Oncology (General Cancer)/fecal fats and cancer

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Question
Hey doc. You may think I'm over reacting. I'm an otherwise healthy 40 y/o male. I dont smoke and have no known health issues. I'm in good physical shape. I take a Zantac daily for heartburn. For about 18 months I have noticed "white specks" in my stool. Almost with every bowell movement. The look like small grains of rice. I ran it by my doctor on a couple occassions ( I have yearly physicals and blood work labs has alwasy been normal). Last week, I made an appointment to see a Gastro due let him check it out ( I have traveled abroad alot and was curious if it is paraitses or somthing). Anyway, the Gastro called back and said he ran "numerous" test on the stool. He said the only "abnormal" fiding was "abnomral amount of fat in stool". He rambled off numerous things it could be but didnt act overly concerned. He stated that protocol in his practice with this finding is a 72 hour fecal fat study and possibly an abdominal CT scan. Natually, "cancer" popped into my head. DOes an abnormal fecal fat study necessarly spell doom? I still have no idea what these white specks could be as I was almost certian it was a parasite!

Answer
I don't know what is going on, but I doubt it is cancer.  Excess fecal fat can give an appearance like you describe, as can certain parasites, however, usually parasites are easy to recognize by a pathologist.  A fecal fat test is ok.  Reasons for excess fat in the stool have to do with chronic liver or gall bladder disease, or metabolic problems like hypertriglyeridemia.  On the other hand, white specks like small grains of rice would suggest to me, undigested food, parasites, etc.  If you were my patient I'd want to have a gastroenterologist see you as well, since I think what is going on has nothing to do with my specialty.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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