Fat, or lipid, malabsorption refers to a group of disorders characterized by a disruption of digestion and fat absorption. In these disorders, your body is unable to break down or absorb dietary fats. As a result, they pass through your digestive system intact, giving rise to symptoms including stomach upset, bloating, gas, diarrhea and possibly steatorrhea, the term used to describe bulky, light-colored stools that are high in fat. The organs involved in fat metabolism include the pancreas, the small intestine, the liver and the gallbladder.
Pancreas
Although not part of the digestive tract per se, the pancreas plays an essential role in digesting fat. Specifically, your pancreas releases digestive juices rich in both bicarbonate and the enzyme lipase, which breaks down dietary lipids into smaller molecules your body can absorb. When the pancreas is not functioning properly, dietary fats build up in your small intestine, providing food for bacteria and attracting water. The result is flatulence and foul-smelling diarrhea.
Pancreatitis
Pancreatitis is characterized by inflammation of the pancreas. It may be acute or chronic, depending on its duration. Pancreatitis is most commonly caused by alcoholism, although gallstones are frequently to blame. In chronic pancreatitis, repeated insult to the organ results in irreversible destruction. This is characterized by impaired fat digestion and usually involves abdominal pain and diarrhea.
Cystic Fibrosis
Cystic fibrosis is a widespread disorder that affects fluid secretion in the glands of your respiratory, gastrointestinal and reproductive tracts. Most CF patients suffer damage to their pancreas. In these patients, formation of bicarbonate, an essential component of pancreatic juices, is diminished. This impairs the function of lipase, which depends on the alkaline-rich environment bicarbonate provides. The result is fat malabsorption. Because fat-soluble vitamins depend on the proper metabolism of dietary fat to enter the bloodstream, CF and other fat malabsorption disorders are often characterized by deficiencies in one or more of the vitamins A, D, E and K, according to "Current Medical Diagnosis and Treatment."
Hepatobiliary Disorders
Your hepatobiliary system is comprised of the liver and gallbladder. The liver manufactures bile, which plays a role in the absorption of fats. Specifically, bile makes fats soluble, so that they may enter your bloodstream. Bile is stored in the gallbladder. Disorders that impair the liver's ability to make, or the gallbladder's ability to release, bile can cause fat malabsorption. An example is cirrhosis of the liver, which can be due to long-standing hepatitis. Gallstones that obstruct the gallbladder can also diminish bile flow, resulting in impaired fat absorption.
References
- "Pathologic Basis of Disease"; Vinay Kumar; 2005
- "Current Medical Diagnosis and Treatment"; Stephen J. McPhee; 2011
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