METABOLISM IN IDIOPATHIC STEATORRHEA. I. THE INFLUENCE OF DIETARY AND OTHER FACTORS ON LIPID AND MINERAL BALANCE

Abstract

Case histories and metabolic studies are reported on four patients with idiopathic steatorrhea (non-tropical sprue). Subjects exhibited great individual variation in their tolerance of fat[long dash]but fecal excretion of fat in each subject was nearly constant for a given regime. Low dietary intakes of fat prevented steatorrhea. Tolerance of fat was not improved in one instance by replacing dietary starch with monosaccharides; another patient revealed a good tolerance for butter fat and phospholipid while on a low starch diet. Ox bile made the steatorrhea of one patient worse. More split fat and more total fatty acid were found in the feces when fecal Ca was high, presumably because more insoluble Ca soaps were formed. Conversely when the dietary Ca was reduced to a low level, fecal Ca and split fatty acids decreased. Loss of Ca from the body was observed in three patients even when steatorrhea was controlled by a low fat regime and the intake of Ca was maintained in excess of one gram daily. Other evidences of vitamin deficiency presented by these patients were hypocalcemia, hypophosphatemia and an advanced grade of osteoporosis.