What does neutral fat mean in a coprogram? Diagnostics

Cal is the final product of processing the products that enter the body. A healthy person who does not suffer from problems with digestion has designed stools that do not contain neutral fat in their composition. The result of the digestion of food and the absorption of residual products in the intestine should be covered with an insignificant amount of mucus and cells of the cylindrical epithelium. If there is neutral fat in the stool, this condition is called steatorrhea. It is considered pathological and can talk about diseases of the pancreas, bile ducts or liver.

What are fats?

Neutral fats are called esters of fatty acids and glycerol. Depending on how many hydroxyl groups of glycerin are esterified with fatty acids, the following types of lipids of this group are distinguished:

• Triglycerides - three groups;
• Diglycerides - two groups;
• Monoglycerides - one group.

Neutral fat is in the human body in the form of a backup material or becomes protoplasmic fat, which is part of the cells. The role of these forms is different. Protoplasmic lipids have a constant composition and exist in cells in a certain amount that does not change with the development of obesity or in case of a person's weight loss. The amount of reserve fat has a property to fluctuate.

Triglycerides

This group is the most numerous among all representatives of neutral lipids. The fatty acids that make up the composition can be unsaturated and saturated. The most common are oleic, stearic and palmitic acids. If the radicals that make up the triglyceride belong to the same acid, then it is called simple, in the case of their relation to different acids - mixed.

The physicochemical properties of neutral fats depend on what acids are in the composition. Features are as follows:

• The greater the number and length of residues of saturated fatty acids, the higher the melting point of lipids;
• The more unsaturated fatty acids and shorter their chain, the melting point is lower;
• Triglycerides can participate in the saponification reaction, resulting in the decomposition of fatty acids and glycerol;
• The process of saponification is characteristic for enzymatic hydrolysis, the action of alkalis and acids.

Properties of lipids

Neutral fat is a substance that melts easily, it is lighter than water, but insoluble in it. At room temperature, lipids have a solid, ointment or liquid state and can melt over a significant temperature range.

Substances practically do not dissolve in water, but the addition of soap or some emulsifier leads to the formation of persistent aqueous emulsions. Neutral fat is readily soluble in alcohol and various solvents (ether, benzene, benzene, chloroform).

Phospholipids do not have color, but quickly darken on contact with air. This is due to the oxidation of unsaturated fatty acids that make up the composition. The properties of neutral fats in the human body are as follows:

• Layered structures that are formed upon contact with solutions, enable the participation of lipids in the construction of cell membranes;
• Entering into a close relationship with proteins located on the surface of cell membranes, regulate the processes of entry into the cell of organic substances that participate in metabolic processes;
• Are antioxidants of natural origin.

The dependence of the physico-chemical properties of neutral fats on their structure explains the possibility of their participation in vital processes occurring in the human body. Especially a lot of phospholipids are found in the nervous tissue, liver, heart.

Steatoreya and its types

Neutral fat in the feces is a pathological condition. Depending on the etiology, the following types of steatorrhoea are distinguished:

1. Intestinal type. Because of certain reasons, lipids are not digested in the intestinal tract, but go out with the feces.
2. Alimentary type. The basis of this pathology is inadequate nutrition. With food products in the human body receives a huge amount of phospholipids, which are not able to digest in full.
3. Pancreatic type. It occurs as a result of disorders in the pancreas. There is a decrease in the synthesis of lipase, the enzyme responsible for normal lipid cleavage.

Stethorrhea differs in the variety of components. Feces may contain a significant amount of neutral fats (triglycerides), soaps and fatty acids, or all three components at the same time.

Causes of pancreatic steatorrhoea

Neutral fat in the feces of a child or adult can appear against a background of a number of abnormal conditions.

1. Diseases of the pancreas:

• Pancreatitis of acute nature during the first six months;
• Inflammation of the pancreas lasting more than half a year (chronic process);
• Narrowing of the Virpsung duct (on it pancreatic juice enters the duodenum);
• Zolinger-Ellison syndrome - a tumor process, resulting in ulceration of the stomach and intestinal tract.

2. Liver pathology:

• Hepatitis acute and chronic;
• Hepatitis, resulting from the abuse of alcohol;
• cirrhosis of the liver;
• Cholangitis sclerosing type - inflammatory disease of the intrahepatic bile ducts, which is accompanied by the formation of scars;
• Hemochromatosis - a violation of metabolic processes associated with iron, which is accompanied by its pathological accumulation in the body;
• Amyloidosis of the liver;
• Tumors and cysts.

3. Pathology of the gallbladder and ducts:

• cholelithiasis;
• Inflammation of the gallbladder acute and chronic;
• Cholangitis - inflammatory processes of the bile duct;
• Infection of bile ducts with lamblia.

