Digestive Health Daily Care How to Know When Pale or Clay-Colored Stool May Be a Problem By Amber J. Tresca Amber J. Tresca Facebook LinkedIn Twitter Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16. Learn about our editorial process Updated on May 01, 2023 Medically reviewed by Robert Burakoff, MD, MPH Medically reviewed by Robert Burakoff, MD, MPH LinkedIn Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases. Learn about our Medical Expert Board Fact checked by Nick Blackmer Fact checked by Nick Blackmer LinkedIn Nick Blackmer is a librarian, fact-checker, and researcher with more than 20 years’ experience in consumer-oriented health and wellness content. Learn about our editorial process Print Table of Contents View All Table of Contents What Stool Colors Mean Causes Diagnosis Treatment Prevention 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. Verywell / Zoe Hansen 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: Stool color Indication or Explanations All shades of brown Normal Pale, light or clay-colored Liver diseases, such as cirrhosis or hepatitis Bile duct obstruction, including gallstones Large doses of medications containing bismuth subsalicylate, such as Kaopectate or Pepto-Bismol Green Foods that pass too quickly through the digestive tract, such as due to diarrhea Eating green leafy vegetables like spinach or with artificial green food coloring Yellow or orange A malabsorption disorder, such as celiac disease Giardiasis, an intestinal parasitic infection Eating food with a lot of carotenes (like carrots) or turmeric Bright red Bleeding in the lower digestive tract, such as due to hemorrhoids Eating beets, lots of cranberries or tomatoes, or foods with artificial red food coloring Black or tarry Bleeding in the upper digestive tract, due to everything from stomach ulcers to colon cancer Taking iron supplements Eating black licorice An Overview of the Bristol Stool Chart 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 blockedBiliary hypoplasia: A condition where an infant is born with a decreased number of smaller bile ductsBiliary 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. Watch for Signs of Jaundice If you have problems with your liver, clay-colored stool might be accompanied by yellow skin and eyes (jaundice) or dark urine. This is due to a buildup of bilirubin in your body. See a healthcare provider immediately as these are signs of an acute liver infection or injury. 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) What Is ERCP? 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. How Hepatitis C Is Treated 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. 13 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Mount Sinai. Stools - pale or clay-colored. Ohno H, Murakami H, Tanisawa K, Konishi K, Miyachi M. Validity of an observational assessment tool for multifaceted evaluation of faecal condition. Sci Rep. 2019;9:3760. doi:10.1038/s41598-019-40178-5 National Cancer Institute. Biliary system. National Institute of Diabetes and Digestive and Kidney Diseases. Your digestive system and how it works. National Library of Medicine. Acholic stools. MedlinePlus. Stools - pale or clay-colored. MedlinePlus. Gallbladder disease. Hodler J, Kubik-Huch RA, von Schulthess GK. Chapter 5: disease of the gallbladder and biliary tree. In: Diseases of the Abdomen and Pelvis 2018-2021: Diagnostic Imaging - IDKD Book. Cham (CH): Springer; 2018. Santos Silva E, Moreira Silva H, Azevedo Lijnzaat L, et al. Clinical practices among healthcare professionals concerning neonatal jaundice and pale stools. Eur J Pediatr. 2017;176(3):361-369. doi:10.1007/s00431-016-2847-y Centers for Disease Control and Prevention. Viral hepatitis. U.S. Department of Health and Human Services. Dietary guidelines for Americans, 2020-2025. 9th edition. Jennison E, Patel J, Scorletti E, Byrne CD. Diagnosis and management of non-alcoholic fatty liver disease. Postgrad Med J. 2019;95(1124):314-22. National Institute of Diabetes and Digestive and Kidney Diseases. Eating, diet, and nutrition for gallstones. Additional Reading Kasırga E. The importance of stool tests in diagnosis and follow-up of gastrointestinal disorders in children. Turk Pediatri Ars. 2019;54(3):141-148. doi:10.14744/TurkPediatriArs.2018.00483 Seattle Children's Hospital. Stools - unusual color. By Amber J. Tresca Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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