Loose greasy stools

Loose greasy stools


  • Malabsorption
  • Answers to 7 FAQs About Poop
  • Diarrheal Diseases – Acute and Chronic
  • Gastrointestinal Problems: Greasy, Bulky Stools
  • What Your Pet’s Stools Say About Their Health
  • Malabsorption

    Print Overview Acute diarrhea is one of the most commonly reported illnesses in the United States, second only to respiratory infections. Worldwide, it is a leading cause of mortality in children younger than four years old, especially in the developing world. Diarrhea that lasts less than 2 weeks is termed acute diarrhea.

    Persistent diarrhea lasts between 2 and 4 weeks. Chronic diarrhea lasts longer than 4 weeks. Symptoms Diarrheal stools are those that take shape of the container, so they are often described as loose or watery. Some people consider diarrhea as an increase in the number of stools, but stool consistency is really the hallmark.

    Associated symptoms can include abdominal cramps fever, nausea, vomiting, fatigue and urgency. Chronic diarrhea can be accompanied by weight loss, malnutrition, abdominal pain or other symptoms of the underling illness.

    Clues for organic disease are weight loss, diarrhea that wakes you up at night, or blood in the stools. These are signs that your doctor will want to do a thorough evaluation to determine the cause of your symptoms.

    Also tell your doctor if you have a family history of celiac disease, inflammatory bowel disease IBD , have unintentional weight loss, fever, abdominal cramping or decreased appetite. Tell your doctor if you experience bulky, greasy or very bad smelling stools.

    Causes — Acute Diarrhea Most cases of acute, watery diarrhea are caused by viruses viral gastroenteritis. Causes — Chronic Diarrhea Chronic diarrhea is classified as fatty or malabsorption, inflammatory or most commonly watery.

    Chronic bloody diarrhea may be due to inflammatory bowel disease IBD , which is ulcerative colitis or Crohn's disease.

    Other less common causes include ischemia of the gut, infections, radiation therapy and colon cancer or polyps. Infections leading to chronic diarrhea are uncommon, with the exception of parasites.

    The two major causes of fatty or malabsorptive diarrhea are impaired digestion of fats due to low pancreatic enzyme levels and impaired absorption of fats due to small bowel disease. These conditions interfere with the normal processing of fats in the diet. The former is usually due to chronic pancreatitis which is a result of chronic injury to the pancreas.

    Alcohol damage to the pancreas is the most common cause of chronic pancreatitis in the United States. Other causes of chronic pancreatitis include cystic fibrosis, hereditary pancreatitis, trauma to the pancreas and pancreatic cancer.

    The most common small bowel disease in the U. There are many causes of watery diarrhea, including carbohydrate malabsorption such as lactose, sorbitol, and fructose intolerance. Symptoms of abdominal bloating and excessive gas after consuming dairy products suggests lactose intolerance. This condition is more common in African-Americans and Asian-Americans. Certain soft drinks, juices, dried fruits and gums contain sorbitol and fructose, which can lead to watery diarrhea in people with sorbitol and fructose intolerance.

    Diarrhea is a frequent side effect of antibiotics. Certain other medications such as NSAIDs, antacids, antihypertensives, antibiotics and antiarrhythmics can have side effects leading to diarrhea. Parasitic intestinal infections such as giardiasis can cause chronic diarrhea.

    Diabetes mellitus may be associated with diarrhea due to nerve damage and bacterial overgrowth; this occurs mainly in patients with long-standing, poorly-controlled diabetes. Irritable bowel syndrome IBS is a condition often associated with diarrhea, constipation or more frequently alternating diarrhea and constipation. Other common symptoms are bloating, abdominal pain relieved with defecation and a sense of incomplete evacuation. Risk Factors Exposure to infectious agents is the major risk factor for acute diarrhea.

    Bacteria and viruses are often transmitted by the fecal-oral route, so hand washing and hygiene are important to prevent infection. Soap and water are better because alcohol-based hand sanitizers may not kill viruses. Medications such as antibiotics and drugs that contain magnesium products are also common offenders. Recent dietary changes can also lead to acute diarrhea.

    These including intake of coffee, tea, colas, dietetic foods, gums or mints that contain poorly absorbable sugars. Acute bloody diarrhea suggests a bacterial cause like Campylobacter, Salmonella or Shigella or Shiga-toxin E.

