Feces - the end product of the processing of products entering the body. A he althy person who does not suffer from digestive problems has shaped stools that do not contain neutral fat. The result of digestion of food and absorption of residual products in the intestine should be covered with a small amount of mucus and cylindrical epithelial cells. If neutral fat is present in the stool, this condition is called steatorrhea. It is considered pathological and may indicate diseases of the pancreas, bile ducts or liver.
What are fats?
Neutral fats are esters of fatty acids and glycerol. Depending on how many hydroxyl groups of glycerol are esterified with fatty acids, the following types of lipids of this group are distinguished:
- triglycerides - three groups;
- diglycerides - two groups;
- monoglycerides - one group.
Neutral fatis in the human body in the form of a reserve material or becomes protoplasmic fat, which is part of the cells. The role of these forms is different. Protoplasmic lipids have a constant composition and exist in cells in a certain amount that does not change with the development of obesity or in the case of a person losing weight. The amount of reserve fat tends to fluctuate.
Triglycerides
This group is the most numerous among all representatives of neutral lipids. The fatty acids that make up the composition can be unsaturated and saturated. The most common are: oleic, stearic and palmitic acids. If the radicals that make up the triglyceride belong to one acid, then it is called simple, in the case of their relationship to different acids - mixed.
The physical and chemical properties of neutral fats depend on what acids are included in the composition. Features are as follows:
- the greater the number and length of saturated fatty acid residues, the higher the melting point of lipids;
- the more unsaturated fatty acids and the shorter their chain, the lower the melting point;
- triglycerides can participate in the saponification reaction, resulting in breakdown into fatty acids and glycerol;
- saponification process is characteristic of enzymatic hydrolysis, action of alkalis and acids.
Properties of lipids
Neutral fat - a substance that melts easily, it is lighter than water, but insoluble in it. At room temperature, lipids are solid, ointment-like, or liquid.condition and can melt over a wide temperature range.
Substances are practically insoluble in water, but adding soap or some kind of emulsifier to them leads to the formation of stable aqueous emulsions. Neutral fat dissolves well in alcohol and various solvents (ether, gasoline, benzene, chloroform).
Phospholipids are colorless but darken rapidly when exposed to air. This occurs as a result of the oxidation of unsaturated fatty acids that make up the composition. The properties of neutral fats found in the human body are as follows:
- layered structures, which are formed upon contact with solutions, enable lipids to participate in the construction of cell membranes;
- entering into a close relationship with proteins located on the surface of cell membranes, regulate the processes of entry into the cell of organic substances that are involved in metabolic processes;
- are naturally occurring antioxidants.
The dependence of the physicochemical properties of neutral fats on their structure explains the possibility of their participation in vital processes occurring in the human body. Especially a lot of phospholipids are found in the nervous tissue, liver, heart.
Steatorrhea and its types
Neutral fat in feces is a pathological condition. Depending on the etiology, the following types of steatorrhea are distinguished:
- Intestinal type. Due to certain reasons, lipids are not absorbed in the intestinal tract, but go outside withfeces.
- Alimentary type. The basis of this pathology is irrational nutrition. With food, a huge amount of phospholipids enters the human body, which are not able to be absorbed in full.
- Pancreatic type. It occurs as a result of disorders in the pancreas. There is a decrease in the synthesis of lipase - the enzyme responsible for the normal breakdown of lipids.
Steatorrhea also differs in the variety of components. Stools may contain significant amounts of neutral fats (triglycerides), soaps and fatty acids, or all three.
Causes of pancreatic steatorrhea
Neutral fat in the feces of a child or adult may appear against a background of a number of abnormal conditions.
1. Pancreatic diseases:
- acute pancreatitis during the first six months;
- inflammation of the pancreas lasting more than six months (chronic process);
- narrowing of the Wirsung duct (through it the pancreatic juice enters the duodenum);
- Zolinger-Ellison syndrome is a tumor process that results in ulceration of the stomach and intestinal tract.
2. Liver pathologies:
- acute and chronic hepatitis;
- hepatitis due to alcohol abuse;
- cirrhosis of the liver;
- sclerosing type cholangitis - an inflammatory diseaseintrahepatic bile ducts, which is accompanied by scarring;
- hemochromatosis is a violation of metabolic processes associated with iron, which is accompanied by its pathological accumulation in the body;
- liver amyloidosis;
- tumors and cysts.
3. Pathology of the gallbladder and ducts:
- gallstone disease;
- inflammation of the gallbladder, acute and chronic;
- cholangitis - inflammation of the bile ducts;
- infection of the biliary tract with Giardia.
