that isn't is me so it seems.  If anyone finds out what this oil is I'd love to know.

by gills, Mar 02, 2004 12:00AM
Reading some of comments I can find similarities to my situation.  Years ago I was diagnosed with