Feces - the final product of the processing of products entering the body. A healthy person who does not suffer from digestive problems has formalized bowel movements that do not contain neutral fat. The result of digestion of food and absorption of residual products in the intestine should be covered with a small amount of mucus and cells of the cylindrical epithelium. If there is neutral fat in the feces, this condition is called steatorrhea. It is considered pathological and can talk about diseases of the pancreas, bile ducts or liver.
What are fats?
Neutral fats are esters of fatty acids and glycerol. Depending on how many hydroxyl groups of glycerol are esterified with fatty acids, the following types of lipids of this group are distinguished:
- triglycerides - three groups;
- diglycerides - two groups;
- monoglycerides - one group.
Neutral fat is in the human body as a reserve material or becomes the protoplasmic fat that is part of the cells. The role of these forms is different. Protoplasmic lipids have a constant composition and exist in cells in a certain amount, which does not change with the development of obesity or in the case of a person losing weight. The amount of reserve fat tends to fluctuate.
Triglycerides
This group is the largest among all representatives of neutral lipids. Fatty acids, which are part of the composition, can be unsaturated and saturated. The most common are: oleic, stearic and palmitic acids. If the radicals that make up the triglyceride belong to one acid, then it is called simple, in the case of their relationship to different acids - mixed.
The physico-chemical properties of neutral fats depend on which acids are in the composition. Features are as follows:
- the greater the number and length of saturated fatty acid residues , the higher the melting temperature of lipids;
- the greater the amount of unsaturated fatty acids and the shorter their chain, the lower the melting point;
- triglycerides can participate in the saponification reaction, resulting in decomposition into fatty acids and glycerin;
- the saponification process is characteristic of enzymatic hydrolysis, the action of alkalis and acids.
Lipid properties
Neutral fat is a substance that melts easily, it is lighter than water, but insoluble in it. At room temperature, lipids have a solid, buttery or liquid state and can melt in a significant temperature range.
Substances practically do not dissolve in water, but the addition of soap or any emulsifier to them leads to the formation of persistent aqueous emulsions. Neutral fat is highly soluble in alcohol and various solvents (ether, gasoline, benzene, chloroform).
Phospholipids are colorless, but quickly darken on contact with air. This occurs as a result of the oxidation of unsaturated fatty acids that make up the composition. The properties of neutral fats in the human body are as follows:
- layered structures that form upon contact with solutions make it possible for lipids to participate in the construction of cell membranes;
- entering into a close relationship with proteins located on the surface of cell membranes, regulate the processes of entry into the cell of organic substances that are involved in metabolic processes;
- are antioxidants of natural origin.
The dependence of the physicochemical properties of neutral fats on their structure explains the possibility of their participation in vital processes occurring in the human body. Especially a lot of phospholipids are found in nerve tissue, liver, heart.
Steatorrhea and its types
Neutral fat in feces is a pathological condition. Depending on the etiology, the following types of steatorrhea are distinguished:
- Intestinal type. Due to certain reasons, lipids are not absorbed in the intestinal tract, but go out with feces.
- Alimentary type. The basis of this pathology is irrational nutrition. With food, a huge amount of phospholipids enters the human body, which are not able to be fully absorbed.
- Pancreatic type. It arises as a result of violations in the pancreas. There is a decrease in the synthesis of lipase, an enzyme responsible for the normal breakdown of lipids.
Steatorrhea also varies in the variety of components. The feces may contain a significant amount of neutral fats (triglycerides), soaps and fatty acids, or all three components at the same time.
Causes of Pancreatic Steatorrhea
Neutral fat in feces in a child or adult can appear against the background of a number of abnormal conditions.
1. Diseases of the pancreas:
- acute pancreatitis during the first six months;
- pancreatic inflammation lasting more than six months (chronic process);
- narrowing of the Wirsung duct (through which the pancreatic juice enters the duodenum);
- Zolinger-Ellison syndrome is a tumor process that results in ulceration of the stomach and intestines.
2. Pathology of the liver:
- acute and chronic hepatitis;
- hepatitis resulting from alcohol abuse;
- cirrhosis of the liver;
- sclerosing type cholangitis is an inflammatory disease of the intrahepatic bile ducts, which is accompanied by scarring;
- hemochromatosis - a violation of metabolic processes associated with iron, which is accompanied by its pathological accumulation in the body;
- liver amyloidosis;
- tumors and cysts.
3. Pathology of the gallbladder and ducts:
- cholelithiasis;
- acute and chronic gallbladder inflammation;
- cholangitis - inflammatory processes of the bile ducts;
- biliary tract infection with lamblia.
