IMPROVED STEATOCRIT RESULTS OBTAINED BY ACIDIFICATION OF FECAL HOMOGENATES ARE DUE TO IMPROVED FAT EXTRACTION

Conflicting results have been reported on the value of the steatocrit as a screening test for steatorrhea. We recently modified the test pro cedure by fecal acidification with the hope of improving fat extractio n and consequently the sensitivity of the test. The aim of the present study was to ascertain whether or not fecal acidification led to impr oved fat extraction by comparing the fat content of both fatty and sol id layers obtained by centrifugation of 12 acidified (acid steatocrit) and unacidified (classical steatocrit) steatorrheal stool samples. Th e fat content of fatty and solid layers was evaluated using the semiqu antitative (+ = 1, ++ = 2, +++ = 3) scoring system described by Drumme y for the interpretation of the Sudan microscopic method for fecal fat . The fatty layers sum of scores for the 12 samples examined was 31 an d 16 for the acid and classical steatocrit, respectively. The solid la yers sum of scores for the 12 samples was 13 and 24 for the acid and c lassical steatocrit, respectively. Fat extraction from stool samples w as significantly improved after fecal sample acidification (p < 0.005) . Acid steatocrit results agreed better with chemically measured fecal fat than classical steatocrit results. We conclude that fecal acidifi cation, by improving fat extraction, increases the reliability of the steatocrit method for the detection of steatorrhea.