What Does It Mean If Your Stool Is Oily?

Changes in the stools are the most noticeable symptom of steatorrhea.

Changes that you may observe in stools include:

• Bulky stools
• Oily
• Foul smell
• Pale colored
• Foamy
• Loose
• Greasy
• Foamy stools

Other symptoms of oily stools include:

• Foamy or mucus-filled stools
• Bulkier than normal or loose or runny stools or diarrhea
• Abdominal pain, cramps, bloating, and gassiness
• General tiredness
• Muscle, bone, and joint pains

Steatorrhea can be caused by conditions affecting your pancreas, small intestine, bile ducts, and liver.

• Exocrine pancreatic insufficiency:
  • Chronic pancreatitis
  • Gallstone pancreatitis
  • Cystic fibrosis
  • Pancreatic cancers
  • Zollinger-Ellison syndrome
  • Alcohol use disorder
• Bile and liver duct diseases: Bile and liver work together and tend to affect each other. This affects the ability of the liver to make bile juices, which results in the improper breakdown of fats that results in steatorrhea. The conditions include:
  • Cirrhosis of the liver
  • Liver failure
  • Cholestasis
  • Biliary cholangitis
  • Primary sclerosing cholangitis
• Improper digestion and malabsorption conditions: Some conditions affect the small intestine and cause the inability to break down fats and improper absorption of fats (malabsorption). Conditions that interfere with improper digestion and absorption include:
  • Celiac disease
  • Crohn's disease
  • Whipple's disease
  • Lymphoma
  • Short gut syndrome
  • Amyloidosis
  • Giardiasis
  • Lactose intolerance

Common foods and drinks that cause steatorrhea include:

• High-fat fish, such as escolar or oily fish, fatty tuna fish
• Excessive consumption of alcohol
• Nuts, especially whole nuts with shells intact
• Essential oils
• Whole wheat products
• Coconut oil and palm kernel oil consumption
• Artificial fats

Steatorrhea alone is not an emergency, but if it is consistent and associated with any other medical conditions, seek medical advice from your healthcare provider. It is very important to be diagnosed and treat the underlying condition that results in oily stools.

Consult your doctor immediately if you experience any symptoms of malabsorption, such as cramping in the abdomen and weight loss, and changes in your stools, such as oily, foamy, bulky, or color.

Your doctor will ask you detailed questions about your medical history and symptoms before recommending common fecal tests.

• Qualitative test of fecal fat: Measures the number of fat globules in one stool sample. Typically, fewer than 50 neutral fat and 100 fatty acid globules are seen under a microscope.
• A quantitative test of fecal fat: Stool samples are collected for two to four days. Then, all the samples are studied to know the total amount of fat in each day’s stool. Average results contain two to seven grams per 24 hours for adults, with fat about less than 20 percent of the solid stool sample.

To treat steatorrhea, your underlying condition must be treated by a healthcare provider.

• You may require pancreatic enzyme replacement therapy if you have exocrine pancreatic insufficiency.
• If your intestines are not getting enough bile, you might benefit from a bile acid replacement, such as Ursodiol (ursodeoxycholic acid).

You may require additional treatment to avoid complications of fat malabsorption. Long-term fat malabsorption can result in severe fat-soluble vitamin deficiencies (A, D, E, and K).

Treatment for various levels of malnutrition and its complications could be required.