Steatorrhea
One of the foremost investigators on this subject presents a summary of his present concept of the classification, pathogenesis and differential diagnosis of the major types of steatorrhea. It is not sufficient that a stool specimen merely contain more than the normal amount of fat, an actual decreased absorption of fat must be demonstrated. Steatorrheas are classified as pancreatogenous, hepatogenous—due to deficiency of bile sals, and enterogenous—due to anatomical lesions in the bowel wall or mesenteric lymph nodes, and other conditions which do not reveal anatomical changes in the intestines. The latter group includes gluten-induced entropathy (recently shown to be the most common cause of the celiac syndrome), tropical and non-tropical sprue, and steatorrhea due to intestinal shunts. An approach to the differential diagnosis of these conditions on clinical and laboratory grounds is given. It is shown how accurate diagnosis has led to more successful therapy of the various types of steatorrhea.
