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Steatorrhea medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2] Aditya Ganti M.B.B.S. [3]

Overview

Overview

Management of steatorrhea include treatment of underlying etiology, control of diarrhea and correction of nutritional deficiencies.

Medical Therapy

Medical Therapy

Management of steatorrhea include treatment of underlying etiology, control of diarrhea and correction of nutritional deficiencies.[1][2][3]

Correction of Nutritional Deficiencies

  • Oral supplementation with vitamins and minerals is usually well tolerated in patients who are are undergoing specified treatment for underlying etiology.
  • Rapid recovery following the identification of a nutritional deficiency can be achieved by supplementation with 5 to 10 times the Recommended Dietary Allowance.

Antidiarrheal agents

Bile acid binding resins

  • Preferred regimen (1) : Cholestyramine 4 g three times daily
  • Preferred regimen (1) : Colestipol granules 5 to 10 g three times daily
    • Note: Administer ≥1 hour before or >4 hours after other drugs to prevent decreased absorption of other drugs.

Pancreatic enzymes

  • Preferred regimen (1) : Pancrelipase delayed-release capsules (Creon minimicrospheres)
  • Preferred regimen (1) : Pancrelipase tablets and powder (Viokase) 1 g
  • (equivalent to 20,000 units lipase component) with meals
    • Note:  Approximately 30,000 units (90,000 USP) (lipase component) with each meal.

Management of Underlying Etiologies

  • For a detailed explanation of management of Crohn’s disease click here
  • For a detailed explanation of management of celiac disease click here
  • For a detailed explanation of management of gallstones disease click here
  • For a detailed explanation of management of cystic fibrosis disease click here
  • For a detailed explanation of the management of small bowel bacterial overgrowth syndrome click here
References

References

  1. Marotta RB, Floch MH (1989). “Dietary therapy of steatorrhea”. Gastroenterol. Clin. North Am. 18 (3): 485–512. PMID 2509353.
  2. “Varieties of steatorrhea”. Br Med J. 2 (5524): 1214–5. 1966. PMC 1944784. PMID 5917827.
  3. Koch J, Garcia-Shelton YL, Neal EA, Chan MF, Weaver KE, Cello JP (1996). “Steatorrhea: a common manifestation in patients with HIV/AIDS”. Nutrition. 12 (7–8): 507–10. PMID 8878143.

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