This article reports on steatorrhea, daily food intake, and fecal substances other than fecal fat (e.g., neutral sterols, bile acids, short-chain fatty acids) in pancreatic exocrine dysfunction arising from chronic pancreatitis (CP) in Japanese. European, and American patients. Changes in upper small intestinal pH and lipase secretion, plasma fatty acid profiles, serum fat-soluble vitamin levels and symptoms of their deficiency, and nutritional status are discussed in detail. Treatment of pancreatic steatorrhea is described. Throughout this study, we compared characteristics of maldigestion and malabsorption in these patient populations and our study revealed that fecal fat excretion reflected quantitative differences in fat consumption, plasma fatty acid profiles reflected quantitative and qualitative differences in fish oil consumption, and there were no differences in pancreatic exocrine dysfunction among these three groups. Since differences in fecal fat excretion and plasma fatty acid profiles appear to depend on dietary fats, the pathology and treatment of CP patients should be evaluated and the findings used to prescribe treatments.