From the Guidelines
Yes, pancreatitis can cause greasy stools, a condition known as steatorrhea, due to the pancreas's reduced ability to produce digestive enzymes that break down fats in food. This occurs because pancreatitis damages the pancreas, leading to a decrease in the production of pancreatic enzymes, such as lipase, which is essential for fat digestion 1. Without sufficient pancreatic enzymes, fats pass through the digestive system undigested, resulting in oily, foul-smelling stools that may float in the toilet and be difficult to flush.
According to the most recent study, management of steatorrhea in pancreatitis typically involves pancreatic enzyme replacement therapy (PERT) such as pancrelipase (Creon, Zenpep) taken with meals, usually starting at 500 lipase units per kg per meal and adjusting as needed 1. Patients should also follow a low-fat diet (limiting fat to 30-50g daily) and avoid alcohol completely. The greasy stools improve as the pancreatic enzymes help digest fats properly, allowing better nutrient absorption and reducing gastrointestinal symptoms.
Key points to consider in the management of pancreatitis-related steatorrhea include:
- Pancreatic enzyme replacement therapy (PERT) is the mainstay of treatment for exocrine pancreatic insufficiency (EPI) 1
- A low-fat diet and avoidance of alcohol are essential for managing steatorrhea 1
- The dose of PERT may need to be titrated, and acid-suppression medication may be required in some cases to prevent denaturation of both endogenous and administered enzymes 1
- Other additive causes of malabsorption should be considered in some cases 1
It is essential to note that fat malabsorption can occur even in mild or moderate chronic pancreatitis, and not just in severe cases, as previously thought 1. Therefore, early diagnosis and treatment of EPI are crucial to prevent adverse gastrointestinal symptoms, undernutrition, and nutrient deficiency.
From the Research
Pancreatitis and Greasy Stools
- Pancreatitis can lead to greasy stools due to fat malabsorption, also known as steatorrhea, which is a common clinical manifestation of exocrine pancreatic insufficiency 2.
- Steatorrhea is characterized by the fecal excretion of more than 6 g of fat per day, resulting in greasy and foul-smelling stools 2.
- The relationships between pancreatic maldigestion, intestinal ecology, and intestinal inflammation can contribute to the development of steatorrhea in patients with chronic pancreatitis 2.
- Fat malabsorption can also lead to a deficit of fat-soluble vitamins (A, D, E, and K) with consequent clinical manifestations 2.
- While the other studies do not directly address the issue of greasy stools, they provide information on the management and treatment of pancreatitis, including dietary recommendations and nutritional support 3, 4, 5, 6.