    The best method of prevention is to avoid eating and drinking contaminated or raw foods and beverages. See a doctor if you feel ill, have bloody diarrhea, severe abdominal pain or diarrhea lasting more than 48 hours.

    In patients with mild acute diarrhea, no laboratory evaluation is needed because the illness generally resolves quickly. Your doctor may perform stool tests for bacteria and parasites if your diarrhea is severe or bloody or if you traveled to an area where infections are common. If you have severe diarrhea, blood tests will be helpful to guide replacement of fluid and electrolytes and minerals such as magnesium, potassium and zinc that can become depleted.

    If you have chronic diarrhea, your doctor will want to further assess etiologic factors or complications of diarrhea by obtaining several tests. These can include a blood count to look for anemia and infections, an electrolyte and kidney function panel to assess for electrolyte abnormalities and renal insufficiency, and albumin to assess your nutritional status.

    A stool sample may help define the type of diarrhea. The presence of fat, microscopic amounts of blood, and white blood cells will help determine if a fatty, inflammatory, or watery diarrhea is present. Endoscopic examination of the colon with flexible sigmoidoscopy or colonoscopy and upper endoscopy are helpful in detecting the etiology of chronic diarrhea, as this allows direct examination of the bowel mucosa and the ability to obtain biopsies for microscopic evaluation.

    Double-balloon enteroscopy and capsule endoscopy are sometimes used to examine the mucosa of the small intestine that lies beyond the reach of conventional endoscopes. Radiographic studies such as an upper GI series or barium enema are not routinely performed in the evaluation of chronic diarrhea, and have largely been replaced by cross-sectional imaging. Ultrasound and CT scan of the abdomen can be helpful to evaluate the bowel, pancreas and other intra-abdominal organs.

    Treating Acute Diarrhea It is important to take plenty of fluid with sugar and salt to avoid dehydration. Salt and sugar together in a beverage help your intestine absorb fluids. Milk and dairy products should be avoided for 24 to 48 hours as they can make diarrhea worse.

    Initial dietary choices when refeeding should begin with soups and broth. Anti-diarrheal drug therapy can be helpful to control severe symptoms, and includes bismuth subsalicylate and antimotility agents such as loperamide. These, however, should be avoided in people with high fever or bloody diarrhea as they can worsen severe colon infections and in children because the use of anti-diarrheals can lead to complications of hemolytic uremic syndrome in cases of Shiga-toxin E.

    Your doctor may prescribe antibiotics if you have high fever, dysentery, or moderate to severe traveler's diarrhea. Some infections such as Shigella always require antibiotic therapy. Treatment of chronic diarrhea depends on the etiology of the chronic diarrhea. Often, empiric treatment can be provided for symptomatic relief, when a specific diagnosis is not reached, or when a diagnosis that is not specifically treatable is reached. Antimotility agents such as loperamide are the most effective agents for the treatment of chronic diarrhea.

    They reduce symptoms as well as stool weight. Attention should be paid to replacing any mineral and vitamin deficiencies, especially calcium, potassium, magnesium and zinc. Updated April Updated December

    Answers to 7 FAQs About Poop

    Malabsorption Malabsorption refers to decreased intestinal absorption of carbohydrate, protein, fat, minerals or vitamins. There are many symptoms associated with malabsorption. Weight loss, diarrhea, greasy stools due to high fat content , abdominal bloating and gas are suggestive of malabsorption. Vitamin and mineral deficiencies resulting from malabsorption may cause glossitis sore tongue , cheilosis a fissuring and dry scaling of the surface of the lips and angles of the mouth , and anemia.

    Chronic diarrhea is often the first symptom prompting one to seek medical evaluation, although diarrhea need not be present for one to have malabsorption.

    Steatorrhea, or fatty stools, is indicative of malabsorption. Stools will be frothy, foul smelling, and a ring of oil may be left on the toilet water. The gastrointestinal tract and liver play key roles in the digestion, absorption and metabolism of nutrients. Diseases of the gastrointestinal tract and liver may profoundly disturb normal nutrition. An understanding of the anatomy of the gastrointestinal tract as well as the role each major segment plays in the digestion and absorption of food will help one understand the causes of malabsorption and shed light on the rationale for specific treatment regimens.

