Stool color can provide important clues about your health. While normal stool color can range from light yellow to brown to almost black, some colors may indicate an underlying issue. Knowing when to see your doctor is important, especially if stool color changes persist or are accompanied by other symptoms.
What Causes Stool Color Changes?
Normal stool gets its color from bile, which is produced in the liver to help digest fats. Bile is initially green but turns brown as it travels through the digestive tract. Here are some common causes of abnormal stool colors:
- Black or very dark stool – can indicate bleeding in the upper GI tract, like an ulcer or cancer
- Red or maroon stool – suggests bleeding in the lower GI tract, like hemorrhoids or diverticulitis
- Green stool – could be from eating lots of leafy greens or taking iron supplements
- Yellow or pale stool – suggests not enough bile reaching the stool, which may indicate an obstruction
- Greasy or shiny stool – could be a sign your body isn’t properly absorbing fats
- Orange or yellow stool – may indicate not fully digesting foods or celiac disease
When to See Your Doctor
While an unusual stool color once in a while is not necessarily cause for concern, there are some circumstances where you should seek medical advice:
- If stool is black or maroon AND accompanied by symptoms like dizziness, fatigue, cramping, fever, or chills
- If red or black stool persists for more than 2 bowel movements
- If stool is pale, white, yellowish, or clay-colored persistently
- If greenish stool persists AND you have severe diarrhea or abdominal pain and cramping
- If greasy or shiny stool persists
- If you observe any blood in the stool, even small amounts
In these situations, schedule an appointment with your doctor for an evaluation. Persistent changes in stool color can sometimes reflect more serious underlying issues that need medical attention.
Common Conditions Linked to Stool Color Changes
Here is an overview of some common conditions that may cause abnormal stool colors:
Bleeding in the Upper GI Tract
Causes of upper GI bleeding like gastric ulcers or ulcers in the first part of the small intestine can lead to black, tarry stools. The dark color results from partially digested blood. Upper GI bleeding warrants emergency medical care.
Bleeding in Lower GI Tract
Irritation, infections, or growths in the colon, rectum or anus can lead to lower GI bleeding, resulting in red or maroon colored stool. Common causes include:
- Hemorrhoids
- Anal fissures
- Inflammatory bowel diseases like Crohn’s or ulcerative colitis
- Colon polyps or colorectal cancer
Bright red blood coating the stool or blood mixed into the stool indicates lower GI bleeding. Seeking prompt medical care is recommended.
Malabsorption Issues
Stool may appear yellow, greasy and foul smelling if your small intestine cannot properly absorb fats and food particles. This is seen with celiac disease, cystic fibrosis, pancreatitis, infection, or after gallbladder removal. Pale stool can indicate poor bile production.
Liver Disease
Since bile gives stool its normal brown color, discolored stool may result from reduced bile production in certain liver conditions. Yellow, greasy stool can occur with hepatitis. Pale stool is typical with cirrhosis.
Medications
Iron supplements can turn stool black. Certain anticancer drugs and antibiotics may also produce very dark stool. Oral bismuth found in some anti-diarrheal medicines can make stool black. Active charcoal and black licorice are other potential causes.
Foods
Eating lots of green leafy vegetables like spinach can lend a green hue to stool. Carrots, sweet potatoes and supplemental carotene can produce an orange stool color. Beets and food coloring may redden stool.
Inflammatory Bowel Disease
Ongoing diarrhea plus cramping and pain may be signs of an inflammatory bowel disease like Crohn’s or ulcerative colitis. There can be mucus and blood in stool. These require GI testing and treatment.
When to Visit the ER
While most stool color changes can be evaluated by your regular doctor, some signs and symptoms warrant an immediate ER visit. Seek emergency care if you experience:
- Black, tarry stool OR vomiting blood, which may signal upper GI bleeding
- Maroon or bright red stool, especially if you feel dizzy or faint
- Severe abdominal pain that comes on suddenly, which could indicate a GI emergency like appendicitis or a perforated bowel
Rapid bleeding and resulting anemia can lead to symptoms like lightheadedness, confusion, rapid heart rate, and passing out. If you are experiencing any of these emergency red flags, call 911 or have someone drive you to the nearest ER.
