Steatorrhea

Description:

Steatorrhea - (steatorrhoea) - allocation of excess amount of fat with a fecal masses (more than 5 g/day) owing to disturbance of absorption of fats in intestines.

Steatorrhea symptoms:

At the patients suffering from a steatorrhea allocation of a plentiful, unpleasant and fat chair which blurs on a surface and is hardly washed away is often observed. Diarrhea is a usual characteristic symptom of a disease. Existence at the patient of jaundice with the decoloured chair and dark urine indicates disturbance of outflow of bile which plays an essential role in absorption of fats and liposoluble vitamins.

At patients with chronic pancreatitis the uncertain pains in epigastric area irradiating in a back and amplifying during food are noted. The pains in epigastric area amplifying during food can be observed at patients with Zolingera-Ellison's syndrome which is characterized by excessive formation of the gastric juice (decrease рН a gastric chyme) causing a lipase inactivation. It is usually observed at patients with symptoms of a round ulcer resistant to conservative therapy. The pains in the right ileal area observed at patients with a disease Krone are caused by a terminal ileitis

At patients with a disease of gluten insufficiency the growth inhibition, the inadequate food which is followed by development of anemia and an atrophy of muscles is quite often noted. They observe pains owing to demineralization, a cerebellar ataxy and peripheral neuropathy.

At Whipple's disease which causative agent is Tropheryma whippleii at patients in addition to a steatorrhea joint pains, temperature increase, a xanthopathy and increase in peripheral lymph nodes are observed.

The steatorrhea is the main manifestation of an intestinal lymphoma. Besides, at the patient abdominal pains and fervescence, and sometimes the phenomena of intestinal impassability can be observed.

The disease Krone is characterized by formation of ulcers on a mucous oral cavity, perianal abscesses, pains in the right ileal area and release of blood from a rectum. Abetalipoproteinemiya, a hereditary disease (autosomal and recessive inheritance) who is developing as a result of lack of apolipoprotein B and followed by disturbance of formation of chylomicron is characterized by development in the patient of an ataxy and a night blindness owing to a pigmental degeneration of a retina (a pigmental retinitis).

Earlier postponed intestines resection, including terminal department of an ileal gut, promotes disturbance of absorption of fat owing to decrease in circulation of bilious salts between a liver and intestines. Moreover, at reduction of extent of the soaking-up surface of intestines also the period of a passage of intestinal contents on intestines decreases and, respectively, fat absorption decreases. The states which are followed by stagnation of intestinal contents, decrease in peristaltic activity of intestines and reduction of secretion of a gastric juice promote intensive reproduction of a bacterial flora and the accelerated splitting of bilious salts.

The steatorrhea often is followed by disturbance of absorption in intestines, and at patients the cachexia can develop. Existence of ulcers on a mucous oral cavity is observed at patients with a disease Krone or a disease of gluten insufficiency. Fingers in the form of drum sticks are observed at patients with a disease Krone, cirrhosis, a disease of gluten insufficiency and cystous fibrosis. Some are followed by disturbance of exocrine function of a pancreas.

Jaundice can be observed at patients with impassability of bilious ways and damage of a liver. Emergence on a body of bruises is caused by coagulability disturbance, owing to deficit of vitamin K, and the reason of the ostealgias revealed at a research is osteomalacy as a result of deficit of vitamin D.

Classical rash of herpetiform dermatitis can be observed at patients with a disease of gluten insufficiency. The nodular erythema (a nodose erythema) is a characteristic symptom of a disease Krone which is also followed by morbidity in the right ileal area, development of perianal abscesses and fistulas. At patients with damage of a liver the hepatomegalia is quite often observed, and the splenomegaly is observed at an intestinal lymphoma.

Steatorrhea reasons:

It is observed preferential at pancreas diseases, at obstruction of Virsungianov Canal, sometimes and at-nyakh Bazedov and Addison. The page can also take place as a result of introduction with food of excessively large amounts of fat. Macroscopically fecal masses at S. gets a characteristic grayish and clay shade and gives when standing on a surface the plaque having an appearance of the stiffened fat. In cases of sharp disturbance of processes of splitting and utilization of fats (e.g. at severe damages of a pancreas) the calla may contain the dry rest to 50 — 80% of fat. At-nykh with the broken function of a pancreas after giving 250 g of oil of an excrement take macroscopically easily defined, characteristic form of "a fat chair". Insufficient utilization of fats, resp. the steatorrhea, can take however place and at rather good, and in some cases even not changed process of a lipolysis. So, at chronic pancreatitis the normal lipolysis can be observed at its loss with a stake in number of 70 — 80% (Gross).

Treatment of the Steatorrhea:

Treatment of a basic disease is carried out.