Pancreatitis Support Group

Chronic pancreatitis can present as episodes of acute inflammation in a previously injured pancreas, or as chronic damage with persistent pain or malabsorption. Patients with chronic pancreatitis can present with persistent abdominal pain or steatorrhea, as well as severe nausea. Some patients with chronic pancreatitis often look very sick, while others don't appear to be unhealthy at all.

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Greasy stools or oil in stools?

Sorry in advance for the graphic stool descriptions.

I've heard that people with chronic pancreatitis experience pale, greasy stools with oil droplets that float to the top.

For those who have experienced this, is the description accurate?

Should I really be looking for oil droplets, or is the description not quite right?

My stools are not pale, but lately I've been seeing what appears to be a "slick" along the surface of the water. I'm not exactly sure if it's "oily" per se.

And doesn't your CP have to be pretty advanced before stool symptoms appear?

Replies

deleted_user
deleted_user

It's called Steatorrhea, and is excess fat in the stool due to the body not being able to digest and absorb the fats. Usually this is because the pancreas is no longer producing enough digestive enzymes, particularly lipase. So yes, its typically in advanced CP that this happens.

I don't have it personally, so can't give a personal description, but I understand that it usually floats, stinks, and is hard to flush.

Occasional oil slick in the toilet, without the pale color, foul odor and floating stool, is not a reason to think you have Steatorrhea. At least that's what I've read and heard from others.
deleted_user
deleted_user

Jane is correct. I have Steatorrhea right now and the description that you give is accurate, including the pale color. I've had it as long as 3 weeks, although that is an extreme condition and is fairly rare. I ended up in the hospital until it was under control. My first bout with it was 3 or 4 weeks after being diagnosed with pancreatic divisum. So I wouldn't necessarily say that you have to have an advanced case of CP to get it. I've had it now for about a week, but I know it's from indulging in Holiday goodies.

It is brought on, as I've been told by my PCP, by either too much fat or protein in your diet, by the pancreas not producing enough enzymes or both. Try reducing the fat and protein in your diet; not just the fat, cut back on the protein as well. Are you taking pancreatic enzymes? If not, talk to your GI about starting on them. As far as I've been told, it's nothing bad to worry about as long as you get it under control quickly.... it's just nasty.

Hope this helps!
deleted_user
deleted_user

Thanks for your replies. Just to clarify, I have not been diagnosed with anything yet.

I've had persistent abdominal pain for the last 16 months and no tests so far have been able to pinpoint the cause. It's been very frustrating.

I'm fearing pancreatitis, but I don't seem to experience the "classic" symptoms.

For example, here are mine:

1. pain usually most prominent in the upper-right quadrant, under ribs

2. pain is usually gnawing and sometimes feels like a foreign object is there.

3. pain doesn't seem to coincide with meals; many times I awake in the morning to the pain, when my stomach is empty.

4. my stools, more often than not, seem to float. They are not pale.

5. sometimes the pain is all through my upper quadrant, from the right side to the left and sometimes radiates to my back on the right.

I've had an upper and lower abdominal CT scan, an ultrasound, HIDA scans, one upper endoscopy and several blood tests. All normal, except for some mild damage to my lower esophagus from GERD that is being treated with Prilosec.
deleted_user
deleted_user

Man, sorry to hear what you're dealing with, and I do understand the frustration. Abdominal pain is notoriously hard to diagnose. I still don't have a cause for my pain either, and it's been a year for me. I've had the CT Scans, and HIDA scans and MRCP, and EGD and colonoscopy. They did find a problem with my gallbladder and removed it in August, but that didn't resolve the problem.