    In order for food to be absorbed, it must first be digested. Digestion is the mechanical and chemical process by which food is prepared for absorption. After a meal, food must first be broken down into simpler substances that can pass through the cells of the small intestine into the blood which transports them to all the cells of the body.

    The cells of the body can utilize these simpler substances as a source of energy. Digestion converts dietary protein into simple amino acids, dietary fats into fatty acids and monoglycerides, and starch into glucose. Anatomical and physiological considerations Digestion of food begins in the mouth where through the mechanical action of chewing and the chemical action of enzymes found in saliva, a bolus of food is formed and then passes through the esophagus.

    Contraction of the muscles in the esophagus moves the food bolus into the stomach by a process called peristalsis. Once in the stomach, the food is broken down further by strong contractions which expose it to gastric juices including hydrochloric acid and digestive enzymes which are secreted by glands in the lining of the stomach. The food is eventually converted into a liquid material called chyme which is then passed into the first part of the small intestine, the duodenum.

    The intestine is where food is eventually absorbed. In the intestine, the presence of chyme stimulates the production and release of a variety of enzymes from the pancreas and small intestinal glands. Each enzyme has a specific role in digestion. There are special enzymes that digest protein into amino acids, starch into glucose and fat into fatty acids.

    The liver produces a substance called bile which helps to digest fat. Bile is formed in the liver, stored in the gallbladder and released into the small intestine as needed. The small intestine is about 23 feet long in the adult and has three segments. The duodenum is the first part of the small intestine and is about 10 inches long. The jejunum is the middle segment of the small intestine and is about 8 feet long. The last portion of the small intestine, the ileum, is about 12 feet long.

    The absorptive surface of the small intestine is greatly enhanced by the numerous folds and finger-like projections called villi and microvilli. It has been estimated that given all the folds, villi and microvilli, the total absorptive surface of the small intestine is about the size of a half of a basketball court!

    Absorption of nutrients takes place all along the intestine, but each segment of the intestine absorbs only certain nutrients. Carbohydrates are ingested primarily in the form of starch or carbohydrates, sucrose table sugar , fructose fruit sugar and lactose milk sugar.

    Salivary and pancreatic amylase digestive enzymes break up the starch into long chains of sugars called oligosaccharides and shorter chains called disaccharides and trisaccharides. Most starch hydrolysis breaking up a molecule into its smaller components occurs in the duodenum and absorption takes place in the duodenum and jejunum. Specific enzymes that hydrolyze disaccharides disaccharidases into their simplest forms or monosaccharides are located along the small intestine microvilli.

    Once the sugar is in the form of a monosaccharide, it can then be absorbed into the blood. Carbohydrate malabsorption occurs in pancreatic disease, in selective deficiency of disaccharidases such as lactase digests lactose or sucrase digests sucrose , in disorders of small intestinal cell function such as sprue or regional enteritis, and in loss of intestinal mucosal surface which occurs after resection of bowel.

    Abdominal distention, bloating and gas may be signs of carbohydrate malabsorption. Proteins are broken down into long chains of amino acids by pancreatic enzymes. Small intestinal enzymes activate the pancreatic enzymes so that digestion and absorption of protein can take place.

    Absorption of amino acids and peptides occurs in the duodenum and jejunum. Dietary fat is normally absorbed in the duodenum and jejunum.

    Before fat can be absorbed, however, it must first be made into a water-soluble form. Broken down dietary fats combine with bile salts and phospholipids substances present in bile from the liver to form a packet called a micelle.

    The micelle is water-soluble and is easily absorbed in the duodenum and jejunum. Large amounts of water are involved in digestion and must be recycled in order to prevent dehydration. Water is reabsorbed in the large intestine.

    From the large intestine, water goes back into the bloodstream and the waste passes into the rectum and out the anus. Tests for malabsorption There are several tests that can be performed to help diagnose malabsorption: Blood tests These can be used to identify suspected malabsorption and are usually the first tests done. They are not specific because low levels of certain substances could be due to disorders other than malabsorption e.

