Zollinger-Ellison syndrome (excess gastrin) causes steatorrhea (fatty stools) primarily because:
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Correct answer: Low duodenal pH inactivates lipase and precipitates bile salts
Pancreatic lipase requires a neutral pH to function, and bile salts precipitate in acidic environments. The massive acid output in Zollinger-Ellison syndrome overwhelms the pancreatic bicarbonate, leading to fat malabsorption.
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