脂肪便

脂肪便（しぼうべん、英: Steatorrhea）とは、大便中に過剰な脂肪が存在している状況をいう。大便は、過剰な脂肪ゆえ比重が小さいので水に浮き、脂っぽい外観で、特に悪臭を放つ。肛門からの脂肪の漏出やある程度の大便漏れが起こる場合もある。脂肪の漏出が増加するような場合、どの程度の脂肪が漏出するかを調べることができる。どの程度の脂肪が含まれていたら脂肪便と呼ぶかは必ずしも標準化されていない。

考えられる原因

考えられる原因として胆汁の不足（例えば、肝臓障害、脂質低下薬、胆嚢摘出手術により胆嚢がない場合）、膵液（酵素）の欠損、粘膜細胞の障害などがあげられる。胆汁が分泌されないと便は灰色になったり白っぽくなったりする。その他の脂肪便の原因として先端巨大症の治療薬であるオクトレオチド（octreotide）やランレオチド（lanreotide）の副作用があげられる。次のような場合にも見られる。

炎症性腸疾患、セリアック病、先天的脂肪吸収障害などによる吸収不良
膵外分泌機能不全
膵臓炎
総胆管結石症（胆石による胆管の障害）
膵癌（胆汁分泌障害）
原発性硬化性胆管炎
細菌異常増殖
短腸症候群（Short bowel syndrome）
嚢胞性線維症
ゾリンジャー･エリソン症候群
ランブル鞭毛虫症
オルリスタット（Orlistat）などの痩せ薬の摂取

減量剤や機能性食品の副作用

脂肪便は、オレストラ（Olestra）のような非消化性脂肪を食べたり、オーリスタットのような脂肪吸収を阻害する減量剤の副作用としても起こる^[1]^[2]^[3]^[4]。

治療

脂肪便の治療は、根本原因を除去し、同時に、消化酵素薬を投与することである^[5]。

脚注

[脚注の使い方]

^ Squires, Sally (2006年1月24日). “Weighing a Pill For Weight Loss”. Washington Post 2007年7月6日閲覧. "While the Food and Drug Administration (FDA) still must approve the switch, the agency often follows the advice of its experts. If it does, Orlistat (xenical) -- currently sold only by prescription -- could be available over-the-counter (OTC) later this year. But it's important to know that the weight loss that's typical for users of the drug -- 5 to 10 percent of total weight -- will be less than many dieters expect. And many consumers may be put off by the drug's significant gastrointestinal side effects, including flatulence, diarrhea and anal leakage."
^ “Frito-Lay Study: Olestra Causes "Anal Oil Leakage"”. Center for Science in the Public Interest. (February 13, 1997) 2007年7月7日閲覧. "The Frito-Lay report states: "The anal oil leakage symptoms were observed in this study (3 to 9% incidence range above background), as well as other changes in elimination. ... Underwear spotting was statistically significant in one of two low level consumer groups at a 5% incidence above background." Despite those problems, the authors of the report concluded that olestra-containing snacks "should have a high potential for acceptance in the marketplace.""
^ “The Word Is 'Leakage'. Accidents may happen with a new OTC diet drug.”. Newsweek. (June 25, 2007) 2007年6月21日閲覧. "GlaxoSmithKline has a tip for people who decide to try Alli, the over-the-counter weight-loss drug it is launching with a multimillion-dollar advertising blitz—keep an extra pair of pants handy. That's because Alli, a lower-dose version of the prescription drug Xenical, could (cue the late-night talk-show hosts) make you soil your pants. But while Alli's most troublesome side effect, anal leakage, is sure to be good for a few laughs, millions of people who are desperate to take off weight may still decide the threat of an accident is worth it."
^ “Reported medical side-effects of Olestra according to Procter and Gamble studies”. Center for Science in the Public Interest 2007年6月21日閲覧. "Olestra sometimes causes underwear staining associated with "anal leakage." Olestra sometimes causes underwear staining. That phenomenon may be caused most commonly by greasy, hard-to-wipe-off fecal matter, but occasionally also from anal leakage (leakage of liquid olestra through the anal sphincter)."
^ WrongDiagnosis >Treatments for Steatorrhea Retrieved on 20 Mars, 2009

外部リンク

中村光男, 丹藤雄介、「慢性膵炎における脂肪便の病態解析」『日本消化器病学会雑誌』 2000年 97巻 11号 p.1347-1354, doi:10.11405/nisshoshi1964.97.1347, 日本消化器病学会

[WP-1] Squires, Sally (2006年1月24日). “Weighing a Pill For Weight Loss”. Washington Post 2007年7月6日閲覧. "While the Food and Drug Administration (FDA) still must approve the switch, the agency often follows the advice of its experts. If it does, Orlistat (xenical) -- currently sold only by prescription -- could be available over-the-counter (OTC) later this year. But it's important to know that the weight loss that's typical for users of the drug -- 5 to 10 percent of total weight -- will be less than many dieters expect. And many consumers may be put off by the drug's significant gastrointestinal side effects, including flatulence, diarrhea and anal leakage."

[CSPI-2] “Frito-Lay Study: Olestra Causes "Anal Oil Leakage"”. Center for Science in the Public Interest. (February 13, 1997) 2007年7月7日閲覧. "The Frito-Lay report states: "The anal oil leakage symptoms were observed in this study (3 to 9% incidence range above background), as well as other changes in elimination. ... Underwear spotting was statistically significant in one of two low level consumer groups at a 5% incidence above background." Despite those problems, the authors of the report concluded that olestra-containing snacks "should have a high potential for acceptance in the marketplace.""

[NW-3] “The Word Is 'Leakage'. Accidents may happen with a new OTC diet drug.”. Newsweek. (June 25, 2007) 2007年6月21日閲覧. "GlaxoSmithKline has a tip for people who decide to try Alli, the over-the-counter weight-loss drug it is launching with a multimillion-dollar advertising blitz—keep an extra pair of pants handy. That's because Alli, a lower-dose version of the prescription drug Xenical, could (cue the late-night talk-show hosts) make you soil your pants. But while Alli's most troublesome side effect, anal leakage, is sure to be good for a few laughs, millions of people who are desperate to take off weight may still decide the threat of an accident is worth it."

[CSPI2-4] “Reported medical side-effects of Olestra according to Procter and Gamble studies”. Center for Science in the Public Interest 2007年6月21日閲覧. "Olestra sometimes causes underwear staining associated with "anal leakage." Olestra sometimes causes underwear staining. That phenomenon may be caused most commonly by greasy, hard-to-wipe-off fecal matter, but occasionally also from anal leakage (leakage of liquid olestra through the anal sphincter)."

[5] WrongDiagnosis >Treatments for Steatorrhea Retrieved on 20 Mars, 2009

[1]

[2]

[3]

[4]

[5]

考えられる原因

減量剤や機能性食品の副作用

治療

脚注

関連項目

外部リンク