American Board of Internal Medicine (ABIM) Certification Practice Exam

What condition is associated with bulky, greasy, oily, malodorous stools and weight loss?

1. Osmotic diarrhea

2. Steatorrhea

3. Secretory diarrhea

4. Motility-related diarrhea

The correct answer is: Steatorrhea

The condition characterized by bulky, greasy, oily, malodorous stools and weight loss is steatorrhea. This condition results from the malabsorption of fats in the gastrointestinal tract. When fat is not adequately absorbed, it leads to the presence of excess fat in the stool, which creates the distinctive greasy appearance. Individuals may experience weight loss because the body is not effectively utilizing the calories and nutrients from the food consumed, especially fat, due to the malabsorption. This can be caused by various underlying conditions, such as pancreatic insufficiency, celiac disease, or certain liver disorders, which all disrupt the normal digestion and absorption of dietary fats. Osmotic diarrhea typically results from the presence of unabsorbable substances in the intestines and is associated more with watery stools that decrease when the offending substance is removed. Secretory diarrhea involves an active secretion of electrolytes and water into the intestinal lumen, usually not characterized by oily stools. Motility-related diarrhea is caused by rapid transit through the gastrointestinal tract and can lead to loose stools but does not typically present with the greasy quality associated with steatorrhea.