Following a Billroth II procedure, what is the likely cause of steatorrhea?

The occurrence of steatorrhea, or fat malabsorption, following a Billroth II procedure primarily relates to the changes in digestive enzyme secretion and hormone regulation that occur as a result of the surgery. In this procedure, part of the stomach is removed and the remaining portion is connected to the jejunum. This alteration can affect the normal flow of pancreatic secretions and the release of duodenal hormones, which are crucial for the proper digestion and absorption of nutrients, particularly fats.

After a Billroth II surgery, the denervation of the duodenum can lead to a decrease in the secretion of hormones such as secretin and cholecystokinin (CCK). These hormones are responsible for stimulating the pancreas to release digestive enzymes and regulating bile secretion from the gallbladder. A reduction in these secretions means that there are fewer enzymes available to emulsify and digest fats, leading to their insufficient absorption and resulting in steatorrhea.

The other options do not directly account for the physiological changes that lead to steatorrhea following this specific surgery. For example, while bacterial overgrowth can indeed occur and contribute to malabsorption, it is not the primary factor arising directly from the surgical changes typical of a