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Stools - Unusual Color

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Does this describe your child's symptoms?

 

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.

If not, see these topics

First Aid:

 

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When to Call Your Doctor

call now

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 within 24 hours

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 within 24 hours

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

home care

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

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HOME CARE ADVICE FOR STOOLS - UNUSUAL COLOR

  1. 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.

  2. 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.

  3. Avoid: Eliminate the suspected food or drink from the diet. The unusual color should disappear.

  4. Sample: For persistent unusual color, bring in a stool sample for testing. Keep it in the refrigerator until you leave.

  5. 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

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

© 2000-2017 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.