Normal stools can vary in shades of brown, mostly due to your diet. Pale 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 may become pale or clay-colored.
Having pale 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.
There are many possible causes of pale stools. Some of the common causes include:
Certain medications, such as the nonsteroidal anti-inflammatory drugs ibuprofen (Advil) and naproxen (EC-Naprosyn), 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 in the majority of people.
Viral hepatitis is a swelling or inflammation of the liver caused by viruses such as the hepatitis A, B, or C viruses. Hepatitis C often leads to liver disease.
Your doctor can diagnose the type of hepatitis virus you have and help you figure out the best treatment plan for you.
Alcoholic hepatitis is swelling or inflammation of the liver caused by drinking excessive amounts of alcohol. Alcoholic hepatitis can lead to liver disease or liver failure.
To treat this form of hepatitis, you’ll have to stop drinking alcohol. Your doctor can help you if you’ve become dependent on alcohol. Alcoholic hepatitis can also cause malnutrition, so you may also need to be put on a special diet to get the vitamins and other nutrients you need.
Medications such as prednisone (RAYOS) and pentoxifylline (Pentopak) can also treat liver inflammation.
In severe cases, a liver transplant may be needed.
Biliary cirrhosis is an inflammation or irritation of the bile ducts in the liver. The inflammation or irritation blocks the flow of bile to the intestines. The exact cause of biliary cirrhosis is unknown. There is no cure for biliary cirrhosis, and the disease can be fatal.
Treatment can help manage your symptoms and prevent complications. Commonly prescribed medications include cholestyramine (Questran) to treat itching and ursodiol (Urso Forte), which aids in removing bile from the bloodstream.
Your doctor may also suggest taking vitamins A, K, E, and D, to replace the nutrients that are lost in the fatty stools. Calcium supplements can also help prevent loss of bone density.
In severe cases, your doctor may suggest a liver treatment.
Gallstones are hardened deposits in the gallbladder that can block the flow of bile.
Medications can sometimes dissolve gallstones. You may need surgery to remove your gallstones if they’re large or medication isn’t effective.
Sclerosing cholangitis is an inflammation or scarring of the bile ducts, which are the tubes that carry bile throughout the body. The exact cause of this disease is unknown, but genetic factors may be partially responsible.
Both medications and surgeries are possible treatments for sclerosing cholangitis. Commonly prescribed medications include:
- cholestyramine (Questran)
- prednisone (RAYOS)
- ursodiol (Urso Forte)
- azathioprine (Azasan)
- cyclosporine (Sandimmune)
Your doctor may also prescribe supplements for vitamins A, D, E, and K to replace what the body has lost. Your doctor may also prescribe antibiotics.
Common surgeries used to treat sclerosing cholangitis include:
- endoscopic balloon: inserting a balloon at the end of a long tube into the bile ducts to open any narrowing
- biliary drainage catheter: placing a drain in the narrowing of the bile ducts
- removal of the colon and rectum in severe cases
- liver transplant
Structural defects in the biliary system
You may have been born with structural defects in your biliary system that prevent the flow of bile.
After a physical exam, your doctor may order several tests to determine if you have structural defects. These tests include blood tests, scans, and X-rays.
Your doctor may be able to surgically repair the defects. The type of defect will determine the type of surgical procedure the doctor will use.
Gallbladder removal surgery can result in the narrowing of the bile ducts. This condition is known as biliary stricture.
Your doctor may be able to correct the problems using surgery or a stent. A stent is a small tube that a surgeon places inside the ducts to keep them open so that bile can flow freely.
Benign (noncancerous) or malignant (cancerous) tumors in the biliary system can interfere with bile flow or inflame the liver.
Your doctor may be able to remove the tumor surgically. If the tumor is cancerous, you may need radiation, a therapy that uses X-rays or gamma rays to destroy cancerous cells. Chemotherapy can also be used. This is the use of powerful drugs to kill cancer cells.
Cysts on the bile ducts can prevent the flow of bile.
The cysts may go away without treatment, or your doctor may perform surgery to remove them. The surgery is done laparoscopically and with small incisions and less discomfort that common surgery.
One of the most common complications of pale stools is jaundice. This is due to a buildup of bile in your body. Jaundice is a yellowing of your skin or around the whites of your eyes. See your doctor immediately if you have signs of jaundice because it may also be a symptom of liver disease.
Brightly colored stools in children are usually caused by colorful foods like breakfast cereal. However, pale, white, or clay-colored stools in children can be caused by something more serious. Some of the causes are:
- a milk-only diet
- barium sulfate from barium enema
- blocked bile ducts or liver disease
You should contact your doctor any time your child’s stool changes color, especially if they haven’t had any brightly colored foods or if the stools are pale, white, or clay-colored. Only your doctor can determine the exact cause and provide the proper treatment.
If the cause is a food or medication, removing it from the child’s diet will clear up the condition. If the cause is liver disease or a blocked bile duct, this can be life-threatening and may require surgery or medications.
Your doctor will ask you questions about accompanying symptoms and medications you’re taking. Your doctor may also perform tests to help diagnose the cause of your pale stools. Possible tests include:
- blood tests, to check for infections and jaundice
- computed tomography (CT) scans, to see if you have any swelling of your liver or bile ducts
- magnetic resonance cholangiopancreatography (MRCP), a special type of magnetic resonance imaging (MRI) that captures detailed images of the biliary system
- abdominal ultrasound, to develop a picture of your organs
Once the underlying cause of pale stools is treated, your stools should return to a normal brown color. However, some causes, such as liver disease and some cancerous tumors, are incurable. If the cause is incurable, you will continue to have pale or clay-colored stools.
Some of the causes of pale stools are not preventable, but others are. Some forms of hepatitis have vaccines for prevention. Alcoholic hepatitis can be prevented by not drinking alcohol in excess. If the cause is unknown, work toward having healthy bowel movements by eating a balanced diet that is high in fiber.