Symptoms A-Z

Greasy Stool Symptoms, Causes & Common Questions

Are you experiencing fatty stools that are hard to flush? Don't worry, many of us suffer from greasy or fatty stools from time to time. However, persistent oily stool can point to a disorder in the gut, such as pancreatitis, IBS, or gallstones. Read below to learn what may be causing your oily stool and what you can do about it.

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Steatorrhea, or Fatty Stool, Symptoms Explained

Now and then, all of us might suffer from greasy or fatty stools that typically float in the toilet and are hard to flush. Occasional fat in the stool is normal, especially after a very rich meal at a fancy French restaurant, for example, where you probably feasted on high-fat foods. However, persistent fatty stools are not normal and may indicate some type of disorder in the gut. Because greasy stool symptoms typically indicate an inability to absorb fats and, therefore, fat-soluble vitamins, the condition must be addressed to prevent deficiency in these nutrients.

Greasy stool, or steatorrhea, means that you have too much fat in your stool. Sometimes, this condition can be caused by weak bile in the system, as bile helps us to break down the fats in our stool effectively and absorb all our fat-soluble vitamins from them, like vitamins A, E, D, and K [1, 3]. Too much fat in the stool can also be a sign of malabsorption, meaning you aren't absorbing nutrients well when food passes from the stomach into the intestines[2, 3].

Consistently greasy stools are a sign of some problem with fat absorption in the body.[4] Over time, such inability to absorb fats can cause all kinds of problems, as essential fatty acids are crucial to virtually all of of our systems, from keeping our eyes moist and liquid, to keeping our skin youthful, to manufacturing hormones. So see a doctor if greasy stool symptoms are a persistent problem.

If you have steatorrhea you'll typically notice a cluster of symptoms that accompany the fatty stool such as:

What Causes Fatty, Oily Stool?

Greasy stools are a sign of a malabsorption of fats in the digestive tract [2, 3]. A wide range of diseases and disorders can cause this problem with absorption.

Most common causes of greasy stools:

  • Pancreatitis: The pancreas manufactures enzymes that help us break down fats properly. They work in conjunction with bile (produced by the liver) to break fat globules down into tiny fat particles and help us extract nutrients from our foods. If the pancreas is not functioning properly, you may not be breaking down fat effectively, causing the greasy stool [5, 6, 7].
  • Whipple disease: This disease is caused by a bacterial infection in the intestines. Whipple's disease negatively impacts your body's ability to break down both fat and carbohydrates and is a common cause of malabsorption and greasy stool [8, 9].
  • Food intolerances: Allergies and intolerances to foods like dairy or gluten can also impact nutrient absorption in the gut, leading to fatty stools [10].
  • Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD), and Crohn's disease: All of these conditions of the bowel and intestine are inflammatory conditions that impact how well nutrients and fats are absorbed by the body. Therefore, gut issues like these can all cause greasy, fatty stools [11, 12, 13].
  • Cystic fibrosis: This disease, usually symptomatic since early childhood, causes the mucous membranes in the body to become sticky as mucus becomes thick. This mucus blocks ducts and valves, or passages in the pancreas, and prevents the normal release of bile and enzymes that break down fat. Greasy, foul-smelling stools are one of the hallmark symptoms of this disease [14].

10 Possible Greasy Stool Conditions

The list below shows results from the use of our quiz by Buoy users who experienced greasy stool. This list does not constitute medical advice and may not accurately represent what you have.

Irritable bowel syndrome (ibs)

Irritable bowel syndrome (IBS) is a chronic disorder of the large intestine. It is characterized by recurrent abdominal pain and bowel movement issues that can be difficult to treat. Signs and symptoms of IBS are usually not severe or life-threateni...

Chronic gallstones

Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver.

Rarity: Uncommon

Top Symptoms: nausea, loss of appetite, unintentional weight loss, vomiting, pain in the upper right abdomen

Urgency: Primary care doctor

Gallstones

Gallstones are small, round deposits found in the gallbladder, the organ where bile is stored. Gallstones can be subclassified a number of ways. Oftentimes, gallstones will be referred to as either cholesterol stones or pigment stones depending on the makeup of the gallstone.

Gallstones can also be class...

Chronic hepatitis c

Chronic hepatitis C is a liver inflammation caused by Hepacivirus C.

If someone is infected with hepatitis C and gets the acute form of the disease, there is about a 50% chance of the disease becoming chronic. This means that the virus remains in the body after the acute, short-term disease is over, and may or may not cause further illness.

Some patients have no symptoms of chronic hepatitis C until years later, when liver damage has developed and the signs of cirrhosis (scarring) begin to appear. Hepatitis C can also lead to liver cancer.

Diagnosis is made through blood tests.

Treatment for chronic hepatitis C involves taking medications prescribed by the physician; avoiding alcohol; and using no supplements or prescription medications without a doctor's clearance. In some cases, a liver transplant will be needed to save the patient's life.

The best prevention is to never share needles, toothbrushes, or other personal care items, and to always practice safe sex. There is no vaccine for hepatitis C.