What I am doing next is going to see a pancreatic/biliary specialist Doctor to attempt to find some answers. Are you seeing a Gastroenterologist? Do you live near a teaching hospital?
deleted_user
deleted_user

Jane78C & erinTag-

I basically have the same exacts symptoms as you have both described. It will be close to one year since it started. They have not found a reason for the pain. Blood tests and EUS were normal. I was going to Northwestern University hospital GI department, and recently switched to the University of Chicago for a second opinion. Both are major research institutions with world-class reputations. The U of C doctor recently scheduled a colonoscopy (my first ever) for later this month to check out my intestines. Not looking forward to it, except to get further clarity. My trigger foods seem to have more fat than not, though I consume likely very little fat to begin with. My doctors are circling an IBS-type diagnosis, but it does not feel much like IBS. IT is rather hard to be positive with so much ambiguity, and I fear the worse (like CP) and try to live as if I have it (low fat, no booze) to at least keep me somewhat healthy.

Jane-did you have a hard time finding a specialist in that clinical area?
deleted_user
deleted_user

To clarify, I do not have the stool symtoms that erinTag describes -- not at all. I am very regular, neither constipated, nor diahhrea, and normal stool. My problem is pain and flareups of worse pain that last for days. And I have major flatulance and belching during flareups, but that may have something to do with my gallbladder being gone about 4.5 months ago.

The doctor I am going to see is a Pancreatic/Biliary Surgeon out of University of Texas, Medical Branch, at Galveston. I found her from an article someone on another board sent me. Her team performs the Total Pancreatectomy with Islet Cell Transplant (TP/ICT), in addition to other surgeries obviously. The article was about a 24 year old woman who lives just 20 miles from me and how this TP/ICT surgery changed her life.

I found that this Doctor was "in network" with my insurance, and I made the appointment online. An RN responded to my online request for appoint within 4 hours on a Sunday if you can believe that! And I will go see this doctor on January 21st.

I don't know much else about her yet! What I'm hoping for from her and her team is more specialized testing of my biliary and pancreatic system to find the cause of my pain and flareups.

I am getting more and more sensitive to anything I put in my mouth, and am flaring more often -- just eating 1 oz of lowfat cheese with 2.5 grams of fat in it sends me into flareup for hours or even days. I ate just 2 ounces of very lean filet mignon as a special treat over the holidays and went into a flare for 7 days. I'm not even sure it was the steak that caused the flare, but it's the only thing I can think of to blame it on. Obviously I don't eat cheese or red meat anymore, and my list of what I CAN eat is getting smaller by the day.

I just want some answers. I want to know WHY I hurt. If they can figure out why, then at least I'll know whether there are potential treatments, surgically or otherwise. Right now I'm just "assuming" that I have CP caused by alcohol, but all tests so far come back normal - normal pancreas, normal everything. Because my wonky gallbladder and sludge caused an acute attack, and that I'm getting worse since the gallbladder is gone, I can't help but think I have a biliary problem of some kind. My regular Gastro Doctor is too busy and seems largely disinterested in my problem, so I am going to try and get answers elsewhere.

Anyway, sorry to ramble on -- hope I answered your question!
deleted_user
deleted_user

i have cp and i deal with the oily stools too as if someone pors grease in the tolet. mine at times is wene i have diahhrea .wene mine flares up dont have and answer yet as to why.also i am dealing with black tarry stools right now ,iam wateing on a call back from the doctor now .he thinks iam bleeding somewere.hope you find answers too and good with everthing.beka.
deleted_user
deleted_user

I too have had the same symptoms you describe here-ive had chronic pancreatitis for a few years now. I also have sphincter of oddi dysfunction and primary biliary cirrhosis. For me it is a gnawing burning pain RUQ thru to my back, sometimes radiates to the shoulder and neck area or even into my right arm. Nothing seemed to make it better or worse (as in eating or not eating).

I have had everything from oily stools to completely white stools. I never knew poop could even be white! I am not a protein shake only diet can no longer digest food. Diarrhea is my middle name. Obviously fatty foods, dairy products, spicey food, and alcohol should be avoided....
deleted_user
deleted_user

I have not been diagnosed with cp but I have the same symptoms. I have had all the tests done too and all have come back normal with the exception of the 72 hour fecal fat test that came back at 7.5 showing that I am malabsorbing. I have had left sided pressure like pain in my ribs for 3 years- it is not as bad any more and I only have mild pain every couple of months. The doctors are insistent that I have nothing wrong with my pancreas. I continue to have oily diarrhea everyday unless I don't eat fat -it's as clear as a bell the oil slick in the toilet. They say I have irritable bowel syndrome. Let me know how you are.
deleted_user
deleted_user

I also have no diagnosis as yet and often have these oily floating stools, perhaps 50% of time though less since been on stronger pain killers. I have done a test for pancreatic exorcine insufficiency this week but don't have results. My symptoms are upper central abdomen pain, low grade fever - swollen lymph nodes around bile duct and liver (had 2 endoscopies in October and November) and next possible laparoscopy to remove some to analyse. Oh, and my amylase level has been raised since gallbladder removal in July.

