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Idiopathic Steatorrhea

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Abstract

IDIOPATHIC steatorrhea or sprue is a condition in which many of the equally applicable to other disorders producing malnutrition and steatorrhea.

Sprue or idiopathic steatorrhea may be defined as a chronic deficiency disease with a definite tendency to remission and relapse, characterized by glossitis, stomatitis, anorexia, gastrointestinal symptoms, by the passage of large frothy, foul-smelling stools, by great muscular wasting, nervous symptoms, decalcification, and in adults by a macrocytic hyperchromic anemia.

The etiology of steatorrhea or fatty stool may be classified as follows:

  1. Lack of secretions

    1. Lack of bile (calculi, carcinoma, etc.)

    2. Lack of pancreatic secretions (calculi, chronic pancreatitis, neoplasm, cystic fibrosis)

  2. “Secondary” sprue

    1. Postgastrectomy

    2. Gastrocolic and jejunocolic fistulae

    3. Mesenteric lymph node disease (tuberculous, neoplasm)

    4. Lymphatic obstruction

    5. Intestinal lipodystrophy (Whipple’s disease)

    6. Regional enteritis

    7. Sequelae of protozoan and bacillary dysenteries

    8. Amyloidosis of small intestine

  3. “Primary” sprue

    1. Tropical sprue

    2. Non-tropical sprue

    3. Coeliac disease

The recent war stimulated medical interest in these diseases. One writer’ observed more than 1000 cases of sprue in a prison camp. Also the introduction of folic acid and the work by Spies and his associates2 aroused attention concerning sprue and allied conditions.

The etiology of sprue is still not understood. It was originally thought to be due to intestinal parasites, particularly the Monilia group of organisms;, however, it is generally agreed that the finding of parasites in the stool is merely coincidental in these patients.

In sprue there is some change in. . .


 

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