Steatorrhea

Introduction Steatorrhea is a manifestation of digestive malabsorption syndrome, commonly known as oil-like diarrhea. Refers to diarrhea caused by digestion and malabsorption of fat. There are many diseases that can cause steatorrhea. The main manifestations of steatorrhea are diarrhea, abdominal fullness, loss of appetite, backward development, small size, malnutrition, and different prognosis of steatorrhea caused by different diseases. Most of the elimination of the cause of steatorrhea can be relieved.

Cause

There are several types of diseases that can cause steatorrhea:

Chronic pancreatitis and pancreatic cancer in pancreatic lesions. Mainly due to the significant decrease in pancreatic lipase secreted by the pancreas, resulting in fat indigestion, resulting in a large amount of fatty substances discharged from the stool.

Extrahepatic biliary obstruction in the biliary obstruction lesion, or obstruction of the intrahepatic biliary tract. Because biliary obstruction is most likely to cause bile retention, bile composition changes, resulting in a significant decrease in bile acid concentration in the intestinal lumen, which affects the digestion of fat hydrolysis and fatty acid decomposition, forcing fat to excrete from the stool and cause steatorrhea. Extensive resection of the small intestine in small bowel disease, primary intestinal lymphoma, intestinal ischemia caused by arteriosclerosis, intestinal lipid metabolism syndrome, eosinophilic gastroenteritis, food allergies, etc., may damage the small intestine mucosa The digestive function of epithelial cells produces steatorrhea.

Adrenal insufficiency, hypothyroidism, and even steatorrhea in a small number of hyperthyroidism patients in endocrine diseases. This is because of endocrine disorders, which are prone to cause lipid metabolism disorders, and steatorrhea occurs. Also, such as beta lipoproteinemia, gamma globulinemia, most of the stomach resection, and scleroderma are also likely to cause decreased fat metabolism and steatorrhea.

an examination

Related inspection

Basal metabolism, blood electrolyte, examination, fecal fat, fecal fat, fecal fat, quantitative

1. Fecal examination is the most basic examination of Abdominal Enlightenment, including appearance, microscopic examination and culture. Microscopic examination should pay attention to the presence or absence of red blood cells, white blood cells, eggs, protozoa, etc. Different staining of the application can achieve different detection purposes. For example, dry gram staining can be used for bacteriological examination. Note that the proportion of clubs can be checked by Sudan III staining for fat. Drops, iodine stained chicken nests with or without starch granules. The true examination of the stool and the analysis of the bacteria spectrum contribute to the etiological diagnosis of diarrhea.

2. Other tests for blood routine, erythrocyte sedimentation rate, electrolytes, urea nitrogen, and carbon dioxide binding. If suspected of gastric diarrhea, gastric juice analysis should be performed. For patients suspected of hyperthyroidism, relevant tests such as basal metabolic rate and thyroid iodine absorption rate can be performed.

3, absorption function check

D-xylose absorption test, vitamin B12 absorption test, pancreatic function test, and the like. Mainly used for the diagnosis of steatorrhea, indicating that diarrhea is pancreatic.

Differential diagnosis

Atherosclerosis: a clinical manifestation of childhood pancreatic insufficiency and neutropenia syndrome. Pancreatic insufficiency in children and neutropenic syndrome were reported by Shwachman in 1964, so it is also called Shwachman syndrome, Shwachman-Diamond syndrome. Intrinsic is a congenital pancreatic insufficiency accompanied by hypoplasia of the bone marrow hematopoietic system. More than 2 to 10 months of infants and young children, there is a familial incidence, may be autosomal recessive inheritance.

Mainly due to insufficient exocrine function, such as amylase, protease, lipase reduction or lack, manifested as loss of appetite, nausea and vomiting, diarrhea, atherogenic diarrhea, steatorrhea or celiac disease. Intestinal manifestations may have physical developmental malnutrition, such as short stature deformity and development of long bone epiphysis. Due to the abnormal development of the bone marrow, the expression of neutrophils is reduced, the resistance is decreased, and the respiratory tract infection, otitis media, and sinusitis are easily combined, and the reduction of anemia and platelets can also be exhibited.

Celiac disease: previously known as non-tropical sarcolemma (celiac disease), also known as chyluene diarrhea, glucan-induced enteropathy (glutinine-induced enteropathy). People who suffer from this disease eat more pasta. If they do not eat pasta, the symptoms can be alleviated. Therefore, it is suggested that wheat gelatin may be the causative factor of this disease. Rubin later confirmed this view. Rubin injects wheat flour into the jejunum of a stationary patient, which can cause symptoms and reveal pathological changes in the intestinal mucosa.

Explosive water diarrhea: a type of diarrhea, the frequency of bowel movements is significantly higher than the frequency of usual habits, thin feces, increased water, daily defecation more than 200g, or contains undigested food or pus and mucus. Diarrhea is often accompanied by symptoms such as urgency of bowel movements, anal discomfort, and incontinence.

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