Steatorrhea and Weight Gain

[fransky]

I've had loose, short and flat stools along with steatorrhea (23 g/24 hrs) no more than once per day for at least four years. I am male and 52 y/o. I have loss of muscle tone, spinal osteopenia and, at 225 pounds, I am fifty pounds overweight. I have no digestive pain, I have lots of energy and I follow a very healthy diet. I have a normal abdominal CT, abdominal ultrasound, liver function and lower GI series. I've tried almost every nutritional supplement in the book, although I have no identifiable nutritional deficiency, but my body hasn't been able to heal itself. I don't use any drugs, including alcohol and tobacco. I used to be a competitive swimmer before these symptoms began but I had to stop because of the muscle tone and bone loss. Your insight is extremely appreciated.

[Kevin Pho, MD]

Steatorrhea can be caused by chronic pancreatitis or various causes of malabsorption.  The normal CT scan would make chronic pancreatitis less likely.  I would consider a lower endoscopy (i.e. colonoscopy) to evaluate for any type of malabsorption.  Blood tests can also be considered to look for celiac disease.  

These options can be discussed with your personal physician or on conjunction with a GI opinion.

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.

Kevin, M.D.
kevinmd_

[fransky]

My confusion is that if I am malabsorbing, why am I gaining weight. I've seen people with malabsorption and they are skinny.

[Eyes have it]

While most people with malabsorption do lose weight that is not always the case.  My daughter is being successfully treated for malabsorption.  Her weight is quite stable when medicated but will rise rapidly when she is off her meds.  If you read about celiac and other malabsorption disorders you will see that weight gain can be a symptom.  Follow up with a GI.  I hope you find a treatment that is as effective as my daughter’s has been.

[fransky]

Your daughter's weight gain when off her medications sounds like she is retaining water from protein loss due to malabsorption. That is not something that is happening to me. I've already stumped a number of GIs. I'd thought I'd ask here for a differential diagnosis. Thanks for your help.

[debfromoakland]

The muscle tone loss and weight gain issues sound like hormonal to me.  Have you dealt w/ an endocrinologist?  Loss of muscle tone for a man at your age seems like a testosterone, or some hormone, issue.