Stool fat excretion

Fecal steroid and lipid excretion. Fiber supplements from sugar cane residue (bagasse), administered to volunteers for 12 weeks, increased stool weights and stool fat excretion. Bagasse increased the daily loss of acid steroids and decreased transit time without alteration in fecal flora. The increased excretion of bile acids and fatty acids failed to lower the plasma cholesterol and TGs after 12 weeks ". 

The effects of pancreatic exocrine supplements (four capsules with meals, two with snacks each capsule containing lipase 10 000 units, protease 37 500 units, amylase 33 200 units) on glucose metabolism have been studied in a 2-week parallel, randomized, placebo-controlled trial in 29 patients with chronic pancreatitis who had stool fat excretion of over 10 g/day, 18 of whom were diabetic and 15 of whom were malnourished (902). There were major problems with blood glucose control in 28 of the 29 patients. 

A periodic measurement of stool fat excretion by means of the method of Van de Kamec [97] or using the less unpleasant near-infrared analysis [98-100] allows quantitative evaluation of the degree of steatorrhea. Besides this, several function tests where the pancreas is directly stimulated by an infusion of secretin and/or cholecystokinin (reviewed in Ref. 101) or indirect tests requiring the administration of an exogenous pancreas enzyme substrate as V-benzoyl-L-tyrosyl-p-aminobenzoic acid (NBT-PABA) or fluorescein dilaurate (pancreo-lauryl test) (Fig. 12) are available. The NBT-PABA test measures intraluminal... 

D. Pancreatic Enzyme Replacements Steatorrhea, a condition of decreased fat absorption coupled with an increase in stool fat excretion, results from inadequate pancreatic secretion of lipase. The abnormality of fat absorption can be significantly relieved by oral administration of pancreatic lipase (pancrelipase) obtained from pigs. Pancreatic lipase is inactivated at a pH below 4.0 thus, up to 90% of an administered dose will be destroyed in the stomach, unless the pH is raised with antacids or drugs that reduce acid secretion. 

Hemagglutinin activity. Saline extract of the dried seed, at a concentration of 10%, was active on the human red blood cells L Hypocholestrolemic activity. Fresh root, taken orally by human adults at a dose of 200 g/person, was active. Daily ingestion at breakfast for 3 weeks decreased cholesterol in serum by 11%, increased fecal bile acid and fat excretion by 50%, and increased stool weight by 25%° . 

Normally there is very little fat in the feces. However, fat content in stools may increase because of various fat malabsorption syndromes. Such increased fat excretion is steatorrhea. Decreased fat absorption may be the result of failure to emulsify food contents because of a deficiency in bile salts, as in liver disease or bile duct obstruction (stone or tumor). Pancreatic insufficiency may result in an inadequate pancreatic lipase supply. Finally, absorption itself may be faulty because of damage to intestinal mucosal cells through allergy or infection. An example of allergy-based malabsorption is celiac disease, which is usually associated with gluten intolerance. Gluten is a wheat protein. An example of intestinal infection is tropical sprue, which is often curable with tetracycline. Various vitamin deficiencies may accompany fat malabsorption syndromes. 

Measurement of stool weight and quantitative fecal fat excretion on three consecutive days during a balanced diet are common screening tests for both pancreatic insufficiency and other pathologies that result in malabsorption. However, these tests are insensitive and nonspecific for pancreatic malfunction Steatorrhea occurs only after loss of more than 90% of exocrine parenchyma, and other causes of malabsorption (e.g., celiac sprue or Crohn s disease) may also induce abnormal fecal fat excretion of more than 7 g/day or more than 5 g/100 g. 

Steatorrhoea is the formation of non-solid faeces. Floating stools, due to excess fat, are oily in appearance and foul smelling. There is increased fat excretion, which can be measured by determining the faecal fat level. Possible biological causes can be lack of bile acids (due to liver damage or hypolipidaemic drugs), defects or a reduction in pancreatic enzymes (lipase), and defective mucosal cells. The absence of bile acids will cause the faeces to turn grey or pale. 

A high fiber diet will help by redirecting fat soluble metabolites to the colon rather than bladder. THC is eliminated primarily in the stool via bile acids. Both EMIT and RIA detect a secondary metabolite which is reabsorbed from the intestines. Thus a person with a high fiber diet will excrete a majority of THC [metabolites] in the stool [Anonlj. A fiber-based laxitive will also help by binding bile-acids. Use caution. Fiber laxitives can alter one s bowel schedule and lead to dependancy. 

