Steatorrhea is the presence of excess fat in feces.

Fatty stools may be bulky and difficult to flush, have a pale and oily appearance, and can be especially foul-smelling.

Some level of fecal incontinence may occur. 

There is increased fat excretion in the stool.

Impaired digestion or absorption can result in fatty stools. 

Causes of steatorrhea include: exocrine pancreatic insufficiency, with poor digestion from lack of lipases, loss of bile salts, which reduces micelle formation, and small intestinal disease-producing malabsorption, medicines that block fat absorption or indigestible or excess oil/fat in diet.

Other manifestations of fat malabsorption may also occur such as reduced bone density, difficulty with vision under low light levels, bleeding, bruising, and slow blood clotting times.

Exocrine pancreatic insufficiency can be caused by chronic pancreatitis, cystic fibrosis and pancreatic cancer.

Steatorrhea can occur with conditions affecting bile salts: Obstruction of the bile ducts by gallstones, primary sclerosing cholangitis, intrahepatic cholestasis, hypolipidemic drugs, or changes following cholecystectomy.

Conditions producing intestinal malabsorption: celiac disease, bacterial overgrowth, tropical sprue, Giardiasis, Zollinger-Ellison syndrome, short bowel syndrome, inflammatory bowel disease and abetalipoproteinemia.

Drugs that can produce steatorrhea include orlistat, octreotide or lanreotide.

Steatorrhea can occur in Graves’ disease.

Ezetimibe/simvastatin) tablets can cause steatorrhea in some people.

Stool lipids are increased when whole nuts are eaten, as lipids in nuts are significantly less well absorbed.

Consuming jojoba, escolar and oilfish will often cause steatorrhea.


Steatorrhea should be suspected when the stools are bulky, floating and foul-smelling.

Fats in feces can be measured.

Testing includes triglycerides test and fecal elastase, to detect possible fat maldigestion due to exocrine pancreatic insufficiency, or tests to detect other causes of malabsorption such as celiac disease.

Stool elastase levels of 200 µg per gram of stool or considered to be abnormal, but only very low values of 50 µg or less are reasonably predictive of steatorrhea.


Treatments are directed at the underlying cause, as well as digestive enzyme supplements.

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