Keriorrhea is a distinctive digestive upset characterized by an oily, foul-smelling discharge from the rectum. This non-infectious condition is a specific physical reaction to consuming certain types of marine life. The discharge typically appears orange or yellow and is often accompanied by an urgent sensation or lack of control. Understanding the source of this reaction helps prevent this uncomfortable, though generally harmless, episode.
Specific Dietary Triggers
The primary cause of keriorrhea is the consumption of deep-sea fish from the Gempylidae family, commonly known as snake mackerels. The two main culprits are Oilfish (Ruvettus pretiosus) and Escolar (Lepidocybium flavobrunneum). These fish are often unintentionally consumed because they are frequently mislabeled in restaurants and markets, sometimes sold as “white tuna” or “Hawaiian Walu.” These misnomers make it difficult for consumers to know exactly what they are eating. Rarely, similar symptoms can occur from consuming non-fish products containing high levels of indigestible oils, such as certain older weight-loss supplements.
The Science Behind the Symptoms
The fish responsible for keriorrhea contain high concentrations of fatty compounds called wax esters, which can constitute up to 20% of the fish’s body weight. These wax esters are sometimes referred to as gempylotoxin, named after the fish family. Humans lack the necessary digestive enzymes, specifically lipases, required to break down these wax esters in the small intestine. Because the wax esters cannot be digested or absorbed, they pass unchanged through the entire digestive tract. This undigested oil acts as a physical laxative, accumulating in the rectum and resulting in the expulsion of the oily, orange substance known as keriorrhea.
Recognizing and Managing Keriorrhea
Symptoms of keriorrhea typically begin quickly, manifesting anywhere from 30 minutes to 36 hours after consuming the offending fish. The defining feature is the spontaneous leakage of oil, with or without a normal bowel movement. Accompanying symptoms can include abdominal cramping, nausea, and general digestive discomfort. Keriorrhea is a benign, self-limiting condition that usually resolves completely within 24 to 72 hours once the indigestible esters have been fully expelled.
Management involves staying well-hydrated and taking protective measures, such as using absorbent material, until the episode passes. Prevention is straightforward and involves avoiding the consumption of Oilfish and Escolar, especially in large portions. Consuming small portions, often limited to less than 170 grams, may reduce the likelihood of a reaction, as can avoiding the fish skin, which has a higher oil concentration. Medical attention is only necessary if symptoms persist for more than a few days or if signs of severe dehydration develop.