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

Having clay-colored or light-colored stool just once, or every now and then, isn't usually a concern. But a consistently pale or light poop color may be a sign of a serious medical condition like hepatitis, gallstones, and other liver or biliary (bile duct or gall bladder) diseases.

This article explains what's normal and abnormal with regard to stool color. It also explains what causes pale stool color, other symptoms to watch for, and how the underlying cause of light-colored stools is diagnosed and treated.

Normal vs. Abnormal Stool Colors

Healthy stools come in many sizes, shapes, and colors. When it comes to color, there are those that are inherently normal and others that may signal a health concern.

Here is what different stool colors possibly mean:

Causes of Clay-Colored Stools

The biliary system consists of the gallbladder, liver, and pancreas which work together to aid with digestion. Bile, a fluid created in the liver, stored in the gallbladder, and released into the small intestine, is one of the key compounds that enable this.

Bile is a yellow, brownish, or olive-green liquid consisting of acids that break down fats so that they can be absorbed by the body. It contains a pigmented compound called bilirubin that causes your stools to turn brown.

When not enough bile is being produced or secreted, stools will be pale, light, or clay-colored due to the lack of bilirubin. The medical term for this is acholia.

There are several reasons why bile levels are decreased. They can be broadly categorized as being either liver-related or gallbladder-related.

Liver-Related Causes

Any dysfunction of the liver can affect bile production. Liver cells (called hepatocytes) produce bile by secreting bilirubin, bile acids, cholesterol, proteins, and water into tiny ducts that feed directly into the gallbladder.

Hepatocytes are less able to produce bile if the liver is injured or inflamed. Hepatitis pertains to liver inflammation, the condition of which can either be acute (sudden and often short-lived) or chronic (persistent or recurrent).

Among the liver diseases that can trigger acholia are:

• Viral hepatitis: Caused by one of five different viruses, known as hepatitis A, B, C, D, or E
• Liver cirrhosis: Generally irreversible liver damage caused by diseases like viral hepatitis, alcoholic fatty liver disease (AFLD), and non-alcoholic fatty liver disease (NAFLD)
• Liver cancer: Including the most common form, called hepatocellular carcinoma (HCC)
• Drug-induced hepatitis: Often-reversible injury caused by some over-the-counter or prescription drugs as well as supplements and herbal remedies that are toxic to the liver
  

Gallbladder-Related Causes

Once produced by the liver, bile is secreted through tiny canals into a structure called the common bile duct. From there, bile is fed to the gallbladder, where it is stored and released on demand whenever food enters the stomach.

Bile is released at the first section of the small intestine, called the duodenum., situated immediately after the stomach.

There are several reasons why bile is not secreted as it is supposed to, including:

• Gallstones: Calcium deposits in the gallbladder that block bile ducts, also known as cholelithiasis
• Biliary cirrhosis: Generally irreversible damage to the gallbladder often caused by autoimmune diseases like celiac disease, Sjogren syndrome, and autoimmune thyroid disease
• Sclerosing cholangitis: Inflammation or scarring of the bile ducts whose cause is unknown but is thought to be genetic
• Biliary stricture: An abnormal narrowing of the common bile duct, often caused by gallbladder surgery
• Biliary cysts: Fluid-filled pockets, also known as choledochal cysts, that can form in the bile duct and block the flow of bile
  
• Bile duct cancer: A rare type of cancer also known as cholangiocarcinoma

What Causes Light-Colored Stools in Children?

Acholia can affect children and even newborns. While uncommon, it is typically due to congenital abnormalities that a child is born with, such as:

• Biliary atresia: A condition in infants in which the bile ducts outside and inside the liver are scarred and blocked
• Biliary hypoplasia: A condition where an infant is born with a decreased number of smaller bile ducts
• Biliary agenesis: A rare problem in which a child is born without a gallbladder

A viral or bacterial infection soon after birth can also damage the liver or gallbladder and cause acholia.

Diagnosing the Cause of Light-Colored Stools

A healthcare provider must first identify the underlying cause before treating you for clay-colored stools. In addition to a complete medical history, they may order some of the following tests:

• Liver function tests (blood tests to help determine if you have a liver problem)
• Abdominal ultrasound to look at the liver and gallbladder area
• Blood work to test for infection
• Endoscopic retrograde cholangiopancreatography (ERCP), a type of endoscopy to see inside the pancreas and bile ducts
• Magnetic resonance imaging (MRI) or computed tomography (CT scan)

Treatment of Clay-Colored Stools

Treatment for clay-colored stools depends on the underlying cause. For example, if medications or supplements are suspected causes, you may need to adjust or switch which drugs you take.

Likewise, you may need to change your diet if a healthcare provider believes malabsorption is a contributing factor. If the liver is involved, you may be advised to avoid drinking alcohol.

If your pale stools are caused by something structural, like blocked bile ducts, you may need surgery to remove the blockage or widen the passageway. Hepatitis may require antivirals, while a liver transplant is the only way to resolve cirrhosis.

Prevention of Light-Colored Stools

There are several things you can do to reduce your risk of liver or gallbladder disease and, in turn, the development of acholia:

• Hepatitis vaccination: Vaccines are available for both hepatitis A and B.
• Avoid getting viral hepatitis: This includes ensuring food safety with hepatitis A, safer sex practices with hepatitis B and C, and the avoidance of shared needles with hepatitis B and C.
• Reduced alcohol intake: Limit your intake to no more than two drinks per day if you are male and one drink per day if you are female.
• Lose weight: If you are overweight or have obesity, losing weight can prevent the progression of NAFLD and other chronic liver diseases.
• Eat a healthy diet: Eating more fiber, substituting healthy fats, and eating less refined carbohydrates can reduce your risk of getting gallstones.

Summary

An occasional clay-colored stool isn’t usually a concern. However, if pale stools persist, it can point to a problem with bile ducts or another underlying medical condition.

It’s essential to see a healthcare provider, especially if you have any other concerning symptoms, like jaundice or pain.

Your healthcare provider may run some tests to see what's causing clay-colored stools. Treatment depends on the cause and ranges from dietary changes to surgery.