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Having abdominal pain. X-ray normal. Noticed yellow flakes and undigested fat in stool. Any thoughts?

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HI, My name is XXXXXXX I am 53 years old, male, and in good condition otherwise. My question. Lately, I have noted that my stools seem to float. Using the Bristol Stool Scale, They also look like Type 4. To assist you, I have attached alink to where it is located on WIPEDIA: WWW.WWWW.WW As well, when I wipe myself, I examine the toilet paer. There are no signs of blood but, there are small yellow looking flakes, like undigested fat or something in the stool. I have been to emergency three times complaining of abdominal pain. They took urine tests, and tested my pancreas. I also had an upper addominal xray and they found nothing. I also had a Barium swallow and they found nothing. I also had an upper ultrasound and they found nothing. Today, I had a lower addomoen xray, and they gave me the results on a CD. As part of the tests, they took 3 pictures of my pelvic region, and I would like to pass one to see if you had any thoughts. I am supposed to see my doctor at the end of this week, but, I am apprehensive, so, any thoughts you had would be helpful.
Posted Mon, 6 May 2013 in Digestion and Bowels
Answered by Dr. Charles S Narasi 19 minutes later

Thank you for contacting XXXXXXX and the report.

I looked at the x-ray and to me it shows lots of retained gas in the colon and perhaps a hard stool in the lower part of the colon, the sigmoid.

The only concern I have is that your stools float. That might indicate malabsorption and lack of digestive enzymes produced by the pancreas.

You say that pancreas tests were O.K. I want to know if your stool sample was ever tested for the presence of fat. Usually it requires 72 hour stool collection and the lab will measure the fat content.
If there is excess fat in the stool , that does indicate that your pancreas is not producing enough enzymes and the condition is called Pancreatic Insufficiency due to repeated attacks of inflammation. You may need supplemental pancreatic enzymes to correct the deficiency.

You may want to get a CT-Scan or an MRI of the pancreas to look at the organ better. You may even need an ERCP (Endoscopic Retrograde Cholangio-Pancreatography) and check the pancreas and collect fluids for analysis.

I hope you can discuss these with your doctor and take appropriate action. Let me know if you need clarifications.

I wish you the very best.
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