Individuals who have pancreatic insufficiency secondary to pancreatic or biliary tract disease may be unable to efficiently digest and absorb fat normally. The microscopic fecal fat test is a reliable marker for fat malabsorption, and evaluation enzyme therapy in patients with pancreatic exocrine insufficiency. When assessing the root cause of fat malabsorption the following should be considered: dietary fat intake, gastric surgery, pancreatic disease, biliary obstruction, liver disease, mucosal integrity, and problems with chylomicron formation. Supplementation with pancreatic enzymes, HCL, and/or bile salts may be indicated. Steatorrhea is associated with a particularly foul odor of the stool.