Causes of intestinal steatorrhea
Neutral fat in the coprogram in intestinal type pathology may occur as a result of the following conditions:
- in Crohn's disease - a chronic inflammation of the intestinal tract, in which narrowing and ulceration develop;
- with Whipple's disease - a disease of the intestines and regional lymphatic donkeys of an infectious nature;
- with intestinal lymphoma - a tumor that consists of lymphocytes;
- in post-resection condition;
- with enteritis, enterocolitis;
- for amyloidosis;
- with diverticulosis - a pathological process accompanied by the formation of diverticula (protrusions) in the intestinal wall.
Other etiological factors
The causes of the appearance of phospholipids in the stool may be diseases of the endocrine glands. Hypothyroidism and Addison's disease (adrenalinsufficiency).
Abetalipoproteinemia (impaired absorption and transport of lipids), cystic fibrosis (the secretions of all glands are highly viscous and thick) and cealkia (a disease in which gluten is not completely broken down) are congenital conditions that lead to the appearance of neutral fat in baby feces.
The occurrence of phospholipids in the stool can accompany psoriasis and eczema, as well as long-term use of laxatives and drugs used for weight loss.
Clinical picture
The first manifestation of pathology is the frequent urge to defecate. The feces are oily and difficult to wash off the surface of the toilet bowl. The stool leaves a greasy trail. The color of the feces may remain normal, or may change towards a light or gray shade.
In addition, neutral fats, the composition of which has fatty acids and glycerol, appearing in feces, in addition, can be reflected in the following symptoms:
- dry cough;
- dizziness;
- joint and back pain;
- bloating;
- poor performance;
- weakness;
- dry mucous membranes;
- exhaustion;
- bleeding gums.
The appearance of oily stools and at least one of the accompanying symptoms is a reason to seek qualified help.
Diagnostic measures
The collection of complaints and anamnesis is accompanied by a clarification of when the symptoms appeared, with whatthe patient associates their occurrence when the stool has acquired an oily character. The specialist clarifies the presence of congenital diseases or pathologies that are inherited in the patient's relatives. Next, the doctor examines the patient. The presence of exhaustion, the condition of the skin and mucous membranes are determined, palpation and percussion of the abdominal organs are performed.
Coprology (laboratory study of feces) consists of an assessment of the following indicators:
- Macroscopy - steatorrhea appears as lighter stools with a sheen of hardened fat.
- Microscopy determines the presence of lipids, fatty acids, soap. Normally, no more than 5 g of neutral fat should be excreted with feces in 24 hours. The results above are pathological.
If necessary, use a radioisotope study, ultrasound examination of the abdominal organs, colonoscopy, assessment of the hormonal balance of the body, consultation of an endocrinologist and a therapist.
Elimination of steatorrhea
First of all, treatment is aimed at the disease that caused the appearance of neutral fat in the feces. Individual selection of the diet is also carried out on the basis of the underlying pathology. It is obligatory to exclude fried, pickled, smoked products.
The patient should stop drinking alcohol, get rid of bad habits. It is recommended to add to the diet those foods that contain a significant amount of retinol, tocopherol, calciferol and vitamin K. These same fat-soluble vitamins are prescribed in the form of medications.drugs.
Complications and consequences
Complications develop only in case of late treatment. There is a violation of the absorption of nutrients in the intestinal tract. Against this background, hypo- and beriberi, protein deficiency and depletion of the body develop. The pathology of water and electrolyte balance is manifested by a constant feeling of thirst, swelling, dehydration, convulsive seizures.
The specialist diagnoses the appearance of oxaluria (excessive pathological excretion of oxalic acid s alts from the body along with urine) and the formation of urinary stones of oxalate origin. This pathological condition occurs due to the fact that under normal conditions, oxalates do not enter the blood from the intestinal tract, since their combination with calcium makes them insoluble. With the development of steatorrhea, calcium in large quantities is excreted from the body along with feces. This leads to a significant flow of oxalates from the intestines into the blood.
The patient loses body weight rather sharply. The normal functioning of all internal organs and systems is disrupted. Such manifestations lead to psychological problems (insomnia, changes in communication, decreased performance).
Preventive measures
Preventive measures can be divided into primary and secondary. Primary prevention is carried out so that the disease does not appear. It is based on the prevention of the development of pathologies in which steatorrhea becomes one of the symptoms. Important pointsare considered:
- quit smoking and excessive drinking;
- correction of the diet;
- increasing plant foods;
- fractional meals in small portions;
- use of multivitamin complexes;
- strengthening the body's defenses.
The basis of secondary prevention (after the onset of the disease) is the timely rational treatment of the pathological condition.
Conclusion
Early diagnosis and a correct diagnosis will allow the specialist to choose an individual treatment regimen and avoid the development of complications of the disease. Self-medication is not recommended, since only a highly qualified doctor is able to determine the true cause of the appearance of neutral fats in the feces and eliminate it. The prognosis is favorable for those patients who follow the advice and recommendations of the treating specialist, and are also engaged in secondary prevention of pathology.
