Steatorrhea is the presence of excess fat in feces. Stools may also float due to excess lipid, have an oily appearance and be especially foul smelling. Not a disease process but a symptom o Causation of steatorrhea: Enzyme effect Bile deficiency Integrity of the intestinal epithelium
Pancreatic problems may lead to less production of pancreatic enzymes like pancreatic l cholesteryl esterase, and phospholipase A2 which decreases the breakdown of fats. When happens, fats will become too large to be absorbed by the enterocytes and therefore exce fats in the stool occurs (steatorrhe). Pancreatic problems includes: Pancreatic insufficiency ± Cystic fibrosis ± Chronic pancreatitis ± Obstruction of pancreatic duct ± Pancreatic cancer ± Pancreatic resection
Liver or Gall bladder problems may lead to cessation or blockage of production of bile emulsifies fats. And the decrease of these emulsifying agents will lead to increase aggre of fatty acids which will decrease the formation of micelles and will eventually lead to de solubility of fat molecules. This will in turn lead to inabsorption of these molecules therefore be excreted directly to the stool. Liver or Gall bladder problems include: Cholelithiasis Liver Cirrhosis Hepatitis
Intestinal problems like damage or decrease of integrity of the intestinal epithelium may le increase of peristaltic movement which will decrease the absorption of nutrients. T nutrients including fats will be excreted to the stool. Intestinal problems include: y Crohn s disease y Celiac disease / Sprue y Diarrhea
Orlistat works by inhibiting gastric and pancreatic lipases, the enzymes that break down triglycerides in the intestine. Only trace amounts of orlistat are absorbed systemically; the primary effect is local l inhibition within the GI tract after an oral dose. The primary route of elimination is thr the feces.
Importance of Lipids: ENERGY STORAGE Triacylglycerols, stored in adipose tissue, are a major form of energy storage in anim The complete oxidation of fatty acids provides high caloric content, about 9 kc compared with 4 kcal/g for the breakdown of carbohydrates and proteins. NUTRITION Most of the lipid found in food is in the form of triacylglycerols, cholesterol and phospholipids. A minimum amount of dietary fat is necessary to facilitate absorptio fat-soluble vitamins ( A, D, E and K) Humans have a dietary requirement for certain essential fatty acids, such as linol acid (an omega-6 fatty acid) and alpha-linoleic acid (an omega-3 fatty acid) because they cannot be synthesized from simple precursors in the diet. Complication of Fat Malabsorption and Maldigestion: Vitamin A Deficiency ± Night Blindness ± Xeropthalmia Vitamin D Deficiency ± Rickets ± Osteomalacia Vitamin E Deficiency ± Myopathy ± Ataxia Vitamin K Deficiency ± Ecchymosis ± Hematoma Linoleic acid ± Cancer ± Dermatitis Alpha-linoleic acid ± Cardiovascular disease e.g. Coronary heart disease
