Dear rman51-ga;
Thank you for allowing me an opportunity to answer your interesting
question. You must understand of course that we cannot diagnose
medical problems in this forum nor can we provide medical advice.
Ultimately, I am going to recommend you consult your physician but in
the meantime I will arm you with some information so you?ll be
prepared to ask the appropriate questions. Let?s begin?
You may have developed some condition that is causing malabsorption or
maldigestion of fats, one symptom of which is fatty stools. A
quantitive fecal fat test administered by your physician can determine
whether or not malabsorption or maldigestion are the causes of your
oily stools. This article can explain much of what you need to know
about this kind of testing:
MALDIGESTION/MALABSORPTION
http://www.medinfo.ufl.edu/cme/grounds/toskes2/intro.html
Here are some conditions that can lead to such an occurrence:
Chronic pancreatitis
Biliary tract obstruction
Cholestatic liver disease
Bacterial overgrowth in the digestive tract
Small bowel mucosal disease
Surgical resection of the small bowel
Gluten-sensitive enteropathy (celiac sprue)
Whipple's disease
Tropical sprue
Zollinger-Ellison syndrome
. . . . . . . . . . . . . . . . . . . .
Now let?s briefly discuss each of these conditions. For the sake of
accuracy, since these are medically sensitive and perhaps threatening
conditions, I will provide actual quotes where necessary:
CHRONIC PANCREATITIS
Definition:
?Chronic pancreatitis involves persistent inflammation of the pancreas
-- an elongated, tapered gland that is located behind the stomach and
secretes digestive enzymes and the hormones insulin and glucagon.?
Causes, incidence, and risk factors:
?Chronic pancreatitis is most often caused by alcoholism and alcohol
abuse, but sometimes the cause cannot be determined. Conditions such
as hyperlipidemia or hyperparathyroidism, injury, and chronic
obstruction of the pancreatic duct can also be associated with chronic
pancreatitis.?
?In this condition, inflammation and fibrosis cause the destruction of
functioning glandular tissue in the pancreas. The resulting lack of
pancreatic enzymes interferes with the ability to properly digest fat.
The production of insulin is also affected, which can lead to
diabetes.?
?This condition is marked by attacks of abdominal pain and digestive
problems that may become more frequent as the condition progresses.
Chronic pancreatitis occurs more frequently in men than in women,
perhaps because alcohol use disorders are more common in men.?
MEDLINE PLUS
http://www.nlm.nih.gov/medlineplus/ency/article/000221.htm
. . . . . . . . . . . . . . . . . . . .
BILIARY TRACT OBSTRUCTION
?Cholestasis is defined as failure of normal amounts of bile to reach
the duodenum. The source of the interference may reside in the main
bile ducts - extrahepatic cholestasis - or within the liver -
intrahepatic cholestasis.?
?Morphologically, cholestasis is characterised by the accumulation of
bile in liver cells and biliary passages; biochemically, by the
retention of all substances normally excreted in the bile.?
?Presentation is usually with pruritus and the slow onset of jaundice.?
GENERAL PRACTICE NOTEBOOK
http://www.gpnotebook.co.uk/cache/-1221263328.htm
. . . . . . . . . . . . . . . . . . . .
CHOLESTATIC LIVER DISEASE
This condition is very complex and can mean a number of different
things. It can actually be quite serious so it would probably benefit
you to read up about it a bit more:
?The term cholestasis originally derives from Greek and literally
means "a standing still of bile." This disruption of bile flow can
occur on a cellular level in the hepatocyte, at the level of the
intrahepatic biliary ductules or from an extrahepatic mechanical
obstruction of the bile ducts. Frequently, bile flow is only partially
disrupted giving rise to "anicteric cholestasis"?cholestasis without
jaundice. Cholestasis is defined, therefore, both clinically and
biochemically with varying degrees of jaundice, pruritus and elevated
levels of conjugated bilirubin, alkaline phosphatase,
gamma-glutamyltranspeptidase, 5 prime nucleotidase, bile acids, and
cholesterol. A conventional categorization of cholestatic liver
diseases divides them into intrahepatic or extrahepatic causes?
THE CLEVELAND CLINIC ? DISEASE MANAGEMENT PROJECT
http://www.clevelandclinicmeded.com/diseasemanagement/gastro/intrahepatic/intrahepatic1.htm
. . . . . . . . . . . . . . . . . . . .