Causes of intestinal steatorrhea

Neutral fat in the coprogram for intestinal pathology can result from the following conditions:

• With Crohn's disease - a chronic inflammation of the intestinal tract, in which narrowing and ulceration develop;
• With Whipple's disease - a disease of the intestine and regional lymphatic donkeys of an infectious nature;
• With intestinal lymphoma - a tumor that consists of lymphocytes;
• At postresection status;
• With enteritis, enterocolitis;
• With amyloidosis;
• With diverticulosis - pathological process, accompanied by the formation of diverticula (protrusions) in the intestinal wall.

Other etiological factors

The causes of the appearance of phospholipids in feces may be diseases of the endocrine glands. The most frequent provoking factors are hypothyroidism and Addison's disease (adrenal insufficiency).

Abetalipoproteinemia (malabsorption and transport of lipids), cystic fibrosis (the secrets of all glands have high viscosity and density) and celiac disease (a disease in which gluten is not fully split) are congenital conditions that lead to the appearance of neutral fat in the feces of the infants.

The appearance of phospholipids in feces can accompany psoriasis and eczema, as well as long-term intake of laxatives and agents used for weight loss.

Clinical picture

The first manifestation of pathology is the frequent urge to defecate. Fecal masses are oily, they are difficult to wash off the surface of the toilet bowl. Exercises leave a fat trace. The color of feces can remain normal, and can change towards a light or gray hue.

In addition, neutral fats, whose composition has fatty acids and glycerin, appearing in the stool, in addition, can be reflected in the following symptoms:

• dry cough;
• dizziness;
• Pain in the joints and back;
• Bloating;
• Low level of efficiency;
• weakness;
• Dryness of mucous membranes;
• Exhaustion;
• Bleeding gums.

The appearance of an oily stool and at least one of the accompanying symptoms is the reason for seeking qualified help.

Diagnostic measures

The collection of complaints and anamnesis is accompanied by a clarification when symptoms appear, with which the patient associates their occurrence when the stool has acquired an oily character. The specialist specifies the presence of congenital diseases or pathologies transmitted by inheritance from the relatives of the patient. Then the doctor examines the patient. Defined by the presence of exhaustion, the state of the skin and mucous membranes, palpation and percussion of the abdominal cavity are performed.

Koprologiya (laboratory study of feces) consists of an assessment of the following indicators:

1. Macroscopy - steatorrhea manifests itself in the form of more light stool with the gloss of frozen fat.
2. Microscopy determines the presence of lipids, fatty acids, soaps. Normally, within 24 hours, not more than 5 g of neutral fat should stand out with the feces. The results above are pathology.

If necessary, use a radioisotope study, ultrasound examination of the abdominal cavity, colonoscopy, assessment of hormonal balance of the body, consultation of the endocrinologist and therapist.

Elimination of steatorrhea

First of all, the treatment is aimed at the disease, which caused the appearance of neutral fat in the feces. Individual selection of the diet is also carried out on the basis of the underlying pathology. It is mandatory to exclude fried, marinated, smoked products.

The patient should stop using alcoholic beverages, get rid of bad habits. It is recommended to add to the diet those products that contain a significant amount of retinol, tocopherol, calciferol and vitamin K. The same fat-soluble vitamins are prescribed in the form of medicinal preparations.

Complications and consequences

Complications develop only in case of untimely begun treatment. There is a violation of the absorption of nutrients in the intestinal tract. Against this background, hypo- and avitaminosis develops, protein deficiency and exhaustion of the body. The pathology of water-electrolyte balance is manifested by a constant feeling of thirst, swelling, dehydration, convulsive attacks.

The specialist diagnoses the appearance of oxaluria (excessive pathological excretion of oxalic acid salts from the body together with urine) and the formation of urinary stones of oxalate origin. This pathological condition arises from the fact that under normal conditions, oxalates do not enter the blood from the intestinal tract, since their connection with calcium makes them insoluble. With the development of steatorrhea calcium in large quantities is eliminated from the body along with feces. This leads to a significant intake of oxalates from the intestine into the blood.

The patient dramatically loses body weight. The normal functioning of all internal organs and systems is disrupted. Such manifestations lead to psychological problems (insomnia, changes in communication, a decrease in working capacity).

Preventive measures

Preventive measures can be divided into primary and secondary. Primary prevention is carried out in order that the disease does not appear. It is based on preventing the development of pathologies, in which steatorrhoea becomes one of the symptoms. Important points are:

• Refusal of smoking and excessive consumption of alcoholic beverages;
• Correction of the diet;
• Increase in the amount of plant food supplied;
• Fractional meals in small portions;
• The use of multivitamin complexes;
• Strengthening the body's defenses.

At the heart of secondary prevention (after the onset of the disease) is the timely rational treatment of the pathological condition.

Conclusion

Early diagnosis and a correctly diagnosed diagnosis will allow a specialist to select an individual treatment regimen and avoid the development of complications of the disease. Self-medication is not recommended, because only a highly qualified doctor is able to determine the true cause of the appearance of neutral fats in the feces and to eliminate it. The prognosis is favorable for those patients who follow the advice and recommendations of the treating specialist, and also engage in secondary prevention of pathology.