Stools - Unusual Color
Definition
- A stool color other than brown, tan, yellow or green. Any shade of these is normal.
Causes
- Almost always due to food coloring or food additives.
- Stool color relates more to what is eaten than to any disease.
- In children with diarrhea, the gastrointestinal (GI) passage time is very rapid. Stools often come out the same color as the Kool-Aid or Jell-O that went in.
- The only colors we worry about are red, black (not dark green) and white.
Clues to Unusual Stool Colors
Red:
- "Bloody stools": 90% of red stools are NOT caused by blood
- Blood from lower GI tract bleeding
- Foods: red Jell-O, red or grape Kool-Aid, red cereals, red candy, red frosting, tomato juice or soup, tomato skin, cranberries, beets, red peppers, red licorice, Fire Cheetos
- Medicines: red medicines (e.g., Amoxicillin), occasionally other medicines that turn red in the GI tract (e.g., Omnicef)
Black:
- Blood from stomach bleeding (stomach acid turns blood to a dark, tar-like color)
- Foods: licorice, Oreo cookies, grape juice
- Medicines: iron, bismuth (e.g., Pepto-Bismol)
- Other: cigarette ashes, charcoal
- Bile: Dark green stools from bile may look black under poor lighting. Smearing a piece of stool on white paper and looking at it under a bright light often confirms that the color is actually dark green.
Green:
- Green stools are always normal, but they can be mistaken for black stools.
- Bile: Most dark green stools are caused by bile.
- Green stools are more common in formula fed than breast fed infants, but normal with both.
- Green stools are more common with diarrhea (rapid transit time), but also seen with formed stools.
- Foods: green Jell-O, grape-flavored Pedialyte (turns bright green), green fruit snacks, spinach or other leafy vegetables. Dark green stools (e.g., after eating spinach) may look black under poor lighting.
- Medicines: iron (e.g., in formula)
White Or Light Gray:
- Foods: milk-only diet
- Medicines: aluminum hydroxide (antacids), barium sulfate from barium enema
- Liver disease: Young infants with blocked bile ducts have stools that are light gray or pale yellow.
When to call your doctor
Call Your Doctor Now (night or day) If
- Your child looks or acts very sick
- You think your child needs to be seen urgently
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You think your child needs to be seen, but not urgently
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Stool is light gray or whitish and occurs 2 or more times
- Abnormal color is unexplained and persists over 24 hours (EXCEPTION: green stools)
- Suspected food is eliminated and abnormal color persists over 48 hours
Parent Care at Home If
- Unusual stool color probably from food or medicine and you don't think your child needs to be seen
- Green stools
HOME CARE ADVICE FOR STOOLS - UNUSUAL COLOR
- Reassurance:
- Unusual colors of the stool are almost always due to food coloring.
- The only colors that may relate to disease are red, black and white.
- All other colors are not due to a medical problem.
- Green Stools:
- Green color of the stools is always normal and usually caused by bile.
- Green stools are more common in formula fed than breast fed infants, but normal with both.
- Green stools are more common with diarrhea (rapid transit time), but also seen with formed stools.
- If you think it's due to iron medication, be sure your child is not taking too much.
- Avoid: Eliminate the suspected food or drink from the diet. The unusual color should disappear.
- Sample: For persistent unusual color, bring in a stool sample for testing. Keep it in the refrigerator until you leave.
- Call Your Doctor If:
- Unexplained color persists over 24 hours
- Suspected food is eliminated and the abnormal color persists over 48 hours
- Your child becomes worse
Author: Barton D. Schmitt, M.D.
Last reviewed: 9/15/2011
Last revised: 8/1/2011 3:40:59 PM