BACTERIAL OVERGROWTH IN THE DIGESTIVE TRACT
This is exactly what it sounds like ? bacterial growth inside the
digestive tract which interferes with the absorption of fats.
MALDIGESTION/MALABSORPTION
http://www.medinfo.ufl.edu/cme/grounds/toskes2/intro.html
THE FIRST PRINCIPALS OF GASTROENTEROLOGY
http://gastroresource.com/GITextbook/En/Chapter7/7-17.htm
. . . . . . . . . . . . . . . . . . . .
SMALL BOWEL MUCOSAL DISEASE
This phrase sounds a bit vague as a term in itself but it can range
from Coeliac Disease to Crohn?s Disease and the damage it causes is
relatively gradual. In time the bowel can atrophy (or wither) making
it less effective in the absorption of complex materials such a fats.
As such, one of the symptoms in some people is the malabsorbtion or
maldigestion of fats.
TAMPERE UNIVERSITY
http://acta.uta.fi/english/teos.phtml?4255
MEDICINENET.COM
http://www.medicinenet.com/Inflammatory_Bowel_Disease_Intestinal_Problems/article.htm
. . . . . . . . . . . . . . . . . . . .
SURGICAL RESECTION OF THE SMALL BOWEL
You would know, of course, if you had had this procedure done.
Infrequently, some patients who have had a resected bowel (intestinal
bypass, or other surgical removal of a portion of the bowel) can
experience a marked decrease in absorption due simply to the fact that
less bowel is present to do the work. In some instances perhaps
patients might also experience a paralyzing of a portion of the bowel
that can have the same adverse effect.
. . . . . . . . . . . . . . . . . . . .
GLUTEN-SENSITIVE ENTEROPATHY (CELIAC SPRUE)
This topic may be of great importance to you when you talk to your
doctor, due to your current diet and practice of taking in grain-based
supplements:
?Celiac sprue is caused by the interaction of gluten of particular
grains (e.g. wheat) with the small intestinal mucosa. Gluten causes
the intestinal mucosa to lose its villous structure and absorptive
capacity.?
?The severity of symptoms will depend upon the amount and the specific
location of small intestine involved but may include diarrhea,
steatorrhea, foul-smelling flatulence, and weakness. Dehydration,
electrolyte losses, neuropathy, and acidosis may ensue. The incidence
of dermatitis herpetiformis is increased among these patients. Anemia
may result from alterations in iron, folate and vitamin B12
absorption. Impaired fat soluble vitamin absorption may also occur
leading to osteopenia, increased clotting times, and night blindness.?
VIRTUAL HOSPITAL ? A DIGITAL LIBRARY OF HEALTH INFORMATION
http://www.vh.org/adult/provider/familymedicine/FPHandbook/Chapter05/07-5.html
. . . . . . . . . . . . . . . . . . . .
WHIPPLE'S DISEASE
?Whipple's disease is a malabsorption illness. It interferes with the
body's ability to absorb certain nutrients. The disease causes weight
loss, incomplete breakdown of carbohydrates or fats, and malfunctions
of the immune system, and it may affect the heart, lungs, brain, and
eyes. When recognized and treated, Whipple's disease can usually be
cured. Untreated, the disease may be fatal.?
NATIONAL DIGESTIVE DISEASES INFORMATION CLEARING HOUSE
http://digestive.niddk.nih.gov/ddiseases/pubs/whipple/
. . . . . . . . . . . . . . . . . . . .
TROPICAL SPRUE
This probably isn?t what you have since it is fairly confined
geographically to tropical and subtropical regions, but I?m going to
include it just to be thorough:
?Tropical sprue is a malabsorption syndrome of unknown cause that is
prevalent in the tropics and subtropics.?
?The cause of this disease is unknown, but it may be related to an
infectious organism. The condition affects residents of or visitors to
the tropics. The main symptom is diarrhea, which may improve on
leaving tropical areas, or may appear years after leaving the tropics.
Risk factors are residence in the tropics or prolonged travel to
tropical destinations.?
ALLREFER HEALTH
http://health.allrefer.com/health/tropical-sprue-info.html
. . . . . . . . . . . . . . . . . . . .
ZOLLINGER-ELLISON SYNDROME
?Zollinger-Ellison syndrome is caused by gastrin-secreting tumors of
the pancreas that causes severe ulceration (areas of irritation) of
the upper gastrointestinal tract (stomach and small bowel).?