Causes of intestinal steatorrhea
Neutral fat in a coprogram with intestinal type pathology can occur as a result of the following conditions:
- with Crohn’s disease - chronic inflammation of the intestinal tract, in which narrowing and ulceration develop;
- with Whipple's disease - a disease of the intestine and regional lymphatic donkeys of an infectious nature;
- with intestinal lymphoma - a tumor that consists of lymphocytes;
- with a post-resection state;
- with enteritis, enterocolitis;
- with amyloidosis;
- with diverticulosis - a pathological process, accompanied by the formation of diverticula (protrusions) in the intestinal wall.
Other etiological factors
The causes of phospholipids in bowel movements may be endocrine gland diseases. The most common triggering factors are hypothyroidism and Addison's disease (adrenal insufficiency).
Abetalipoproteinemia (impaired absorption and lipid transport), cystic fibrosis (secrets of all glands are highly viscous and dense) and cealcium (a disease in which gluten is not completely broken down) are congenital conditions that lead to the appearance of neutral fat in the feces in infants.
The occurrence of phospholipids in feces can accompany psoriasis and eczema, as well as long-term use of laxatives and drugs used for weight loss.
Clinical picture
The first manifestation of pathology is the frequent urge to defecate. The stool is oily, it is difficult to wash it off the surface of the toilet. The stool leaves a greasy mark. The color of the feces can remain normal, and can change in the direction of a light or gray shade.
In addition, neutral fats, the composition of which has fatty acids and glycerin, appearing in the feces, in addition, can be reflected in the following symptoms:
- dry cough;
- dizziness;
- joint and back pain;
- bloating;
- low level of performance;
- weakness;
- dry mucous membranes;
- exhaustion;
- bleeding gums.
The appearance of an oily stool and at least one of the accompanying symptoms is a reason for seeking qualified help.
Diagnostic measures
The collection of complaints and anamnesis is accompanied by a clarification when the symptoms appeared, with which the patient associates their occurrence, when the stool became oily. The specialist clarifies the presence of congenital diseases or pathologies inherited from the patient's relatives. Next, the doctor examines the patient. The presence of exhaustion, the condition of the skin and mucous membranes is determined, palpation and percussion of the abdominal organs are performed.
Coprology (laboratory examination of feces) consists of an assessment of the following indicators:
- Macroscopy - steatorrhea manifests itself in the form of lighter bowel movements with a sheen of hardened lard.
- Microscopy determines the presence of lipids, fatty acids, soaps. Normally, no more than 5 g of neutral fat should stand out with feces in 24 hours. The results above are pathological.
If necessary, a radioisotope study, ultrasound examination of the abdominal organs, colonoscopy, assessment of the hormonal balance of the body, consultation of the endocrinologist and therapist are used.
Steatorrhea Elimination
First of all, treatment is aimed at a disease that caused the appearance of neutral fat in the feces. An individual diet selection is also carried out on the basis of the underlying pathology. Mandatory is the exclusion of fried, pickled, smoked products.
The patient should give up drinking alcohol, get rid of bad habits. It is recommended to add to the diet those products that contain a significant amount of retinol, tocopherol, calciferol and vitamin K. These same fat-soluble vitamins are prescribed in the form of medications.
Complications and consequences
Complications develop only in case of untimely treatment. There is a violation of the processes of absorption of nutrients in the intestinal tract. Against this background, hypo- and vitamin deficiencies, protein deficiency and exhaustion of the body develop. The pathology of the water-electrolyte balance is manifested by a constant feeling of thirst, swelling, dehydration, convulsive attacks.
The specialist diagnoses the appearance of oxaluria (excessive pathological excretion of oxalic acid salts from the body along with urine) and the formation of urinary stones of oxalate origin. This pathological condition occurs due to the fact that under normal conditions, oxalates do not enter the bloodstream from the intestinal tract, since their combination with calcium makes them insoluble. With the development of steatorrhea, calcium is excreted in large quantities from the body along with feces. This leads to a significant flow of oxalates from the intestine into the blood.
The patient abruptly loses body weight. The normal functioning of all internal organs and systems is disrupted. Such manifestations lead to psychological problems (insomnia, changes in communication, decreased performance).
Preventive measures
Preventive measures can be divided into primary and secondary. Primary prevention is carried out so that the disease does not appear. It is based on preventing the development of pathologies in which steatorrhea becomes one of the symptoms. Important points are:
- refusal from smoking and excessive drinking;
- diet correction;
- increase in the amount of plant food;
- fractional nutrition in small portions;
- the use of multivitamin complexes;
- strengthening the body's defenses.
The basis of secondary prevention (after the onset of the disease) is the timely rational treatment of the pathological condition.
Conclusion
Early diagnosis and a correct diagnosis will allow the specialist to choose an individual treatment regimen and avoid the development of complications of the disease. Self-medication is not recommended, since only a highly qualified doctor is able to determine the true cause of the appearance of neutral fats in feces and eliminate it. The prognosis is favorable for those patients who follow the advice and recommendations of a treating specialist, as well as are involved in the secondary prevention of pathology.