When you eat fat, a small amount of the fat passes out the body through the colon. Some of the different types of fats in the feces include phospholipids, sterols, sphingolipids, cholesteryl esters, glycolipids, soaps and glycerides.
The technical term for too much fat in your stool is steatorrhea. If excess amounts of fat are in the stool, it means the fat is not being absorbed, and there’s malabsorption. This means the fat isn’t being broken down properly by enzymes. It could be because the pancreas is not working properly (potentially due to Whipple disease or another malabsorption disorder).
The Fecal Fat test helps your doctor identify if you have pancreatic or intestinal disorders. It can also show that enzymes, which are prescribed are working in the case of known malabsorption disorders.
Normal Ranges for Fecal Fat in grams fat/24 hours:
18 years and older: 2-7 grams fat/24 hours with <20% fat in the sample
Normal ranges have not been established for patients who are <18 years old.
Infants: < 1 gram/24 hours (with 10-40% fat in breastfed babies and 30-50% fat in bottle-fed babies)
Critical value: > 7 grams fat/24 hours when eating a 100-150 gram fat diet shows malabsorption issues.
All ages: 0-19% fat
Note: If a timed fecal fat is done first, the test may be done over 24, 48, 72 or 96 hours. If the random fecal fat test is done, test values are recorded in percentages. If results for a random specimen are abnormal, a timed collection should be done.
To date, there is minimal literature on the clinical significance of reduced fecal fats. As they are largely of dietary origin, an overall low recovery of these absorptive markers is suggestive of a diet low in fat. Another consideration would be increased intestinal absorption, particularly if dietary fat intake is adequate.
Low levels of Fecal Fat may result from any of the following:
- Mineral oil
If low-fat diet: Consider amount of dietary intake of fat.
Malabsorption occurs when your intestines are not absorbing food as they should, and aren’t assimilating nutrients. It could also happen if you don’t have enough digestive enzymes or not enough bile. Bile is especially important to emulsify or break down the fats during digestion.
Malabsorption causes any of the following symptoms:
- Cramps after eating
- Bad-smelling, fatty stools
- Loose stools
- Weight loss without being on a diet
Some specific causes of high Fecal Fat might be:
- Use of ointments for diaper rash
- The use of barium enemas or having used barium in other medical procedures
- Celiac disease
- Eating too much fiber in your diet
- Use of the medication called Orlistat
- Ingesting Castor oil
- Chronic pancreatitis
- Cystic fibrosis
- Gall bladder stone obstruction
- Tumors in the pancreas, gallbladder, or surrounding organs
- Whipple disease
- Crohn’s disease
- Radiation enteritis
- Small bowel bacterial overgrowth
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