Steatorrhea & Celiac

I am obsessed with poo. I look at it in the toilet, examine it, think about it, wonder if it is too much or too little, and even sometimes take pictures of it. I really use my poo as a gauge of my health. I even ask my kids about their poo habits. I want to talk about a few things poo related – steatorrhea and gastrocolic reflex.


Oily, greasy, smelly poop is common in those with celiac disease, both before and after diagnosis. It is not fun and has a name – steatorrhea. The root cause of steatorrhea is a malabsorption of fat and/or bile salts. But what can cause the malabsorption of fats and why is that bad?

First, there are tests to determine if the cause of the foul smelling, oily poo is from having too much fat in the stool. It is called a fecal elastase test and can be performed by your doctor for an appropriate assessment. Once, you know that Steatorrhea is a problem,

Fat malabsorption can be caused by damage to the small intestine, as in our favorite disease, celiac disease. It can also be caused by diseases affecting the pancreas and gall bladder. In the pancreas, steatorrhea can be caused by a lack of pancreatic enzymes that help break down food. This may be why many people start to feel relief from steatorrhea when they start taking digestive enzymes. This lack of pancreatic enzymes is often called exocrine pancreatic insufficiency. There are lots

Another possible cause is from the gall bladder. In reading in the facebook groups, many people have had their gallbladder out. I’m not really sure why, but I see it a lot. It might be due to pain or it might be due to steatorrhea with an unknown cause. There are medications that can help with fat malabsorption due to bile acid malabsorption.

Dietary fats help build hormones and vitamins. So, if someone is not absorbing fat in their diet, the creation of hormones becomes difficult. Hormones drive lots of functions within the body including sex hormones and vitamin production, such as Vitamin D.

Finally, malabsorption is a symptom not a root cause. Working in conjunction with a doctor, please work to find the proper root cause. Long term malabsorption can cause significant problems so make sure to get to the bottom of it. Yes, pun inteded there.

Gastrocolic Reflex

Some people feel like they go to the bathroom right after every meal and food is passing straight through them. It isn’t.

Have you ever sat down to dinner with a small child? Often times they will need to go to the bathroom right about the time the appetizers or salads come. Or been to dinner with a baby that needs their diaper changed as soon as you get to the restaurant? This is part of the the gastrocolic reflex.

The gastrocolic reflex simulates the lower bowels around meal times. In essence, the bottom of the system is being cleared for more food to go into the top and move everything along.


Sometimes things are normal and sometimes things are not. A good discussion with friends or your doctor or a careful search on the internet or reading my posts is a great way to get a sense of what is normal and what is not.

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