Rarity: Common

Top Symptoms: fatigue, nausea, muscle aches, loss of appetite, joint pain

Symptoms that never occur with chronic hepatitis c: pain in the lower right abdomen, pain in the lower left abdomen, pain in the upper left abdomen, pain around the belly button

Urgency: Primary care doctor

Ulcerative colitis

Ulcerative colitis is a chronic, long-term inflammatory disease of the gastrointestinal tract, specifically involving ulcers and sores of the large intestine (colon) and the rectum. Ulcerative colitis often begins gradually and worsens over time with periods of remission interspers...

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Pancreatic cancer

Pancreatic adenocarcinoma is also called pancreatic exocrine cancer, and means that tumors have begun to grow in the exocrine cells of the pancreas. These cells manufacture the enzymes that help digest fats.

The exact cause of any pancreatic cancer is unknown. Risk factors include smoking; obesity; alcoholism; exposure to certain chemicals; family history of the disease; and pre-existing diabetes, pancreatitis, or cirrhosis of the liver.

Symptoms include jaundice, which is a yellowing of the skin and eyes; dark urine; pale-colored stools; abdominal and/or back pain; loss of appetite; and unintended weight loss.

Diagnosis is made through patient history; physical examination; blood tests; abdominal imaging such as ultrasound or CT scan; and sometimes biopsy of the pancreas or other minor surgical procedure to help make the diagnosis.

Treatment involves a combination of several methods, including chemotherapy; radiation therapy; surgery to remove all or part of the pancreas as well as to help relieve some of the symptoms of the disease; pain management; and psychological support.

Rarity: Rare

Top Symptoms: fatigue, nausea, loss of appetite, diarrhea, unintentional weight loss

Urgency: Primary care doctor

Celiac disease

Celiac disease is also called gluten-sensitive enteropathy, coeliac, or sprue. It is an autoimmune response in the gut to gluten, a protein in wheat, rye, and barley.

  • Repeated exposure to gluten causes damage to the lining of the small intestine.

Most at risk are Caucasians with:

  • Family history of celiac disease.
  • Down syndrome.
  • Type 1 diabetes.
  • Rheumatoid arthritis.
  • Autoimmune thyroid disease.

Symptoms include digestive upset with gas, bloating, and diarrhea. The malnutrition causes fatigue, weight loss, fragile bones, severe skin rash, mouth ulcers, anemia, and damage to the spleen and nervous system.

A swollen belly, failure to thrive, muscle wasting, and learning disabilities are seen in children, and normal growth and development can be severely affected.

Diagnosis is made through blood testing and endoscopy, and sometimes biopsy of the small intestine.

There is no cure for the condition, but celiac disease can be managed by removing all gluten from the diet. Nutritional supplements will be used and sometimes steroid medication is given to help heal the gut.

Rarity: Rare

Top Symptoms: fatigue, stomach bloating, nausea, constipation, diarrhea

Urgency: Primary care doctor

Cystic fibrosis

Cystic fibrosis (CF) is an inherited disease of the mucus and sweat glands, affecting multiple organs, especially the lungs. The mucus clogs the lungs, causing breathing problems and making it easy for bacteria to grow. This can lead to problems such as repeated lung infections and lung damage.

Rarity: Rare

Top Symptoms: shortness of breath, productive cough, salty-tasting skin, decreased exercise tolerance, recurring problem with leaking urine

Urgency: Primary care doctor

Diabetes insipidus

Diabetes insipidus (DI) is caused by a lack of, or decreased sensitivity to the hormone vasopressin. Vasopressin is needed for the kidneys to concentrate urine, making sure you do lose to much fluids. If this function is impaired, it will result in urinating frequently and large amounts, extreme thirst and dehydration.

Rarity: Rare

Top Symptoms: fatigue, irritability, constipation, excesive thirst, dry mouth

Urgency: Primary care doctor

Acute pancreatitis

Acute pancreatitis is the inflammation of the pancreas, which creates and releases insulin and glucagon to keep the sugar levels in your blood stable. It also creates the enzymes that digest your food in the small intestine. When these enzymes accidentally get activated in the pancreas, they digest the pancreas itself, causing pain and inflammation.

Rarity: Rare

Top Symptoms: constant abdominal pain, nausea or vomiting, being severely ill, severe abdominal pain, fever

Symptoms that always occur with acute pancreatitis: constant abdominal pain

Urgency: Hospital emergency room

How to Treat Steattorhea

To treat greasy stools or steatorrhea, any doctor or gastroenterologist will first want to isolate the cause of the problem. Because there are so many gut and organ conditions that can contribute to a problem with fat absorption, he or she will run a battery of stool tests [2, 5].

For individuals with weak bile or who don't have a gallbladder, which stores and concentrates bile, supplemental bile salts or pancreatic enzymes can help the individual to break down fat better, enabling them to absorb fat-soluble vitamins and essential fatty acids [2].

For food allergies and intolerances, simple avoidance of triggers will resolve the problem [10]. For more serious diseases, from pancreatitis cystic fibrosis, medications and lifestyle changes are typically the course of action [11, 12, 13, 14].

FAQs About Greasy Stool

Here are some frequently asked questions about greasy stool.