The effects of unabsorbed substances in the gut lead to diarrhoea, steatorrhoea, abdominal bloating and gas. Other symptoms result from nutritional deficiencies. Patients often lose weight despite adequate food intake. Chronic diarrhoea is the most common symptom and is what usually prompts evaluation of the patient. Steatorrhoea (fatty stool), the hallmark of malabsorption, occurs when >7 g/day of fat is excreted, associated with foul-smelling, pale, bulky and greasy stools. 

Pale stools indicate partial or complete (if the stools are white) blockage of the bile ducts, such that reduced or no bile is excreted. This will affect the absorption of highly lipophilic drugs, e.g. fat-soluble vitamins, as no bile salts will be secreted into the duodenum to solubilise fats. It will also mean that drugs that are cleared exclusively by the bdiary system will have significantly reduced clearance. 

Sucrose polyesters have no primary ester bonds and are not digested. As a result, they remain in the oil phase and are not taken up and are excreted with the stools. In the small intestine, they have some effect on the partitioning of fat-soluble components between the emulsion and micellar phase and as a consequence on their absorption. Reduced absorption of fat-soluble vitamins can be avoided by enriching the sucrose polyesters with these vitamins. Their main use is related to the fact that they can replace usual food fats in many prepared foods but that they do not provide for calories. 

Biliary steatorrhoea is characterized by higher stool weight (>200 g) and increased excretion of fat (>7 g/ day). This condition correlates with the degree of severity of cholestasis. Stools are soft and smell unpleasant. Steatorrhoea is accompanied by additional diarrhoea. All these changes in the stools lead to a loss of liquid, electrolytes, fat-soluble vitamins and important trace elements. Intestinal bile deficiency causes the characteristic acholic stools, (s. tab. 12.6) (s. fig. 13.8)... 

Fecal excretion is the major route of elimination and only minimal amounts of chlordecone are eliminated through urine. By 84 days, 65% of the dose is excreted in the stool and only 1.6% in the urine. A substantial amount of chlordecone representing as much as 1% of the total body content enters the intestine via biliary excretion. However, the major part of biliary chlordecone (90-95%) is reabsorbed by the intestine and recirculated to the liver (entero-hepatic recirculation), while the remaining 5-10% of the biliary chlordecone entering the upper intestine appears in the feces. Elimination of chlordecone from the body is slow. The half-life of chlordecone in the blood and fat tissue is 165 and 125 days, respectively. Lactating women can also excrete substantial amounts of accumulated chlordecone through breast milk. 

Approximately 40% of mitotane is absorbed after oral administration. After daily doses of 5 to 15 g, concentrations of 10 to 90 J.g/mL of unchanged drug and 30 to 50 pg/mL of a metabolite are present in the blood. After discontinuation of therapy, plasma concentrations of mitotane are still measurable for 6 to 9 weeks. Although the drug is found in all tissues, fat is the primary site of storage. A water-soluble metabolite of mitotane is found in the urine approximately 25% of an oral or parenteral dose is recovered in this form. About 60% of an oral dose is excreted unchanged in the stool. 

Vitamin A supplements in pill or capsule form are available in two formulations, those that contain retinol and those that contain beta carotene. It is not possible to take too much of the latter type of vitamin A. The body will not convert excess amounts of carotene into retinol hut will, instead, excrete the excess in the urine or stool. An excess of retinol-based vitamin A, hy contrast, may result in certain medical problems. Since the vitamin is fat soluble, in may he stored in body fat and reach relatively high concentrations if too much is ingested. An excess of retinol in the body may he associated with liver damage, osteoporosis, rash, fatigue, hone and joint pain, nausea, insomnia, and personality changes. 

In obstructive jaundice, bile salts are not excreted in the intestine, and therefore their beneficial effects on fat solubilization and lipid absorption through the intestinal epithelium are lost. Consequently, the liposoluble vitamins are lost in the stools. Vitamin K is also synthesized by the bacterial flora of the intestine. When antibiotics are administered to cure intestinal infection by pathogens, they also eliminate the sapro-... 

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