Causes, incidence, and risk factors:
?Zollinger-Ellison syndrome is caused by tumors usually found in the
head of the pancreas and the upper small bowel. These tumors produce
the hormone gastrin and are called gastrinomas. High levels of gastrin
cause overproduction of stomach acid.?
?High acid levels lead to multiple ulcers in the stomach and small
bowel. Patients with Zollinger-Ellison syndrome may experience
abdominal pain and diarrhea. The diagnosis is also suspected in
patients without symptoms who have severe ulceration of the stomach
and small bowel.?
?Gastrinomas may occur as single tumors or as multiple, small tumors.
About one-half to two-thirds of single gastrinomas are malignant
tumors that most commonly spread to the liver and lymph nodes near the
pancreas and small bowel. Nearly 25% of patients with gastrinomas have
multiple tumors as part of a condition called multiple endocrine
neoplasia type I (MEN I). MEN I patients have tumors in their
pituitary gland and parathyroid glands in addition to tumors of the
pancreas.?
MEDLINE PLUS
http://www.nlm.nih.gov/medlineplus/ency/article/000325.htm
. . . . . . . . . . . . . . . . . . . .
I hope these resources arm you with the information you need. And now,
as promised, I am recommending that you make an appointment with your
physician to follow up on the potential conditions. Feel free to print
this out and take it to him if necessary. I?m certain he will be very
open to discussing your situation and probably quite impressed with
your ability to research your own health and ask all the right
questions. Take care of yourself ? I do hope it works out well for
you.
I hope you find that my research exceeds your expectations. If you
have any questions about my research please post a clarification
request prior to rating the answer. Otherwise I welcome your rating
and your final comments and I look forward to working with you again
in the near future. Thank you for bringing your question to us.
Best regards;
Tutuzdad-ga ? Google Answers Researcher
INFORMATION SOURCES
MALDIGESTION/MALABSORPTION
http://www.medinfo.ufl.edu/cme/grounds/toskes2/intro.html
MEDLINE PLUS
http://www.nlm.nih.gov/medlineplus/ency/article/000221.htm
GENERAL PRACTICE NOTEBOOK
http://www.gpnotebook.co.uk/cache/-1221263328.htm
THE CLEVELAND CLINIC ? DISEASE MANAGEMENT PROJECT
http://www.clevelandclinicmeded.com/diseasemanagement/gastro/intrahepatic/intrahepatic1.htm
MALDIGESTION/MALABSORPTION
http://www.medinfo.ufl.edu/cme/grounds/toskes2/intro.html
THE FIRST PRINCIPALS OF GASTROENTEROLOGY
http://gastroresource.com/GITextbook/En/Chapter7/7-17.htm
TAMPERE UNIVERSITY
http://acta.uta.fi/english/teos.phtml?4255
MEDICINENET.COM
http://www.medicinenet.com/Inflammatory_Bowel_Disease_Intestinal_Problems/article.htm
VIRTUAL HOSPITAL ? A DIGITAL LIBRARY OF HEALTH INFORMATION
http://www.vh.org/adult/provider/familymedicine/FPHandbook/Chapter05/07-5.html
NATIONAL DIGESTIVE DISEASES INFORMATION CLEARING HOUSE
http://digestive.niddk.nih.gov/ddiseases/pubs/whipple/
ALLREFER HEALTH
http://health.allrefer.com/health/tropical-sprue-info.html
MEDLINE PLUS
http://www.nlm.nih.gov/medlineplus/ency/article/000325.htm
SEARCH STRATEGY
SEARCH ENGINE USED:
Google ://www.google.com
SEARCH TERMS USED:
MALDIGESTION
MALABSORPTION
CHRONIC PANCREATITIS
BILIARY TRACT OBSTRUCTION
CHOLESTATIC LIVER DISEASE
BACTERIAL OVERGROWTH IN THE DIGESTIVE TRACT
SMALL BOWEL MUCOSAL DISEASE
SURGICAL RESECTION OF THE SMALL BOWEL
GLUTEN-SENSITIVE ENTEROPATHY (CELIAC SPRUE)
WHIPPLE'S DISEASE
TROPICAL SPRUE
ZOLLINGER-ELLISON SYNDROME |
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