How to Know When Pale or Clay-Colored Stool May Be a Problem

Stools that are pale, white, or look like clay or putty may be the result of a lack of bile or caused by a blockage in the bile ducts. Stools that are light in color or look like clay can also occur after a test in the colon that uses barium (such as a barium enema), because the barium may be passed in the stool.

In the absence of such a test being done, pale stools could be the result of something else happening in the digestive tract. The inability of the digestive system to absorb fats properly may also result in stools that are light in color (straw yellow to gray) and that appear greasy. The medical term "acholic" is used to refer to light-colored stools that result from a lack of bile.

Having a stool that is white or pale just once, or rarely, is not usually a concern, but when the color is consistently too light, it is something that should be discussed with a doctor.

Healthy stools come in many sizes, shapes, and colors. When it comes to how often you move your bowels or what your stool looks like, every person is different and there is a spectrum of "normal," rather than a specific set of rules. There are times, however, when what you're seeing in the toilet bowl is probably outside of what would be considered in the normal range and should be investigated by a physician. Whenever there is a concern about the size, shape, or color of stools, contact a doctor.

The biliary system is the drainage system of the gallbladder, liver, and pancreas. Bile is created in the liver, stored in the gallbladder, and is released into the first section of the small intestine (the duodenum) while food is passing through. Bile is what gives stool its brown color, so if bile is not being produced or if the bile ducts are blocked, and bile isn't entering the small intestine, the result could be stool that is light.

Medical causes of stool that is pale or clay-colored are usually liver and biliary issues such as: 

• Alcoholic Hepatitis: A disease of the liver that occurs after overexposure to alcohol.
• Biliary Cirrhosis: A type of liver disease where the bile ducts are damaged.
• Birth Defect: Being born with a problem in the biliary system.
• Cysts: A cyst may block a bile duct.
• Gallstones: These calcium deposits in the gallbladder could block bile ducts.
• Hepatitis A, B, or C: Infectious liver diseases that may cause a lack of bile.
• Infection: Certain types of infections could affect the biliary system.
• Sclerosing Cholangitis: A disease that can cause a lack of bile production or a blockage in the bile ducts.
• Side Effects of Medication: Overuse of certain medications could cause drug-induced hepatitis, including non-steroidal anti-inflammatories, hormonal birth control, and certain antibiotics.
• Strictures: A narrowing of the intestine could block the flow of bile.
• Tumor: A tumor could block the flow of bile.

Clay-colored stool that is caused by certain medical conditions may be accompanied by a yellow discoloration of the skin and eyes (jaundice) or darkened urine. If signs of jaundice occur, a physician should be consulted immediately.

The presence of jaundice along with pale stools could mean that there is an obstruction in a bile duct or that there is an infection in the liver. Both of these conditions could be serious and should be discussed with a physician in order to receive prompt treatment.

In order to treat pale stools, the underlying cause of the problem must first be diagnosed. In addition to a complete medical history, some of the tests that might be used to make a diagnosis are:

• Liver Function Tests: Liver function tests can help determine if there is a condition that involves the liver that's causing the pale stools.
• Abdominal Ultrasound: A non-invasive test that uses sound waves to see what's inside the body and might help a physician see inside structures like the gallbladder.
• Blood Work to Test for Infection: A variety of blood tests might be done and while they aren't going to diagnose a problem, they can be used to help narrow down the potential conditions.
• Endoscopic Retrograde Cholangiopancreatography (ERCP): Rarely, this type of endoscopy that can be used to see inside the pancreas and bile ducts might be used.

Treatment will depend on the underlying cause. If the cause is the malabsorption of fats, a change in diet and vitamin supplements may be prescribed. In the case of blocked bile ducts, surgery may be required to open the ducts. If the stools are a symptom of another condition, such as hepatitis, the underlying cause should be treated.

People who haven't recently had a barium enema or a barium swallow should see a doctor about having pale stools. This is particularly true if any other symptoms are occurring along with it, especially jaundice or pain. A physician may want to run some tests and see what might be causing a pale-colored stool. If there are any symptoms that are troubling, such as severe pain or jaundice, seeking medical attention right away is important.

It's understandably uncomfortable to talk to someone about your poop, but your doctor wants to know the details so that he or she can better help you. The earlier you have the conversation, the better treatment you can receive.