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Stools - pale or clay colored

Alternative names

Acholic stools


Stools that are pale, or clay or putty-colored may result from problems in the biliary system (the drainage system of the gallbladder, liver, and pancreas).


Jaundiced (yellow) skin often accompanies clay-colored stools.

The liver excretes bile salts into the stool, giving it a normal brown color. Obstruction to the flow of bile out of the liver (you may see the word "cholestasis"), or liver infections like viral hepatitis, may produce clay-colored stools.

Common Causes

Possible causes for clay-colored stool result from problems in the biliary system, and may include:
  • Cancer or benign tumors
  • Strictures (narrowings)
  • Congenital anatomic problems (present at birth)
  • Gallstones
  • Cysts
  • Medications
  • Sclerosing cholangitis
  • Biliary cirrhosis
  • Protein or infectious infiltration
  • Alcoholic hepatitis
  • Viral hepatitis (A,B, or C)

The underlying cause should be investigated.

Home Care

Follow prescribed therapy.

Call your health care provider if

If clay-colored or pale stools, dark (bloody-looking) urine, or jaundice (yellowish discoloration of the skin and eyeballs) appears, contact your health care provider.

The medical history will be obtained and a physical examination performed.

Medical history questions documenting pale or clay-colored stools in detail may include:
  • Time pattern
    • When did this first occur?
    • Is every stool this way?
  • Medications
    • What medications are being taken?
    • Have you changed medication in any way?
  • Associated symptoms
    • Is there any abdominal pain?
    • Is there any jaundice ?
    • Has there been darkening of the urine?
    • Is there diarrhea?
    • Is there any fever, chills, or night sweats?
The physical examination will include emphasis on the abdominal region. The findings may indicate a need for surgery.

Your doctor may perform:

  • A full history, noting any medications or habits, such as heavy drinking or intravenous drug use
  • Blood work, including liver function tests and tests for viruses
  • Imaging studies, such as an abdominal ultrasound
  • Endoscopy studies with a long, flexible scope passed through the mouth to the small intestine (ERCP, endoscopic retrograde cholangiopancreatography)
After seeing your health care provider:
If a diagnosis was made by your health care provider related to pale or clay-colored stools, you may want to note that diagnosis in your personal medical record.

Update Date: 1/26/2004

Sreeni Jonnalagadda, M.D., Interventional and Pancreatobiliary Endoscopy, Washington University School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.

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Last updated: Tue, 06 Jan 2009 00:20:03 GMT