What foods cause greasy stools?

Greasy stool is generally a sign of intestinal malabsorption, associated with conditions such as celiac disease, chronic pancreatitis, lactase deficiency and so on [2].[4]. These conditions disrupt processes of fat breakdown/absorption. In principle, any food that exacerbates these underlying conditions can cause greasy stool. There is less evidence regarding the association between consumption of whole nuts, natural and artificial fats with greasy stools.

Can coffee cause greasy stools?

There have been no studies linking coffee and greasy stool. Caffeine in the coffee is a potent stimulator of smooth muscles in the intestinal tract and thus might have an impact on bowel function. Sometimes dairy products in the coffee can contribute to greasy stool among patients with lactase deficiency.

Why do I have oily stools when pregnant?

Oily, fatty, or greasy stools can be caused by intrahepatic cholestasis of pregnancy (ICP)[15]. Cholestasis is a term used to describe conditions with diminished bile formation and/or excretion as bile is essential to fat absorption. ICP can cause fat malabsorption and, hence, oily stool [2]. ICP typically develops in the late second and/or third trimester and rapidly resolves after delivery. This condition also cause pruritus (itching of the skin) and an elevation in serum bile acid concentrations. The etiology for ICP is not completely understood, but likely involves a combination of genetic susceptibility, hormonal factors, and environmental factors.

Can you have greasy stools after gastric bypass surgery?

Yes. Certain gastric bypass surgeries, such as jejunoileal bypass, biliopancreatic diversion, and Roux-en-Y gastric bypass can cause greasy tool. These procedures shorten the length of the functional small intestine to reduce the effectiveness of nutrient absorption, which contribute to greasy stools.

Why does my stools float?

Stools that float are usually fatty or greasy and are most often due to poor absorption of nutrients (malabsorption) or too much gas (flatulence)[2]. Flatulence can be caused by consumption of foods that are hard to digest, such as fiber, or food that your body cannot tolerate. Malabsorption can be caused by many conditions with compromised processes of food breakdown/absorption.

Questions Your Doctor May Ask About Greasy Stool

To diagnose this condition, your doctor would likely ask the following questions:

  • Have you experienced any nausea?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Any fever today or during the last week?
  • Have you had any changes in your weight?

The above questions are also covered by our A.I. Health Assistant.

If you've answered yes to one or more of these questions

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Greasy Stool Symptom Checker Statistics

People who have experienced greasy stool have also experienced:

  • 10% Diarrhea
  • 9% Abdominal Pain (Stomach Ache)
  • 5% Fatigue

People who have experienced greasy stool were most often matched with:

  • 40% Gallstones
  • 30% Irritable Bowel Syndrome (Ibs)
  • 30% Chronic Gallstones

Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

Greasy Stool Symptom Checker

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References

  1. The Editors of Encyclopaedia Britannica. Bile. The Encyclopaedia Britannica. Updated November 30, 2017. The Encyclopaedia Britannica Link.
  2. Lal SK. Malabsorption. U.S. National Library of Medicine: MedlinePlus. Published May 11, 2016. MedlinePlus Link.
  3. Lal SK. Stools - Floating. U.S. National Library of Medicine: MedlinePlus. Published May 11, 2016. MedlinePlus Link.
  4. Ruiz AR. Overview of Malabsorption. Merck Manual Professional Version. Updated February 2018. Merck Manual Professional Version Link.
  5. Struyvenberg MR, Martin CR, Freedman SD. Practical Guide to Exocrine Pancreatic Insufficiency - Breaking the Myths. BMC Medicine. 2017;15:29. BMC Medicine Link.
  6. 5 Things Your Poop Can Tell You About Your Health. Johns Hopkins Medicine. Johns Hopkins Medicine.
  7. Pancreatitis. National Institute of Diabetes and Digestive and Kidney Diseases. NIDDK Link.
  8. Whipple Disease. National Institute of Diabetes and Digestive and Kidney Diseases. Published August 2014. NIDDK Link.
  9. Ruiz AR. Whipple Disease. Merck Manual Professional Version. Updated February 2018. Merck Manual Professional Version Link.
  10. Zopf Y, Hahn EG, Raithel M, Baenkler HW, Silbermann A. The Differential Diagnosis of Food Intolerance. Deutches Arzteblatt International. 2009;106(21):359-370. NCBI Link.
  11. Irritable Bowel Syndrome (IBS). National Institute of Diabetes and Digestive and Kidney Diseases. NIDDK Link.
  12. Phillips MM. Inflammatory Bowel Disease. U.S. National Library of Medicine: MedlinePlus. Published July 9, 2017. MedlinePlus Link.
  13. What is Crohn's Disease? National Institute of Diabetes and Digestive and Kidney Diseases. Published September 2017. NIDDK Link.
  14. Cystic Fibrosis. National Heart, Lung, and Blood Institute. NHLBI Link.
  15. Intrahepatic Cholestasis of Pregnancy. U.S. National Library of Medicine: Genetics Home Reference. Published October 23, 2018. GHR Link.

Disclaimer: The article does not replace an evaluation by a physician. Information on this page is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes.