Long chain fatty acids (LCFAs) are broken down by pancreatic lipase from dietary triglycerides and are normally readily absorbed by the intestinal mucosa. Elevated levels in the stool suggest fat malabsorption in the small bowel, possibly resulting from bile salt insufficiency, excessive dietary fat, or inflammation within the intestinal mucosa.

Physiological imbalances or disorders that impair lipase activity and bile acid production and release can lead to malabsorption.

Consider the following conditions to help determine the cause of impaired absorption:

– Pancreatic insufficiency (specifically lipase)

– Cholestasis (e.g., bilary obstruction or liver disease)

– Interrupted enterohepatic circulation (e.g., ileal disease or bile salt deconjugation from small bowel bacterial overgrowth)

– Celiac disease

– Short bowel syndrome

– Whipple’s disease (rare)

In general, an elevation in any one of the fecal fat markers is suggestive of malabsorption.

Consider also the following additional tests to help determine the underlying etiology:

– Celiac Panel

– Bacterial Overgrowth of the Small Intestine Breath Test

– Intestinal Permeability Profile