Stools that are pale, clay, or putty-coloured may be due to problems in the biliary system. The biliary system is the drainage system of the gallbladder, liver, and pancreas.
Considerations
The liver releases bile salts into the stool, giving it a normal brown colour. You may have clay-coloured stools if you have a liver infection that reduces bile production, or if the flow of bile out of the liver is blocked.
Yellow skin (jaundice) often occurs with clay-colored stools. This may be due to the buildup of bile chemicals in the body.
Causes
Possible causes for clay-colored stools include:
- Alcoholic hepatitis
- Biliary cirrhosis
- Cancer or noncancerous (benign) tumours of the liver, biliary system, or pancreas
- Cysts of the bile ducts
- Gallstones
- Some medicines
- Narrowing of the bile ducts (biliary strictures)
- Sclerosing cholangitis
- Structural problems in the biliary system that are present from birth (congenital)
- Viral hepatitis
There may be other causes not listed here.
When to Contact a Medical Professional
Call your health care provider if your stools are not the normal brown color.
What to Expect at Your Office Visit
The provider will perform a physical exam. They will ask questions about your medical history and symptoms. Questions may include:
- When did the symptom first occur?
- Is every stool discoloured?
- What medicines do you take?
- What other symptoms do you have?
Tests that may be done include:
- Blood tests, including tests to check liver function and for viruses that might affect the liver
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Imaging studies, such as an abdominal ultrasound, CT scan, or MRI of liver and bile ducts
References
Anstee QM, Jones DEJ. Liver and biliary tract disease. In: Walker BR, Colledge NR, Ralston SH, Penman ID, eds. Davidson’s Principles and Practice of Medicine. 22nd ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 23.
Berk PD, Korenblat KM. Approach to the patient with jaundice or abnormal liver tests. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 147.
Lidofsky SD. Jaundice. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 21.
Marks RA, Saxena R. Liver diseases of childhood. In: Saxena R, ed. Practical Hepatic Pathology: A Diagnostic Approach. 2nd ed. Philadelphia, PA: Elsevier; 2018:chap 5.