Stool Color Changes in Infants and Children
Babies and kids may also experience odd colored stools on occasion. Here is guidance on when to call your pediatrician:
- Black stool – call right away as this can indicate blood
- Red stool – call if persistent or if child seems ill
- Green stool – normal with exclusively breastfed babies; call if persists over 24 hours in formula-fed infants
- White or clay-colored – call right away as this can indicate a liver issue
- Greasy, shiny stool – call your pediatrician promptly
Notify your child’s doctor right away if abnormal stool colors are accompanied by symptoms like fever, vomiting, abdominal pain, diarrhea, or blood in the stool. This can help identify any underlying issues requiring treatment.
When to Return for Follow Up
If your doctor has diagnosed a condition related to stool color change, it is important to return for follow up appointments and tests to monitor the situation. You may need:
- Colonoscopy to examine the colon if cause of lower GI bleeding was not found
- Repeat upper endoscopy if gastric ulcer was treated
- Follow up tests for pancreatic function if fatty stool persists
- Monitoring of celiac disease treatment
- Ongoing tracking of inflammatory bowel disease
Follow your doctor’s recommendations for any prescriptions, dietary changes, or additional testing needed. Call your doctor right away if abnormal stool color returns after treatment.
Improving Your Stool Quality
Certain lifestyle measures can help improve your stool quality and consistency:
- Drink plenty of fluids to stay well hydrated
- Eat more fiber with fruits, vegetables, whole grains, beans, and lentils
- Exercise regularly to stimulate the digestive system
- Reduce stress through relaxation techniques, meditation, yoga
- Consider probiotic supplements to support gut health
Talk with your doctor before making any significant diet or lifestyle changes, especially if you have an underlying digestive disorder.
When to Seek Emergency Care
Most of the time, stool color changes are not an emergency. Still, some alarming signs and symptoms do require emergency medical attention. Seek emergency care if you notice:
- Black or bloody stool accompanied by dizziness, lightheadedness or fainting
- Sudden, severe abdominal pain, especially if concentrated on the lower right side
- Fever over 101°F (38°C) along with vomiting or diarrhea
- Confusion, seizures or loss of consciousness
Call 911 or have someone drive you to the ER right away if you experience any of the above. These can indicate a medical emergency like a perforated bowel, appendicitis, or significant bleeding requiring hospitalization.
When to Visit Your Doctor
Make an appointment with your doctor if you notice any of the following:
- Black or bright red stool persists more than 2 bowel movements
- Maroon, tarry or sticky black stool
- Greasy and foul smelling stool keeps occurring
- Yellowish or clay colored stool persists
- Presence of mucus or pus in the stool
- Ongoing diarrhea or constipation without known cause
Blood in the stool, greasy stool, and changes in stool consistency can all signal underlying conditions needing medical evaluation. Your doctor can check for infections, inflammation, obstructions, and more.
Main Takeaways
- Normal stool color can range from light yellow to almost black as bile pigments change color through the digestive tract.
- See your doctor if abnormal stool color persists more than 2 bowel movements or is accompanied by other symptoms.
- Black or maroon stool may indicate bleeding in the GI tract; bright red blood could be from hemorrhoids or anal fissures.
- Greasy, foul smelling yellow stool can occur with malabsorption problems like celiac disease.
- Pale stool can result from obstructed bile ducts or certain liver conditions.
- See emergency care for dizziness or fainting along with black/bloody stool.
- Follow up monitoring is important after treatment for conditions related to stool color changes.
Pay attention to changes in your stool color, especially if accompanied by other symptoms. Call your doctor or seek emergency care if you have concerning signs that could require further evaluation and treatment. With prompt attention, many causes of abnormal stool color can be effectively managed.
The Bottom Line
Stool color can provide important clues about potential problems. Make an appointment with your doctor if you observe persistent changes in stool color, especially if you have other symptoms. Some alarming signs require immediate emergency care. With an evaluation, proper treatment and follow up, many conditions linked to unusual stool color can be resolved or controlled.
