Fecal fat output

Diagnosis 2.1. Primary Diagnosis 2.1.1. Daily Fecal Fat Output... 

The change in daily output of fecal fat forms the basis for the definitive diagnostic test for gluten induced enteropathy (F16, F21). This diagnosis is justified if the patient presented with the main features of the malabsorption syndrome, if the fecal fat output fell to normal levels on a gluten-free diet, and if subsequent reintroduction of gluten into the diet caused an unequivocal increase in fecal fat... 

Fine, K. D. Ogunji, F. A new method of quantitative fecal fat microscopy and its correlation with chemically measured fecal fat output. Am. J. Clin. Pathol. 2000, 113, 528-534. 

The daily output of fecal fat may be regarded as the simplest quantitative measure of the effect of gluten on these patients. The evidence available suggests that the extra fat is derived from dietary fat and mainly represents interference with absorption. There is usually a disproportionate increase of saturated as compared with unsaturated fats (W4). The reason for this is not clear. There may be selective rejection of longer chain and more saturated fats there may also be increased hydrogenation of unsaturated fatty acids (SI). The increase of fat output may occur within a day or 2, or it may be delayed for 10 days or more. There are many possible explanations for this delay. It may require many small insults to the mucous membrane... 

The role of undigested nutrients has been postulated, following the observation that, when pancreatic enzyme supplementation was withdrawn, CF patients showed a fecal BA output which was comparable to that observed in children with ileal resection[5]. Substitutive therapy was followed by a partial but consistent amelioration in BA loss. In basal conditions, a positive and significant correlation between fecal BA and fecal fat excretion was found and unhydrolyzed triglycerides and/or free fatty acids have been considered as the most responsible factors inhibiting BA absorption in CF. 

Macrocyclic lactones are highly lipophilic and are distributed widely to and eliminated slowly from the body compartments such that they have persistent anthelmintic activity. There are physicochemical differences between ivermectin and moxidectin that confers different lipid solubility on each drug moxidectin has a much longer half-life in body fat (Afzal et al 1997). This constitutes at least a partial explanation for the longer period of suppression of equine fecal worm egg output achieved following dosing with moxidectin compared with ivermectin (Jacob et al 1995,... 

---