Keriorrhea: What you should know

Keriorrhea is an oily, orange-colored bowel movement that occurs when indigestible wax esters are consumed by a person. When a fatty acid combines with fatty alcohol, wax esters form.

There are high amounts of wax esters in their bodies in the Gempylidae family of fish. Commonly known as snake mackerels, these fish include species such as oilfish and escolar fish. The wax esters can accumulate in the rectum when an individual eats these fish, causing the leakage of orange, oily stool.

We look at keriorrhea in greater detail in this article, including its signs, causes , and treatments.

Symptoms

Toilet roll holder

Keriorrhea symptoms typically develop within a couple of hours of eating oilfish or escolar fish  and can last for a few days.

An oily, orange bowel movement is the main symptom of keriorrhea. This bowel movement would appear in the toilet as an orange oil that sits above the water, as oil is less dense than water.

The smell of keriorrhea may be identified as that of strong mineral oil by some individuals.

An individual can also pass feces alongside the oil sometimes. Other times, they may only pass the oil.

Other potential accompanying symptoms of keriorrhea include:

  • stomach pains
  • abdominal cramping
  • nausea
  • vomiting
  • stomach gurgling
  • headaches
  • anal leakage

Causes

Keriorrhea occurs when wax esters from oilfish or school fish are eaten by a person.

Since both fish belong to the fish family of the Gempylidae, some individuals may refer to the wax esters as gempylotoxins and the condition as poisoning of the gempylide fish.

The exact amount of gempylotoxin causing keriorrhea is uncertain and can vary depending on the sensitivity of a person.

Research indicates that almost 20 percent of the body weight of Gempylidae fish is composed of wax esters. The explanation for this is that these fish are unable to metabolize the naturally occurring wax esters in their diet. In the fish ‘s body, wax esters accumulate, including the skin and muscle tissue.

Wax esters consist of a fatty acid and alcohol that is fatty. These are indigestible and non-absorbable materials. Gempylotoxins, therefore, have a laxative effect once within the colon, resulting in oily diarrhea.

Sometimes, sellers of these fish wrongly label them as other types of fish. In other instances, under a different name, such as gemfish, butterfish, or rudderfish, the fish can appear.

Healthcare professionals who treated three individuals with keriorrhea observed in a 2018 scientific study that each person had recently eaten raw fish (sushi) before experiencing their symptoms.

Italy and Japan do not allow school fish to be sold in their countries. Advice from the Food and Drug Administration (FDA) against the import and sale of oilfish and escolar fish..

Treatment

Symptoms will disappear after 24-72 hours in most situations, but they can also last for up to 90 hours. An person with keriorrhea is unlikely to need treatment or hospitalization.

To encourage recovery, a person experiencing keriorrhea may wish to take the following steps:

  • Resting: A person should consider taking time off work and staying at home. If they need to go out, they should be aware that bowel movements may be unexpected and urgent.
  • Drinking plenty of fluids: There is a risk that people with keriorrhea may become dehydrated. An individual should keep drinking plenty of liquid but avoid alcohol and caffeine.
  • Reintroducing foods slowly: There is a lack of research exploring which foods a person should eat when experiencing keriorrhea. However, based on the standard recommendations of what to eat when dealing with diarrhea, they may wish to avoid heavy meals and consume small portions of bland foods.

Other potential causes of oily feces

Other conditions that can produce movements of the oily bowel include steatorrhea. This term describes feces that contains a lot of fat.

These kinds of stools may appear oily, pale, and bulky. They may have a bad smell as well.

Steatorrhea can cause oily anal leakage, as with keriorrhea, and a person may be able to see oil in the toilet bowl on the surface of the water.

Foods

By eating meals or foods that are high in fat, potassium, or fiber, a person can develop steatorrhea. This may include:

  • nuts
  • oily, high fat fish
  • foods high in trans fat

Medical condition

Some medical conditions can adversely impact the absorption of nutrients by the stomach. Poor fat absorption can induce steatorrhea. Some instances of conditions that can cause steatorrhea include:

  • Celiac disease: When a person with celiac disease consumes gluten, it triggers an immune response in which the body attacks its own tissues in the digestive tract and stomach. As this response can affect nutrient absorption, it may cause steatorrhea.
  • Chronic pancreatitis: The pancreas is an organ that aids with digestion. Sometimes, it may become inflamed and stop working properly. This dysfunction can lead to poor digestion and issues absorbing fats, triggering steatorrhea.
  • Crohn’s disease: This chronic condition causes inflammation of the intestines. This inflammation can affect absorption mechanisms and lead to steatorrhea.

When to see a doctor

In a few days, most individuals with keriorrhea will recover, so it is unlikely they will need to see a doctor.

However, they could have steatorrhea if a person has frequent oily bowel movements. To determine the underlying cause, a person should consider seeing a doctor who can perform tests.

Summary

Oily orange bowel movements can be encountered by people with keriorrhea. Usually, the condition results from the consumption of the indigestible wax esters found in oilfish and escolar fish.

Although it can be painful and unpleasant, without needing medical attention, a person with keriorrhea will likely recover at home.

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