Ciulla Clinical Chemistry Practice Test

Steatorrhea signals fat malabsorption, so the substance piling up in the stool is lipids (fats). Normally, fats are emulsified by bile and broken down by pancreatic lipase into fatty acids and monoglycerides, which are then absorbed in the small intestine. When this process is disrupted—due to insufficient bile, pancreatic enzyme deficiency, or mucosal disease—these fats aren’t absorbed and are excreted in the feces. That’s what makes the stool appear bulky, pale, oily, and foul-smelling. While malabsorption can affect other nutrients, the characteristic accumulation in steatorrhea is lipids in the feces.