Floating Oil in Stool: Causes and When to Seek Help

The surface of the stool has a layer of floating oil?

Hello, Dr.
Ke:
Over the past three days, I have noticed that there are floating stains on the surface of my stool that resemble oil.
After researching online, I found that others describe their floating stool as yellow or orange, which is clearly oily, but mine does not have a distinct color and appears slightly reflective, resembling oil stains.
If I do not squat down to look closely at the water's surface, I cannot see it.
I read that approximately 7 grams of oil can be expelled with each bowel movement, and I wonder if this is similar to my situation.
Is my condition abnormal? Should the water surface of the stool be completely clear and free of impurities to be considered normal? Do I need to arrange for an examination?
I also found that floating stool could indicate issues with the liver, pancreas, or small intestine absorption.
I have been having blood tests every two months, and my liver function tests are normal.
Could this indicate a problem with my pancreas? If it were chronic pancreatitis, would there be other obvious symptoms? Currently, I am taking immunosuppressants, including Mycophenolate Mofetil and Azathioprine, along with Colchicine.
Could this be a side effect of the medications? I also do not have a diet high in fats...
I apologize for the lengthy description, as I am concerned that you may not fully understand my situation.
Thank you for your help.
🙏

Xiao Qing, 20~29 year old female. Ask Date: 2020/01/01

Dr. Ke Fangxu reply Surgery

The presence of fat in stool is generally related to dietary content; certain types of fish fat may not be fully digested and absorbed by the body, leading to its appearance in the stool after excessive consumption.
Additionally, some weight loss medications can block fat absorption, resulting in a similar phenomenon.
Chronic pancreatitis may not always present symptoms, so you might consider asking your physician to include pancreatic enzyme levels in your blood tests.
The three immunosuppressants you are taking can also have gastrointestinal side effects, so it may be beneficial to consult with a rheumatologist to determine if these medications are the cause of your symptoms.

Reply Date: 2020/01/01

More Info

Floating oil in stool can be a concerning symptom, and it's understandable that you're seeking clarity on this issue. The presence of oil or a greasy film on the surface of your stool can indicate malabsorption, which is when your body is unable to absorb certain nutrients properly. This can be due to various reasons, including issues with the pancreas, liver, or small intestine.

Causes of Floating Oil in Stool
1. Malabsorption: This is the most common reason for oily stools. Conditions such as celiac disease, Crohn's disease, or chronic pancreatitis can lead to malabsorption of fats. When fats are not absorbed, they can pass through the digestive system and result in oily stools.

2. Pancreatic Insufficiency: The pancreas produces enzymes that are essential for digesting fats. If the pancreas is not functioning properly (as in chronic pancreatitis), it may not produce enough enzymes, leading to undigested fats in the stool.

3. Liver Disease: The liver produces bile, which is necessary for fat digestion. Conditions that affect liver function can lead to problems with fat absorption.

4. Dietary Factors: A diet high in fat can also lead to floating stools, especially if your body is not used to processing such amounts of fat.

5. Medications: Certain medications, including immunosuppressants like the ones you mentioned (e.g., new immunosuppressants and colchicine), can have gastrointestinal side effects, including changes in stool consistency.

When to Seek Help
Given that you have noticed this symptom for three days, it is advisable to consult a healthcare professional, especially since you are on immunosuppressive medication. While your liver function tests are normal, it is important to rule out any pancreatic issues, particularly if you have a history of pancreatitis or other gastrointestinal conditions.

Symptoms of Chronic Pancreatitis
Chronic pancreatitis can present with various symptoms, including:
- Abdominal pain, which may be severe and persistent.

- Weight loss due to malabsorption.

- Fatty stools (steatorrhea), which can appear oily or greasy.

- Nausea or vomiting.

If you experience any of these symptoms, it would be prudent to seek medical attention.

Diagnostic Steps
Your healthcare provider may recommend several tests to investigate the cause of your symptoms:
- Stool Tests: To check for fat content and other abnormalities.

- Blood Tests: To assess pancreatic function and check for any signs of inflammation or infection.

- Imaging Studies: Such as an abdominal ultrasound or CT scan to visualize the pancreas and liver.

Conclusion
In summary, while the presence of floating oil in your stool can be concerning, it is essential to consider the context of your overall health and any accompanying symptoms. Given your current medication and the potential for gastrointestinal side effects, it is advisable to consult with your healthcare provider for a thorough evaluation. They can provide guidance tailored to your specific situation and help determine if further investigation is necessary. Remember, early intervention can often lead to better outcomes, so don’t hesitate to reach out for help.

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