    Blood carotene levels are useful to screen for malabsorption. Low levels of carotene in the blood suggest deficient absorption of fat-soluble vitamins or dietary deficiency. Serum carotene levels are generally low in people with fat malabsorption. Vitamin B12 and folate levels may also be used to screen for malabsorption. There are numerous causes of folate and B12 deficiency, and since the deficiencies often occur together and cause similar types of anemia, both must be measured to ensure proper diagnosis.

    Low calcium levels may result from either malabsorption of vitamin D or to binding of calcium to unabsorbed fatty acids. Vitamin K deficiency resulting from malabsorption may cause bleeding disorders.

    Anemia due to iron deficiency may be caused by malabsorption of iron in the first part of the small bowel. Normal levels of carotene, vitamin B12, folate, iron, calcium, phosphorus, albumin, and protein suggest that malabsorption is not a significant problem.

    Another type of blood sampling can be used to test absorption. A substance can be administered orally and its concentration is then measured in the blood to provide a measure of absorptive capacity.

    The most commonly used test is the D-xylose test. A sugar called xylose is given orally and then measured in the blood 2 hours later. Stool tests Tests of the fat content of stool may be used to determine if fat malabsorption is present. Stool is collected over a period of 72 hours with the person consuming a diet containing g of fat per day. If the amount of fat in the stool is high, it suggests that the body is not absorbing fat.

    Breath tests Breath tests are another method of detecting malabsorption. They are most often performed to test for lactose intolerance. If lactose is being malabsorbed, colonic bacteria will work on the lactose to produce hydrogen gas which will be exhaled by the patient and measured in his or her breath.

    Other tests Tests such as biopsies of the small intestine usually performed using an endoscope passed through the mouth into the intestine are used to diagnose certain malabsorptive conditions. Special tests to image organs such as the pancreas are also useful in some cases. Specific malabsorptive states Lactose Intolerance Perhaps the most common malabsorptive state is due to lactose malabsorption. This is a genetically determined condition and affects many individuals of African or Asian descent.

    In these persons, the body lacks an enzyme to digest lactose, a sugar present in milk, and bloating and diarrhea can result. The enzyme may be totally absent or present in reduced amount so that symptoms may vary depending on the amount of lactose ingested.

    The amount of the enzyme decreases with age and some people first notice symptoms when they reach their twenties. Dairy products are an important source of calcium and this should be considered in planning diets for lactose-intolerant subjects. Lactose intolerance is widespread and under-diagnosed. Recognizing this condition and using milk treated with enzymes to pre-digest the lactose or taking enzyme tablets with dairy products can correct symptoms related to this condition.

    Learn more about lactose intolerance Small intestinal disease Surgical resection or diseases of the small intestine may result in varying degrees of malabsorption depending on the site of resection or disease. Diseases involving the duodenum may be associated with lactose intolerance, poor tolerance of concentrated sugars, and decreased absorption of iron and calcium. Almost all nutrients are usually absorbed in the first three to five feet of the bowel.

    The absorption of most minerals especially iron, calcium and zinc, as well as most vitamins occurs in the upper part of the small intestine. The ileum plays a major role in reabsorption of bile salts, substances produced by the liver to help digest fats that are recycled by the body for use with future meals. The ileum is also important in vitamin B12 absorption.

    If bile salts are not absorbed properly, the amount of these substances in bile falls and fats and fat soluble vitamins A, D, E, K , cannot be properly absorbed. A further problem is that if bile salts reach the colon, they can cause large amounts of fluid to be secreted causing watery diarrhea. If large portions of the bowel are lost to surgical resection, rapid transit of nutrients through the remaining bowel occurs, causing malabsorption.

    Learn about short bowel syndrome Pancreatic disease Diseases of the pancreas can cause severe malabsorption of fats and carbohydrates. Symptoms depend on the severity of the condition but diarrhea with greasy, foul smelling stools is common and weight loss can be profound. Liver and biliary disease In conditions when insufficient bile reaches the intestine, fats are not absorbed and again diarrhea and weight loss occur.

    Vitamins that are absorbed with fats are also affected and vitamin D deficiency can occur. Treatment When the cause of malabsorption is treatable, the primary goal of treatment is to treat the cause. In patients who cannot be completely restored to normal for example after extensive surgical removal of the intestine , special dietary measures need to be adopted. Dietary treatment will also depend on the site of malabsorption.

