脂肪泻（或脂肪性痢疾）是粪便中多余的脂肪。凳子可能笨重，难以冲洗，外观发白，油腻，并且特别难闻。可能会发生油性肛门渗漏或某种程度的粪便失禁。脂肪排泄增加，这可以通过确定粪便脂肪水平来测量。粪便脂肪构成脂肪泻的定义尚未标准化。
内容
1 原因
1.1 相关疾病
1.2 药物
1.3 饮食中过多的全坚果
1.4 天然脂肪
1.5 人造脂肪
2 诊断
3 治疗
4 参考
原因
消化或吸收受损可导致大便肥腻。可能的原因包括外分泌胰腺功能不全，缺乏脂肪酶导致的消化不良，胆汁盐的丢失（减少了胶束的形成）以及小肠疾病引起的吸收不良。各种其他原因包括某些阻碍脂肪吸收的药物，或饮食中不易消化或油脂过多的脂肪。
胆汁分泌不足会导致粪便变成灰色或苍白。脂肪吸收不良的其他特征也可能发生，例如降低的骨密度，在弱光下的视力困难，出血，淤青和缓慢的凝血时间。
相关疾病
条件影响胰腺。外分泌型胰腺功能不全可能由慢性胰腺炎，囊性纤维化和胰腺癌（如果阻塞胆汁流出）引起。
影响胆汁盐的条件。胆结石阻塞（胆管结石症），原发性硬化性胆管炎，肝损害（肝内胆汁淤积），降血脂药或胆囊摘除后的改变（胆囊切除术）。
引起肠道吸收不良的条件。这些疾病包括乳糜泻，细菌过度生长，热带灌肠，贾第鞭毛虫病（原生动物寄生虫感染），佐林格-埃里森综合症，短肠综合症，炎症性肠病和无脂蛋白血症。
其他原因：可以产生脂肪泻的药物包括奥利司他，减肥药或作为奥曲肽或兰肽的不良反应，用于治疗肢端肥大症或其他神经内分泌肿瘤。可以在格雷夫斯病/甲状腺功能亢进症中发现。
药物治疗
Orlistat（也称为商品名Xenical和Alli）是一种减肥药，它通过阻断消化脂肪的酶起作用。结果，一些脂肪无法从肠道吸收，而是从粪便中排泄，而不是被代谢消化和吸收，有时会引起油性肛门泄漏。 Vytorin（依泽替米贝/辛伐他汀）片剂可引起某些人的脂肪泻。
饮食中过多的坚果
一些研究表明，与坚果酱，油或面粉相比，食用全脂坚果时粪便中的脂质增加，并且来自全脂坚果中的脂质吸收率明显降低。
天然脂肪
食用荷荷巴油已被证明可引起脂肪泻和肛门渗漏，因为它不易消化。
食用海鞘和油鱼（有时标错了黄油鱼）常常会引起脂肪热，也被称为gempylotoxim或Gempylid Fish中毒或keriorrhea。
人造脂肪
据报道，用于减少某些食品中可消化脂肪的脂肪替代物Olestra在测试销售阶段导致某些消费者泄漏。结果，该产物在一般释放之前被重新配制为在生理温度下不是液体的氢化形式。美国食品和药物管理局警告显示，过量食用蔗糖聚酯可能会导致“大便稀疏”；但是，自2003年以来就不再需要此警告。
诊断
当粪便笨重，漂浮和有臭味时，应怀疑有脂肪泻。需要进行特殊测试以确认这些特性实际上是由于脂肪含量过多所致。可以在规定的时间内（通常为5天）测量粪便中的脂肪。其他测试包括（13）C混合甘油三酸酯测试和粪便弹性蛋白酶测试，以检测由于外分泌胰腺功能不全而引起的可能的脂肪消化不良，或各种特定测试，以检测其他吸收不良的原因，例如乳糜泻。
治疗
治疗主要是纠正潜在病因，以及补充消化酶。
参考
Adam S Cheifetz; Alphonso Brown; Michael Curry; Alan C Moss (10 Mar 2011). Oxford American Handbook of Gastroenterology and Hepatology. Oxford University Press. p. 234. ISBN 9780199830121.
