What Causes Fatty Stools?

Most nutrients obtained through the diet are absorbed in the small intestine. Malabsorption syndromes that interfere with the action of the small intestine also affect the absorption of proteins, vitamins, and fats. Nutrients not absorbed by the small intestine pass through to the colon and are excreted in the stool. Fatty stools, or a high concentration of lipids on the feces, are caused by medical conditions that affect production and secretion of pancreatic enzymes or bile salts, which are necessary for proper fat absorption.

Dietary fats, or triglycerides, require a complex of pancreatic enzymes to be absorbed properly. The most important of these enzymes is a complex called lipase-colipase. Additionally, a specific concentration of bile salts is also necessary. A deficiency in lipase or colipase, or a low concentration of bile acid, will prevent the intestines from absorbing fats.

The pancreatic enzymes split the long molecular chains of triglycerides into smaller fatty acids and monoglycerides. These smaller molecules combine with the bile salts to form micelles, or a cluster of particles. The micelles pass through the cells lining the walls of the small intestine. Triglycerides with medium length chains are absorbed directly by the intestinal walls.

Malabsorption results from any condition that prevents the intestines from properly absorbing dietary fats. Steatorrhea, or fatty stools, occur when more than 0.25 ounces (7 g) of fat are excreted in the stools per day. They appear light-colored and greasy, and they have a foul odor. In many cases, the stools of people with absorption problems are accompanied by diarrhea, gas and abdominal bloating or pain.

Causes of steatorrhea can be grouped into pancreatic insufficiencies or impaired bile production. Examples of conditions that cause pancreatic insufficiencies are pancreatitis, cystic fibrosis, pancreatic cancer, celiac disease or other mucosal diseases and obstructive biliary or cholestatic liver disease. Conditions that impair biliary function include liver or biliary tract disease or inflammation of the ileum. Overgrowth of bacteria in the small intestine might also cause malabsorption and fatty stools by making the bile acid inactive and preventing micelle formation.

Other than the physical symptoms, malabsorption is associated with vitamin deficiency. If the intestines fail to properly absorb dietary fats, then minerals and fat-soluble vitamins, such as A, D, E and K, are excreted in the feces. Additionally, without proper fat intake, energy levels plummet, and unexplained weight loss is a common symptom of malabsorption.

The treatment depends on the cause of the malabsorption. Medications are available to replace insufficiently produced pancreatic enzymes, and antibiotics might be used to treat bacterial overgrowth in the intestines. People who are suffering from malabsorption might require vitamin supplements to replace the fat-soluble vitamins excreted. Agents that bind bile acids could also be used to aid in fat digestion.

How Can I Prevent Fatty Stools From Happening in My Body?

There are many ways to prevent fatty stools from forming in your body. It is as simple as making some dietary adjustments for your overall health. Try incorporating these suggestions into your daily diet: 

• Drinking daily recommended glasses of water regularly. 
• If you smoke, do it less or quit entirely. 
• Lower alcohol intake. 
• Do not overconsume foods high in potassium oxalate. 
• Intake less dietary fiber and dietary fat. 
• Increasing your intake of fat-soluble vitamins via supplements and dietary changes including A, D, E, and K. 

How Can I Get More Fat-Soluble Vitamins Into My Diet?

Speaking of fat-soluble vitamins, let’s discuss healthy food choices. You can get more fat-soluble vitamins into your diet by changing up the foods you eat to increase your intake and taking a daily multivitamin as support. Here are some foods listed below for each fat-soluble vitamin that you can eat to increase your daily intake. 

A is for Acorn Squash

Foods high in Vitamin A include:

• Eggs
• Milk
• Leafy greens such as broccoli, kale, and spinach. 
• Fish oils
• Red bell pepper
• Mango
• Carrots
• Sweet potatoes
• Tomatoes 
• Beef liver
• Summer (zucchini or crookneck) and winter squash (acorn or butternut)
• Cantaloupe

D is for Dried Shiitake Mushrooms

Some foods where Vitamin D is most present are: 

• Cod liver oil
• Dried or raw shiitake mushrooms 
• Drinks and foods fortified with Vitamin D
• Orange juice
• Plant-based milk. 
• Cereal
• Oatmeal
• Fish species
• Salmon
• Sardines
• Swordfish
• Tunafish

E is for Eggs

Foods where you can get the most Vitamin E are: 

• Peanuts and peanut butter spread
• Sunflower seeds
• Eggs
• Oils such as soybean, safflower, and sunflower 
• Leafy greens such as spinach and beet greens
• Almonds
• Avocado
• Asparagus
• Pumpkin

K is For Kale 

Eat these foods to get your daily intake of Vitamin K:

• Leafy greens including kale, Brussel sprouts, spinach, broccoli, etcetera. 
• Canola and soybean oils
• Fermented soybeans
• Meal replacement shakes fortified with Vitamin K

How Much of Each Fat-Soluble Vitamin Should I Intake per Day?

Get enough fat-soluble vitamins daily to reduce your chances of experiencing fatty stools. Biological scientific studies have shown that following daily recommended amounts to be optimally healthy.

Daily intake needs of vitamins such as Vitamins A, B, E, and K depend on gender and weight. Men should intake higher doses of these vitamins than women because they usually weigh more. 

Vitamin A Daily Doses

Men's daily Vitamin A intake should be 900 micrograms (mcg). Women should consume 700 mcg each day. The tolerable upper limit is 3,000 mcg of preformed Vitamin A within 24 hours.

Vitamin D Daily Doses

Infants younger than 12 months should intake 400 international units (IUs) of Vitamin D. Once they turn a year old, you can increase that dose to 600 IUs per day. Adults up to age 70 should consume 600 IUs of Vitamin D daily. Seniors age 70 and older should intake 800 IUs of Vitamin D each day. 

Vitamin E Daily Doses

Adults should intake 15 mg of Vitamin E daily. Pregnant women can maintain this same daily intake. Breastfeeding women need at least 19 mg of Vitamin E each day. 

Vitamin K Daily Doses

Adults 19 and older need at least 120 mcg of Vitamin K daily if they are male. Females need at least 90 mcg of Vitamin K every day to be healthy. 

What If I Am Pregnant And Experiencing Fatty Stools?

If you are pregnant, take a prenatal vitamin to be sure you and your growing baby are receiving the vital nutrients you both need to support you through your pregnancy journey. Here are the increased daily needs for pregnant women based on recommendations from The American College of Obstetricians and Gynecologists. 

The only vitamin intake that remains the same for pregnant women versus non-pregnant women is Vitamin D. Pregnant women should continue to intake 600 IUs of Vitamin D each day. 

Type of Vitamin	Daily Intake for Women 18 and Under	Daily Intake for Women Aged 19 to 50
Vitamin A	750 mcg	770 mcg
Vitamin B6	1.9 milligrams	1.9 milligrams
Vitamin B12	2.6 micrograms	2.6 micrograms
Vitamin D	600 IUs	600 IUs
Vitamin E	15 mg	15 mg
Vitamin K	90 mcg	90 mcg

While pregnant women do not need to increase their daily intake of Vitamin K during pregnancy, there is an exception. If you are taking anti-seizure medication, you should boost your Vitamin K intake. This interaction can cause a Vitamin K deficiency for your growing baby. 

Final Thoughts

Fatty stools mean that not enough fat is breaking down in your digestive system. If they regularly happen for you, reevaluate your diet for an overall healthier body and way of life.