Pale stool is stool (feces) that is unusually light in color instead of medium to dark brown. The appearance of pale stools can include a variety of light colors or tints, such as white, silver, gray, light yellow, or putty-colored.
Normal brown stool coloring results from the breakdown of bilirubin, which is produced by the breakdown of old red blood cells. Bilirubin is normally processed by the liver and mixed with a substance called bile.
Bile ducts carry bile from the liver and gallbladder to the small intestine, where it mixes with partially digested food. In the colon, bilirubin is broken down into stercobilin, which gives stool its brown color.
Unusually pale or light-colored stool is often caused by a serious condition that interferes with bilirubin metabolism, such as a blockage of the bile ducts or liver disease. Pale stools may also be accompanied by jaundice, a yellowing of the skin and whites of the eyes (sclerae) caused by a buildup of bilirubin in the body.
In some cases, pale stools may be caused by certain over-the-counter medications or substances used in X-ray procedures, such as barium.
Because pale stools may be caused by a serious disease or condition, you should seek prompt medical care if you, or your child, have unusually pale or light-colored stools. Early diagnosis and treatment of the underlying cause of pale stool can reduce the risk of possible complications, such as liver failure.
Seek immediate medical care (call 911) if you, or someone you are with, have serious or life-threatening symptoms that may or may not accompany pale stools, such as lethargy or unresponsiveness, confusion, difficulty breathing, sudden swelling, or an unexpected change in consciousness or alertness.
Normal stools can vary in shades of brown, mostly due to diet. Pale or clay-colored stools are not normal. If your stools are pale or clay-colored, you may have a problem with the drainage of your biliary system, which is comprised of your gallbladder, liver, and pancreas.
Bile salts are released into your stools by your liver, giving the stools a brown color. If your liver is not producing enough bile, or if the flow of the bile is blocked and not draining from your liver, your stools will be pale or clay-colored.
Having pale or clay-colored stools once in a while may not be a cause for concern. If it occurs frequently, you may have a serious illness. You should see your doctor whenever you have pale or clay-colored stools in order to rule out illness and disease.
What other symptoms might occur with pale stool?
Pale stool may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Pale stool caused by liver disease may be accompanied by fairly nonspecific symptoms, such as fatigue, nausea, and poor appetite.
Symptoms related to dietary or medication causes of pale stool
In some cases, pale stool may be caused by certain medications, preparations for procedures, or dietary factors that cause other symptoms including:
- Constipation or hard, infrequent stools
- Loose, watery or frequent stools
Symptoms related to liver or bile duct disease that may occur with pale stool
Pale stool is often caused by an underlying liver or bile duct disease. Symptoms of these conditions that can occur with pale stool include:
- Abdominal pain
- Dark or brown urine
- Flu-like symptoms (fatigue, fever, sore throat, headache, cough, aches and pains)
- Itchy skin
- Jaundice (yellowing of the skin and whites of the eyes)
- Malaise or generally feeling ill
- Nausea, vomiting, diarrhea, light colored diarrhea, light yellow diarrhea
- Poor appetite
- Weight loss
Symptoms that might indicate a serious or life-threatening condition
Symptoms that may occur with pale stool can be caused by life-threatening conditions, such as liver failure, portal hypertension, or esophageal varices. Seek immediate medical care (call 911) if you, or someone you are with, have the following symptoms:
- Bleeding, such as vomiting blood or major rectal bleeding
- Change in level of consciousness or alertness, such as passing out or unresponsiveness
- Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucination or delusions
- Poor cognitive functioning due to the liver’s inability to filter toxins and a buildup of waste products in the blood and brain
- Severe weakness
- Shortness of breath or difficulty breathing
Seek immediate medical care (call 911) if your baby has any of these serious or life-threatening symptoms that may accompany pale stool:
- Extreme fussiness
- Inability to wake your baby easily
- Lack of stool or urine
- Serious feeding problems or inability to breastfeed or bottle feed
- Unusually weak, stiff or floppy body
Medical Conditions That Can Cause Pale or Clay-Colored Stools
There are many possible causes of pale or clay-colored stools. Some of the common causes include:
Certain medications, such as nonsteroidal anti-inflammatory drugs (ibuprofen and naproxen), birth control pills, some antibiotics, and anabolic steroids can cause drug-induced hepatitis. Drug-induced hepatitis is a swelling or inflammation of the liver caused by medications.
Drug-induced hepatitis and the related discolored stools usually go away within a few weeks after the medications are discontinued.
What causes pale stool?
Pale stool can be caused by a variety of mild to serious diseases, disorders and conditions, including dietary habits, medications, and underlying liver disease.
Dietary or medication causes of pale stool
In some cases, pale or unusually light-colored stool can be caused by certain medications and dietary choices including:
- Antacids that contain aluminum hydroxide
- Barium, which is used in some X-ray procedures to help visualize the gastrointestinal tract
- Certain antibiotics and antifungal drugs
- Hepatic (liver) causes of pale stool
Normally, the body continuously replaces older red blood cells with new ones. A yellow pigment called bilirubin is left behind from this process. Bilirubin is processed by the liver and expelled from the body in a substance called bile, which also contains substances to help digestion.
Bile flows through the bile duct into the small intestine to aid in digestion and eventually mixes with stool for elimination. Pale stool is often caused by an underlying disease, disorder or condition that causes a problem with this process. Liver and biliary causes of pale stool include:
- Bile duct narrowing or obstruction (due to cysts, gallstones, pancreatitis or other causes)
- Biliary atresia (blockage in the ducts carrying bile from the liver to the gallbladder)
- Cancer including that of the liver and pancreas
- Cirrhosis (liver scarring due to a variety of liver diseases)
- Congenital abnormalities of the bile duct system or of metabolism
- Drug-induced cholestasis (slowing of bile flow due to medications)
- Hepatitis (liver inflammation, which can be caused by alcoholism, medications or infection)
- Sclerosing cholangitis (scarring and permanent damage of the bile ducts)
Questions for diagnosing the cause of pale stool
To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your symptoms including:
- When did the pale stool first appear?
- What other symptoms do you have?
- What over-the-counter and prescription medications and supplements do you take?
- What are the potential complications of pale stool?
Pale stools can be caused by serious or life-threatening conditions, such as liver disease, which can lead to complications including:
- Esophageal varices
- Hepatic encephalopathy
- Kidney failure
- Portal hypertension
In newborns, complications can include:
- Cerebral palsy
- Hearing loss
- Teeth and vision problems
You can help minimize your risk of serious complications by seeking regular medical care and following the treatment plan you and your health care professional design specifically for you or your child.