Hope you get some answers soon
fighting4change
fighting4change

I also have steatorrhea but, thankfully, no pain. This diagnosis was made from a one-time stool test, not the standard 72 hour test. I was just diagnosed in May but I think I've had it for over 4 years and it seems to have been triggered by surgery.

I haven't done any imaging tests because it seems like they're more often inconclusive than helpful. I did blood test and endoscopy to rule out Celiac. Since I don't have pain, I didn't want to go to the expense of imaging and be radiated (CT scan) for what may be useless. I'd been considering having blood tests for digestive enzymes but from what I've read, the results may indicate normal levels when you're actually deficient.

I took Creon briefly (12,000 then 24,000) but it didn't have much effect. I know they can have adverse effects (if DE deficiency isn't the problem) so I quit taking them instead of increasing the dose. I read that the acidity of the stomach must be right for the DE's to work and if it isn't, you need to add an H2 blocker or take pH-sensitive enteric coated DE's.

Although I'm going to a gastro who's supposed to be tops in my area, he seems puzzled that I don't have pain, bloating, gas or weight loss (although I did have weight loss 4 years ago but I had diarrhea really bad and was generally going 6+ times per day). I went to him back then and all he did was the Celiac blood test and suggested trying a gluten-free diet. Things improved on their own (even after I quit the trial gluten-free diet) but never totally resolved so I finally went back to him this year.
deleted_user
deleted_user

to fighting 4:
I have read that you can suffer from chronic pancreatitis without pain or with mild pain. I have read that up to 30% of people with cp do not experience pain. Has your symptoms become worse over the past 4 years?
fighting4change
fighting4change

Wow - didn't know that as many as 30% don't have pain. I've actually improved over the 4 years since this started. BM's are less frequent and fewer are really loose. But the malabsorption has me concerned. I had my vitamin A level checked to determine the degree of malabsorption. It was 19 (range is 19-83). I'm now taking 25,000 IU's vitamin A as fish liver oil
deleted_user
deleted_user

?It sounds to me like you may have had a blockage at one time that may have caused damage to you pancreas. What were your results for the fecal fat test? What surgury did you have?
deleted_user
deleted_user

When I have steatorreah my experience is similar to what erinTag is describing. My stool is not light-colored....it's dark, but floats, and my stomach feels swollen. I had two acute attacks years ago (1994) and had been fairly asymptomic, for years. I was a drunk, at one time, and abstaining from alcohol seemed to darned near cure me....although my amylase remained at about 400, I was absent any other symptoms. Then, working 7 days a week for years, I went on a binge (in July of this year) of eating McDonald's double-cheeseburgers for about a month (I was just run so ragged - they were quick and cheap). That caused about a two-week bout with steatorreah and a few months later (about 3 weeks ago) I started having pancreatic pain. It was December 13th, 2010.

The pain is mild, but, I can't get rid of it (I really had been living on junk food - honey buns, etc.) and I immediately took all fat out of my diet and started eating yogurt and cereal. When my pancreatitis is flaring my stool has a "sweet smell" - as if I'd eaten nothing but sugar for a month. It's a fairly disgusting topic of conversation but the doctors, years ago, told me that such an odor was one of the first things they look for..... For instance, if I eat pork (which I have done, now and then, since my first attacks) my stool would have that kind of odd odor. I doubt I will ever touch pork again - I'm pretty stressed about why this low-level pain is not going away....

I just switched jobs and need to get a blood work-up, pronto. Now I will have some time....