What are the symptoms of steatorrhea?

Steatorrhea is caused by various reasons in the body that lead to poor intestinal digestion or absorption function, which results in the inability to fully absorb food and easily excreted from the body with feces. Steatorrhea is also called indigestion syndrome, which will manifest as frequent diarrhea, abnormal stool color, or foul-smelling stool, etc. It can also easily lead to body edema, frequent abdominal pain and other symptoms. You should pay more attention to dietary regularity.

Clinical manifestations of steatorrhea

1. Local symptoms

80% to 97% of patients have diarrhea, which is typically steatorrhea. The stool is light-colored, large in volume, greasy or foamy, and often has a foul odor. The frequency of bowel movements ranges from a few times to more than ten times, and sometimes it is intermittent diarrhea. There may be abdominal distension, loss of appetite, etc., but abdominal pain is less common.

2. Systemic symptoms

Symptoms of malnutrition include weight loss, fatigue, tetany, paresthesia, stomatitis, dry cornea, night blindness, edema, etc. Long-term steatorrhea in children can cause developmental delay, small stature, etc.

3. Physical signs

There may be signs such as weight loss, mild abdominal tenderness, paresthesia of the extremities, stomatitis or ulcers, pellagra-like coloration, edema, concave nails, muscle tenderness, and clubbing of fingers (toes).

examine

1. Stool examination

Including appearance, microscopic examination and culture. During microscopic examination, pay attention to the presence of red blood cells, white blood cells, ova, protozoa, etc. Sudan III staining can be used to check for the presence of fat droplets. Fungal examination and bacterial spectrum analysis of stool are helpful in the etiological diagnosis of diarrhea.

2. Microscopic examination of fecal fat

(1) Place a small amount of feces on a glass slide and mix with 1 to 2 drops of saturated Sudan III solution for microscopic examination. Neutral fat can be seen in the form of scarlet round oil droplets; free fatty acids are in the form of dark yellow-red needle-like bundles or short, thin curved needle-like crystals; and bound fatty acids are not colored and appear in the form of piled needles or arranged in a fan shape.

(2) Take one drop each of physiological saline and scarlet red dye saturated alcohol solution, add a small amount of feces and mix well on a glass slide, then cover with a coverslip for microscopic examination. Bubble-shaped neutral fat and crystalline fatty acids can be seen. If more than 1/4 of the specimen is stained red, the test is strongly positive (10+10 or 10+10+10), indicating severe steatorrhea.

3. Quantitative determination of fecal fat

The Vandekamer method is generally used. The test method is: eat a standard meal (containing 60-100g of fat/day) continuously for 3 days, and measure the fecal fat content for 3 days at the same time. Take the daily average value. If the fecal fat amount is >6g per day, or the fat absorption rate is <95%, it can be considered as fat malabsorption.

4. Absorption function test

D-xylose absorption test, vitamin B12 absorption test, pancreatic function test, etc.

5. Other auxiliary examinations

Routine blood test, erythrocyte sedimentation rate, electrolytes, urea nitrogen, carbon dioxide binding capacity, etc. If gastric origin of diarrhea is suspected, gastric fluid analysis should be performed. For patients suspected of hyperthyroidism, relevant tests such as basal metabolic rate, thyroid iodine uptake rate, etc. can be performed. Pancreatic function tests, imaging studies, and endoscopy can help diagnose primary pancreatic and gastrointestinal diseases that cause steatorrhea.