Re: FECAL FATS

Posted By Donna D on September 13, 1998 at 05:11:09:

In Reply to: Re: FECAL FATS posted by HFHSM.D.-ym on September 12, 1998 at 22:56:03:






: : I have had several tests for fecal fat. The latest three day collection showed a total fat of 12 g a day. The weight came in at 1100 g a day(approx). My doctors don't really explain what this means other than to say the fats aren't "normal". Any further info would be appreciated!:)
Dear Donna D.,
Steatorrhea (increased fat excretion in the stool secondary to fat malabsorption) has a variety of causes. Some of these causes include: chronic pancreatitis, reduced availability of bile salts (necessary for fat absorption), reduction in length of the small intestine (such as in short bowel syndrome) or obstruction of lymphatic channels. Steatorrhea often presents with diarrhea, weight loss and greasy, oily stools that sometimes float to the surface of the toilet. A normal person generally absorbs 95-98 percent of dietary lipid. Normal fecal fat excretion should be less than 4-6 grams/day during a 100 gram fat diet. Intestinal malabsorption of fat is often accompanied by malabsorption of carbohydrates, protein, other nutrients, water and electrolytes.
Quantitative measurement of the fat in a timed stool collection (72 hour fecal fat) obtained during controlled dietary fat ingestion has a high degree of sensitivity and specificity for fat malabsorption and is often obtained when a precise diagnosis of steatorrhea is important. If 24 hour fecal fat excretion is less than 5 grams and the combined stool weight is less than 200-250 grams mucosal or pancreatic disease can almost always be excluded. However, patients with symptomatic carbohydrate malabsorption may have increased fecal weight from the increased water but no increase in fecal fat. Fecal fat can be abnormally increased in patients who are taking mineral oil or other  poorly digested lipids. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Muszkat one of our experts in Gastroenterology.
HFHSM.D.-ym
: *Keywords: steatorrhea, fecal fat excretion
Thanks for your reply, it was VERY informative. One more clarification, the weight volume of my 72 hour can this last time came in at around 1100g per day. Last time it was aroung 950 g . I have had my colon (ALL of it) removed. Is this measurement about right for that situation, or is it still high? APPRECIATE IT !!!donna:)
Dear Donna D.,
Elevated fecal fat is not normal, but after a total colectomy it can occur. This is especially true if part of the terminal ileum is resected, diseased or used to fashion an ileoanal anastomosis. Bile acids are actively absorbed in the terminal ileum and if this enterohepatic circulation is disrupted, fat malabsorption can occur. If only a small amount of ileum is resected a medication called cholestyramine (Questran, Prevalite) can help improve diarrhea, but if more than 100 cm of ileum has been resected, a low fat diet and medium chain triglycerides (directly absorbed into the circulation without the need for bile salts) is the treatment. I hope you find this information helpful.
Wish I could tell you just HOW WONDERFUL it is to have access to straightforward, very helpful information!  You have been supremely beneficial to me and I wish I new how to say it differently so that it would be clear JUST HOW MUCH it is appreciated. Thanks, donna
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568 our Referring Physicians' Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: elevated fecal fat