Lindkvist B (2013). "Diagnosis and treatment of pancreatic exocrine insufficiency". World J. Gastroenterol. (Review). 19 (42): 7258–66. doi:10.3748/wjg.v19.i42.7258. PMC 3831207. PMID 24259956.
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Dogliotti, L; Tampellini, M; Stivanello, M; Gorzegno, G; Fabiani, L (2001). "The clinical management of neuroendocrine tumors with long-acting repeatable (LAR) octreotide: comparison with standard subcutaneous octreotide therapy". Annals of Oncology. 12 Suppl 2: S105–9. doi:10.1093/annonc/12.suppl_2.s105. PMID 11762334.
Squires, Sally (2006-01-24). "Weighing a Pill For Weight Loss". Washington Post. Retrieved 2007-07-06. While the Food and Drug Administration (FDA) still must approve the switch, the agency often follows the advice of its experts. If it does, Orlistat (xenical) -- currently sold only by prescription -- could be available over-the-counter (OTC) later this year. But it's important to know that the weight loss that's typical for users of the drug -- 5 to 10 percent of total weight -- will be less than many dieters expect. And many consumers may be put off by the drug's significant gastrointestinal side effects, including flatulence, diarrhea and anal leakage.
"Frito-Lay Study: Olestra Causes "Anal Oil Leakage"". Center for Science in the Public Interest. February 13, 1997. Retrieved 2007-07-07. The Frito-Lay report states: "The anal oil leakage symptoms were observed in this study (3 to 9% incidence range above background), as well as other changes in elimination. ... Underwear spotting was statistically significant in one of two low level consumer groups at a 5% incidence above background." Despite those problems, the authors of the report concluded that olestra-containing snacks "should have a high potential for acceptance in the marketplace."
"The Word Is 'Leakage'. Accidents may happen with a new OTC diet drug". Newsweek. June 25, 2007. Archived from the original on 2007-06-18. Retrieved 2007-06-21. GlaxoSmithKline has a tip for people who decide to try Alli, the over-the-counter weight-loss drug it is launching with a multimillion-dollar advertising blitz—keep an extra pair of pants handy. That's because Alli, a lower-dose version of the prescription drug Xenical, could (cue the late-night talk-show hosts) make you soil your pants. But while Alli's most troublesome side effect, anal leakage, is sure to be good for a few laughs, millions of people who are desperate to take off weight may still decide the threat of an accident is worth it.
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Bad Bug Book - Foodborne Pathogenic Microorganisms and Natural Toxins Handbook: Gempylotoxin, FDA
"Reported medical side-effects of Olestra according to Procter and Gamble studies". Center for Science in the Public Interest. Archived from the original on 2007-07-02. Retrieved 2007-06-21. Olestra sometimes causes underwear staining associated with "anal leakage." Olestra sometimes causes underwear staining. That phenomenon may be caused most commonly by greasy, hard-to-wipe-off fecal matter, but occasionally also from anal leakage (leakage of liquid olestra through the anal sphincter).
Lindkvist, B (14 November 2013). "Diagnosis and treatment of pancreatic exocrine insufficiency". World Journal of Gastroenterology. 19 (42): 7258–66. doi:10.3748/wjg.v19.i42.7258. PMC 3831207. PMID 24259956.
Rubio-Tapia, A; Hill, ID; Kelly, CP; Calderwood, AH; Murray, JA; American College of, Gastroenterology. (May 2013). "ACG clinical guidelines: diagnosis and management of celiac disease". The American Journal of Gastroenterology. 108 (5): 656–76, quiz 677. doi:10.1038/ajg.2013.79. PMC 3706994. PMID 23609613. |
