Abstract
Fecal fat excretion, fecal mass, fecal fat concentration, and the coefficient of fat absorption were evaluated in 31 normal Japanese subjects with a mean fat consumption of 61.8 g and compared with the values in 43 Japanese patients with chronic pancreatitis (CP) with a fat consumption of 40.2g. Fecal fatty acids were analyzed by the gas Chromatographic method. Fecal fat excretion by normal individuals was 1.7±1.0 (Mean±SD) g/day (range, 0.4–4.9 g/day). Steatorrhea was therefore defined as fecal fat excretion that exceeded 5.0 g/day. The patients with CP were divided into three groups: non-steatorrhea (fecal fat ≪5.0g/day), chemical steatorrhea (fecal fat ≥5 g/day and no appearance of fatty stool), and manifest steatorrhea (evaluated from the appearance of fatty stool). In addition, we investigated the correlation between fecal fat excretion and pancreatic exocrine function, obtained by the pancreozymin-secretin (or secretin) test in 24 controls and 30 CP patients. Fecal fat excretion by CP patients was 9.1±8.8 g/day, which was significantly higher (P<0.01) than that of controls. There were 28 (65%) CP patients with steatorrhea. Of these, 15 (35%) showed chemical steatorrhea and 13 (30%) manifest steatorrhea. In CP patients, the fecal mass (250.5±133.6 g vs control, 125.6±52.5 g), fecal fat concentration (3.40±2.16g% vs control, 1.48±0.89g%), and coefficient of fat absorption (77.3±20.2% vs control, 97.2±1.7%) all showed significant differences from the controls. Of these three indices—fecal mass, fecal fat concentration, and coefficient of fat absorption—fecal fat concentration was the most useful for identifying pancreatic steatorrhea. In addition, there were significantly different correlations between fecal fat excretion and pancreatic exocrine function in patients' group and control group. Fecal fat excretion was clearly correlated with amylase output. These findings led to the conclusion that steatorrhea indeed exists among Japanese CP patients who consume small amounts of dietary fat; and that fecal fat excretion is closely correlated with pancreatic exocrine dysfunction.
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Nakamura, T., Takebe, K., Kudoh, K. et al. Steatorrhea in Japanese patients with chronic pancreatitis. J Gastroenterol 30, 79–83 (1995). https://doi.org/10.1007/BF01211379
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DOI: https://doi.org/10.1007/BF01211379