Greasy Stool: Is It a Sign of Pancreatic Issues? - Gastroenterology and Hepatology

Q: Greasy Stool: Is It a Sign of Pancreatic Issues?

Dear Miss Sandy： If you have been feeling unwell for an extended period, it is advisable to consult your physician or seek a second opinion to evaluate the underlying reasons for your condition. <br>This will help in providing the appropriate treatment. <br>Wishing you a speedy r

A long-term feeling of greasy stools that are unformed may indicate a problem with the pancreas?

Hello Doctor: I have been experiencing a greasy feeling in my stool for about one to two years.
The front part of the stool is formed, but the latter part is like a muddy, ice cream consistency.
(Is this considered diarrhea?) The muddy stool eventually spreads out on the water surface...
(The colonoscopy results were normal.) I am unsure if this stool is classified as steatorrhea.
(I have previously taken enzymes, which helped the stool to be more formed.) I often experience sharp stomach pain after eating, but my gastroscopy results were normal.
Taking gastric medication does not alleviate the pain, so I am quite worried that there might be an issue with my pancreas.
The gastroenterologist tested my lipase, amylase, and bilirubin levels, all of which were normal, and also performed an abdominal ultrasound, which showed that the visible part of the pancreas was normal.
However, seeing this type of stool every day affects my mood because I keep questioning whether it is steatorrhea or if there is chronic inflammation of the pancreas.
I also worry if there might be something wrong with my pancreas.
Doctor, should I undergo any further tests to confirm whether there is an issue with my pancreas? Thank you, Doctor.

sandy, 40~49 year old female. Ask Date: 2020/03/26

Dr. Cai Jinji reply Gastroenterology and Hepatology

Dear Miss Sandy: If you have been feeling unwell for an extended period, it is advisable to consult your physician or seek a second opinion to evaluate the underlying reasons for your condition.
This will help in providing the appropriate treatment.
Wishing you a speedy recovery, from Nantou Hospital.

Reply Date: 2020/03/26

More Info

Understanding greasy stool can indeed be a sign of pancreatic issues, particularly when it comes to the function of the pancreas in digesting fats. The pancreas plays a crucial role in the digestive system by producing enzymes that help break down carbohydrates, proteins, and fats. When the pancreas is not functioning properly, it can lead to malabsorption of nutrients, particularly fats, resulting in what is known as steatorrhea, or fatty stools.

From your description, it sounds like you are experiencing symptoms that could be associated with steatorrhea. The fact that your stools are described as "greasy" or "mud-like" and float on water can indicate that they contain an excess of fat. This can occur when the pancreas is not producing enough digestive enzymes, a condition known as exocrine pancreatic insufficiency (EPI). EPI can be caused by various factors, including chronic pancreatitis, cystic fibrosis, or pancreatic cancer.

You mentioned that you have had normal results from tests such as the abdominal ultrasound and blood tests for lipase and amylase. While these tests can provide valuable information, they may not always detect subtle pancreatic issues, especially if the pancreas is still producing some enzymes but not enough to properly digest fats. In cases where EPI is suspected, a more specific test, such as a 72-hour stool test for fat malabsorption, may be recommended. This test measures the amount of fat in your stool over a period of time and can help confirm whether you are indeed experiencing malabsorption.

Additionally, the symptoms of stomach pain after eating could also be related to pancreatic issues, but they could also stem from other gastrointestinal conditions. Since your endoscopy results were normal, it might be worth considering other potential causes, such as gastritis, peptic ulcers, or even functional gastrointestinal disorders like irritable bowel syndrome (IBS).

Given your ongoing concerns and the impact these symptoms have on your quality of life, it would be prudent to follow up with your healthcare provider. You may want to discuss the possibility of further testing, such as imaging studies like a CT scan or MRI, which can provide a more detailed view of the pancreas and surrounding structures. Additionally, consulting with a gastroenterologist who specializes in pancreatic disorders could provide further insights and management options.

In summary, while greasy stools can indicate pancreatic issues, it is essential to consider the entire clinical picture, including your symptoms and test results. If you continue to experience these symptoms, further evaluation may be necessary to rule out any underlying pancreatic dysfunction or other gastrointestinal conditions. Your health and well-being are paramount, so do not hesitate to seek further medical advice to address your concerns.

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