Lab Diagnosis of Excess Fecal Fat

Q: I have been doing a lot of research lately regarding my symptoms of malabsorption of fat. I eat very carefully and still have 33% of body fat, all in the lower part of the body. My Mom and my late grandmother have had a lot of issues. I think I will go the same route if I do not catch the problem in time.

Can you please let me know if low triglycerides, that is below 35 mg/dl in the last 5 years, are in any way related to fat malabsorption or gluten intolerance, though I do not have any symptoms of Celiac. If you can advice me what tests to do further, I will really appreciate it.
– By Jay, female 44 years.

Reply:

Firstly, do you think you are taking enough fat in your diet to have an adequate level of triglycerides?

If yes, and still you have a low level of triglyceride in your blood, may be there is some malabsorption condition.

But this needs to be confirmed before anything may be done. There are several methods for testing fat in stools.

Diagnostics Tests to Confirm the Presence of Fat in Stools

They include:

  • Sudan stain test- Here the stool sample is stained. The number and size of the fat globules per high-power field (hpf) is then scored. Normal <20/hpf 1 to 4 micrometer in size.
    Slightly increased >20/hpf 1 to 8 micrometer in size.
    Definitely increased >20/hpf, 6 to 75 micrometer in size)
  • Steatocrit- Here the stool sample is centrifuged and the amount of fat in it is assessed.
  • Van de Kamer method- Chemical analysis of feces is done here. This is considered the most accurate test for fecal fat quantification.

These tests may be performed in any pathology laboratory. Try to get it done results first and then the different medical conditions giving such situations may be evaluated.

Take Care,

Buddy M.D.

Medical Advice (Q&As) on “How to Test Fat in Stools or Steatorrhea?

  1. Jennifer

    For about a year now or more, I have had white clumps in my stool, some days there are more some days less. I have internal hemorrhoids which have burst at least twice over the years. I normally produce a bowel movement anywhere between 3-4 days but recently for the last couple of weeks I have urges to go sometimes up to 3 times a day. These are sudden urges and produce a soft almost diarrhea like stool. I had an upper endoscopy almost a year ago which showed gastritis. I am not sure if the two would be related. I am wondering if the increase in bowel movements recently plus the white clumps consistently increasing in this same time period should require a trip to the gastroenterologist as well as your thoughts on what it could be? The doctor had mentioned almost a year ago it being mucous but that should clear up on it’s own after a little while and it has not. Any insight you could provide would be helpful.

    Reply
    1. Buddy M.D. Post author

      The white clumps are likely to be fatty globules, mucous, as your doctor said. However, it is suggested that you go for a stool test (analysis) to ascertain what these lumps are.

      You need to go to a pathology lab for this. All hospitals have these labs.

      All your problems are linked and somewhere related to your diet and lifestyle. The whole gastrointestinal tract sounds inflamed. A good nutritionist may help you jot down a diet chart that may help.

      Aim at the following objectives:

      Reduce the total amount of fat you are taking.
      Include plenty of fresh fibrous fruits and vegetables in your diet.
      Drink plenty of water.
      Common beverages people take are acidic in nature and would aggravate gastritis. Try replacing your cups of tea, coffee or alcohol with fruit juices.
      Include plenty of dietary fibers, both soluble and insoluble, in your diet.
      Stay physically active throughout the day.

      Your symptoms would slowly improve as you change your diet. Also, you may get your blood pressure checked up. Hemorrhoids are common in patients with high B.P.

      Reply
  2. Mark

    Can drinking green smoothies and taking vitamins result in floating stools? Mine appear as type 4 on the bristol chart, normal color to green due to the vegetables. There is a lot of air bubbles expressed when submerged in the toilet. My liver enzymes are within normal limits, colonoscopy was negative and belly ultrasound demonstrated mild fatty liver. When searching the internet- there are two different opinions- stools float with lots of fiver or they sink with lots of fiber? Others sites say it’s not a big deal whether stools float or sink? Any help would be greatly appreciated.

    Reply
    1. Buddy M.D. Post author

      Your stools appear to be normal. It needs to be investigated only if you have any symptom, like pain in tummy, acidity, digestion problem, excess farting or any other problem.

      The reason for stool to float may be the presence of too much of fat in them. Most smoothies available in the market are rich in fat. You may consider taking them in moderate amounts only.

      As for vegetables, no rationing is required. They are good for health in any amount.

      Reply

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