Understanding Fatty Stool: Causes & What to Do

What It Looks Like

Large, pale, greasy, foul-smelling stools that float and are difficult to flush suggest steatorrhea (excess fat in stool).

Common Causes

• High-fat diet exceeding digestive capacity.
• Malabsorption syndromes: Celiac disease, Crohn's disease, chronic pancreatitis, cystic fibrosis.
• Medications: Orlistat, antacids (magnesium/aluminum), laxatives.
• Liver/gallbladder disease: Reduced bile secretion (bile emulsifies fat).
• Small intestinal bacterial overgrowth (SIBO).

When to See a Doctor

Persistent oily stools—especially with weight loss, abdominal pain, diarrhea, or fatigue—warrant medical evaluation (stool fat test, blood work, imaging).