A Simplified Method of Investigating Steatorrhoea

For years, the fiveor ten-day fat-balance study has been considered the only sure way to determine the presence of steatorrhoea. Owing to the shortage of trained nursing staff and diet kitchens in many hospitals, this method of investigation is open to many inaccuracies. To physicians, the method has seemed impracticable and timeconsuming, and pathologists have not welcomed the laborious analyses of fat in dried faeces. Anderson, Frazer, French, Gerrard, Sammons, and Smellie (1952) have for some years used a quicker method of fat analysis based on the principles of homogenizing the wet faeces and estimating the total fatty acid content of a sample by the method of van de Kamer, ten Bokkel Huinink, and Weijers (1949). This technique has been used here, and, following the work of Annegers, our patients have not been on a weighed intake of fat but on normal ward diet. Annegers, Boutwell, and Ivy (1948) carried out investigations on 40 normals who were given standard amounts of fat in their diet of two types, namely, lard and homogenized vegetable oil. Specimens were collected for five-day periods and the fat content determined. Their conclusions were that fat balance "digestibility" studies are of questionable validity, since within ordinary dietary limits faecal fat excretion is, in their experience, independent of dietary intake.