    If fat is being malabsorbed, a low fat diet should be consumed. Certain oils called medium chain triglyceride oils are easier to absorb in certain disease states and may be helpful as a calorie supplement. For carbohydrate malabsorption, disaccharides, specifically lactose, often must be restricted.

    Other common symptoms are bloating, abdominal pain relieved with defecation and a sense of incomplete evacuation.

    Diarrheal Diseases – Acute and Chronic

    Risk Factors Exposure to infectious agents is the major risk factor for acute diarrhea. Bacteria and viruses are often transmitted by the fecal-oral route, so hand washing and hygiene are important to prevent infection. Soap and water are better because alcohol-based hand sanitizers may not kill viruses. Medications such as antibiotics and drugs that contain magnesium products are also common offenders.

    Recent dietary changes can also lead to acute diarrhea. These myfreemp3 juice intake of coffee, tea, colas, dietetic foods, gums or mints that contain poorly absorbable sugars. Acute bloody diarrhea suggests a bacterial cause like Campylobacter, Salmonella or Shigella or Shiga-toxin E. The best method of prevention is to avoid eating and drinking contaminated or raw foods and beverages.

    See a doctor if you feel ill, have bloody diarrhea, severe abdominal pain or diarrhea lasting more than 48 hours. In patients with mild acute diarrhea, no laboratory evaluation is needed because the illness generally resolves quickly.

    Your doctor may perform stool tests for bacteria and parasites if your diarrhea is severe or bloody or if you traveled to an area where infections are common. If you have severe diarrhea, blood tests will be helpful to guide replacement of fluid and electrolytes and minerals such as magnesium, potassium and zinc that can become depleted.

    If you have chronic diarrhea, your doctor will want to further assess etiologic factors or complications of diarrhea by obtaining several tests. These can include a blood count to look for anemia and infections, an electrolyte and kidney function panel to assess for electrolyte abnormalities and renal insufficiency, and albumin to assess your nutritional status.

    A stool sample may help define the type of diarrhea. The presence of fat, microscopic amounts of blood, and white blood cells will help determine if a fatty, inflammatory, or watery diarrhea is present. Endoscopic examination of the colon with flexible sigmoidoscopy or colonoscopy and upper endoscopy are helpful in detecting the etiology of chronic diarrhea, as this allows direct examination of the bowel mucosa and the ability to obtain biopsies for microscopic evaluation.

    Double-balloon enteroscopy and capsule endoscopy are sometimes used to examine the mucosa of the small intestine that lies beyond the reach of conventional endoscopes. Radiographic studies such as an upper GI series or barium enema are not routinely performed in the evaluation of chronic diarrhea, and have largely been replaced by cross-sectional imaging.

    Ultrasound and CT scan of the abdomen can be helpful to evaluate the bowel, pancreas and other intra-abdominal organs. Treating Acute Diarrhea It is important to take plenty of fluid with sugar and salt to avoid dehydration. Salt and sugar together in a beverage help your intestine absorb fluids. The Bristol Stool Chart is the most useful tool developed for assessing the texture and shape of your stool.

    On a scale ofyou rate your stool on how solid or liquid it is. For instance, small, hard lumps that are difficult to pass would be a 1, and entirely liquid would be a 7. On this scale, could signify constipation, are healthy stools, and point to diarrhea.

    Why do some stools float and others sink? Most stool sinks because the contents of feces tend to be denser than water.

    However, some stool just floats and, generally, this is nothing of concern, as it is usually the result of gas within the fecal matter, or a high fibre intake. Excess fat in the stool steatorrhea can also cause feces to float. Why does it hurt when I have a bowel movement? There are many reasons why defecation might cause pain.

    Depending on the type and severity of the pain, it could be anything from what you ate to an irritated hemorrhoid. In rare cases, a tumour in the intestine could make bowel movements painful. If you have any concerns about persistent pain, see your physician. Here are some common causes: Constipation is the most common cause of pain ; if your stools are hard and difficult to pass, this could be the culprit Diarrhea can also cause cramping, leading up to elimination If you eat too much spicy food, the oils can stay in your stool and cause burning upon defecation, in the same way that they can make your mouth burn when you eat them Hemorrhoidsanal fissures tears in the anusand abscesses can cause pain and bleeding Severe pain while experiencing bowel movements could signify a tumour obstructing the rectum or anus 7.

