Greater than 30 g of fat is excreted in feces per day. The cause is
**Core Concept**
The exocrine pancreas secretes digestive enzymes into the small intestine to facilitate fat absorption. Insufficient exocrine pancreatic function can lead to impaired fat digestion and absorption, resulting in excessive fat excretion in the feces.
**Why the Correct Answer is Right**
Exocrine pancreatic insufficiency (EPI) is characterized by a deficiency of pancreatic enzymes, including lipase, amylase, and trypsin. The lack of lipase enzyme activity impairs the breakdown of triglycerides into fatty acids and glycerol, which are then absorbed by the small intestine. As a result, undigested fat is excreted in the feces. This condition is often seen in patients with chronic pancreatitis, pancreatic cancer, or cystic fibrosis.
**Why Each Wrong Option is Incorrect**
**Option A:** Rapid transient diarrhea may lead to fat malabsorption, but it is not the primary cause of excessive fat excretion in the feces. Diarrhea can lead to a loss of fat in the stool, but it does not explain the underlying mechanism of excessive fat excretion.
**Option B:** Normal individuals can excrete up to 7 grams of fat in the feces per day, but excessive fat excretion (greater than 30 g/day) is not considered normal.
**Option C:** Small intestinal disease can lead to malabsorption of nutrients, including fat, but it is not the primary cause of excessive fat excretion in the feces.
**Clinical Pearl / High-Yield Fact**
The Steatorrhea Grading Scale is used to quantify the amount of fat in the feces, with a score of 1-6, where 1 represents less than 7% fat in the feces and 6 represents greater than 14% fat. A score of 2 or higher is indicative of steatorrhea.
**✓ Correct Answer: A. Exocrine pancreatic insufficiency**