    Why does my poop smell so bad? Meat produces more smell than vegetables and intestinal bacteria produce several sulphur-containing compounds that are the primary smelly culprits along with fatty acids and skatole, a product resulting from the naturally-occurring process of amino acids being broken down in the intestine.

    The human nose can detect hydrogen sulphide in concentrations as low as one-half part per billion, making it easy for us to smell stool! Malabsorption Malabsorption refers to decreased intestinal absorption of carbohydrate, protein, fat, minerals or vitamins. There are many symptoms associated with malabsorption. Weight loss, diarrhea, greasy stools due to high fat contentabdominal bloating and gas are suggestive of malabsorption.

    Vitamin and mineral deficiencies resulting from malabsorption may cause glossitis sore tonguecheilosis a fissuring and dry scaling of the surface of the lips and angles of the mouthand anemia. Chronic diarrhea is often the first symptom prompting one to seek medical evaluation, although diarrhea need not be present for one to have malabsorption.

    Gastrointestinal Problems: Greasy, Bulky Stools

    Steatorrhea, or fatty stools, is indicative of malabsorption. Stools will be frothy, foul smelling, and a ring of oil may be left on the toilet water. The gastrointestinal tract and liver play key roles in the digestion, absorption and metabolism of nutrients.

    Diseases of the gastrointestinal tract and liver may profoundly disturb normal nutrition. An understanding of the anatomy of the gastrointestinal tract as well as the role each major segment plays in the digestion and absorption of food will help one understand the causes of malabsorption and shed light on the rationale for specific treatment regimens.

    In order for food to be absorbed, it must first be digested. Digestion is the mechanical and chemical process by which food is prepared for absorption. After a meal, food must first be broken down into simpler substances that can pass through the cells of the small intestine into the blood which transports them to all the cells of the body.

    The cells of the body can utilize these simpler substances as a source of energy. Digestion converts dietary protein into simple amino acids, dietary fats into fatty acids and monoglycerides, and starch into glucose. Anatomical and physiological considerations Digestion of food begins in the mouth where through the mechanical action of chewing and the chemical action of enzymes found in saliva, a bolus of food is formed and then passes through the esophagus.

    Contraction of the muscles in the esophagus moves the food bolus into the stomach by a process called peristalsis. Once in the stomach, the food is broken down further by strong contractions which expose it to gastric juices including hydrochloric acid and digestive enzymes which are secreted by glands in the lining of the stomach.

    The food is eventually converted into a liquid material called chyme which is then passed into the first part of the small intestine, the duodenum. The intestine is where food is eventually absorbed. In the intestine, the presence of chyme stimulates the production and release of a variety of enzymes from the pancreas and small intestinal glands. Each enzyme has a specific role in digestion. There are special enzymes that digest protein into amino acids, starch into glucose and fat into fatty acids.

    The liver produces a substance called bile which helps to digest fat. Bile is formed in the liver, stored in the gallbladder and released into the small intestine as needed. The small intestine is about 23 feet long in the adult and has three segments.

    The duodenum is the first part of the small intestine and is about 10 inches long. The jejunum is the middle segment of the small intestine and is about 8 feet long. The last portion of the small intestine, the ileum, is about 12 feet long. The absorptive surface of the small intestine is greatly enhanced by the numerous folds and finger-like projections called villi and microvilli. It has been estimated that given all the folds, villi and microvilli, the total absorptive surface of the small intestine is about the size of a half of a basketball court!

    What Your Pet’s Stools Say About Their Health

    Absorption of nutrients takes place all along the intestine, but each segment of the intestine absorbs only certain nutrients. Carbohydrates are ingested primarily in the form of starch or carbohydrates, sucrose table sugarfructose fruit sugar and lactose milk sugar. Salivary and pancreatic amylase digestive enzymes break up the starch into long chains of sugars called oligosaccharides and shorter chains called disaccharides and trisaccharides.

    Most starch hydrolysis breaking up a molecule into its smaller components occurs in the duodenum and absorption takes place in the duodenum and jejunum. Specific enzymes that hydrolyze disaccharides disaccharidases into their simplest forms or monosaccharides are located along the small intestine microvilli.


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