Pale, Clay, Gray Stool or White Bowel Movement and Diarrhea

Normal bowel movement color can be any shade of brown, ranging from tan and yellowish-brown to darker shades of brown. There can be temporary changes in the stool color after consuming certain foods with strong pigments but it may only last for a day or two at most. When there is an abnormality in the stool color, especially if it persists or is accompanied by other symptoms like diarrhea or abdominal pain, then it needs to be investigated further.

In order to understand why stool may appear pale to gray or even white in color, it is important to first understand why stool has a characteristic brown color. This is mainly due to a substance known as bilirubin. It is a substances that is constantly produced in the liver as a result of the breakdown of red blood cells. It is an ongoing cycle as red blood cells are constantly being removed from circulation and replaced by new red blood cells.

This bilirubin is then passed out of the liver with bile. It is stored in the gallbladder and eventually released into the gut at the point of the duodenum (the first part of the small intestine). The bilirubin is converted into a substance known as stercobilin within the gut by the normal intestinal flora (“good bowel bacteria”). It is this stercobilin that is responsible for the brown color of stool.

Causes of White Bowel Movement

When less than normal or no bile is excreted from the liver into the bowel (cholestasis), excreted stool will be pale, clay, gray, or white. Someone can describe it as a light color, but this is not bright yellow bowel movement, and also not mucus in the bowel movement that is jelly-like and translucent. Main causes of white bowel movement are:

  • Obstruction of the biliary duct (due to gallstones, inflammation, fibrosis, cancer, pressure from outside (pancreatic cancer or cyst, abdominal tumor like fibroma) may cause cramping pains in the right upper abdomen.
  • Obstruction of the outflow of the bile from the liver due to a liver disease (viral hepatitis, fatty liver, alcohol liver disease, cirrhosis, hemochromatosis or, rarely, tuberculosis, spread of cancer into the liver (liver metastases) may cause fullness or pain in the upper right abdomen, jaundice, nausea, or vomiting.

It is important to note that when bile outflow is hampered (cholestasis) then the bilirubin builds up in the bloodstream. The bilirubin is then deposited in various tissues and is most noticeable in the skin, whites or the eyes and inner lining of the mouth, all of which are stained a yellow color. This is known as jaundice and this type of jaundice is known as cholestatic or obstructive jaundice.

Read more on obstructive jaundice.

Another common symptoms that also arises with the pale to white stools in these cases is dark urine. It arises due to the excess bilirubin in the bloodstream, which cannot be passed out with bile. Similar to the bilirubin that is converted to stercobilin in the bowels, bilirubin is converted to urobilin in the kidneys. This urobilin in large quantities can cause the urine to become darker in color.

White Diarrhea

Above reasons (obstruction of the bile flow), or lack of pancreatic enzyme lipase that digests fats prevents fat absorption in the small intestine. Unabsorbed fats will reach the colon and irritate it, causing diarrhea. Loose, white, sticky, greasy, foamy, floating, smelly stool appearing several hours after a fatty meal is called steatorrhea. Main causes of white diarrhea are:

  • Acute or chronic pancreatitis (low appetite, pain in the middle or left upper abdomen, nausea)
  • Pancreatic cancer (low appetite, weight loss).
  • Liver or biliary duct disease
  • Infections of the bowel such as cholera which causes a characteristic white ‘rice water’ stool.
  • Severe inflammation of small intestine (Crohn’s disease, celiac disease, tuberculosis, severe food poisoning).
  • Candida overgrowth in the large intestine (in persons with lowered immunity, like in AIDS or after a chemotherapy).

Other Causes of White Stool

White stool may appear after:

  • Barium enema, a diagnostic procedure where a fluid is used to make the bowel more visible on x-ray.
  • Antacids, especially overuse of antacids containing calcium.
  • Supplementation with excessively high doses, particularly of calcium.

White Specks in the Stool

White specs in the stool may represent:

  • Undigested food, like rice or seeds.
  • Unabsorbed drugs or supplements.
  • Parasite eggs in very large quantities (uncommon).
  • Clumps of fungi (Candida albicans) when extreme overgrowth occurs in disease like AIDS, or in immunosuppression from chemotherapy or radiation therapy.

Diagnosis

Stool analysis involves collecting a stool sample and sending it to a laboratory for further testing. One of the important findings that needs to be noted is the presence of fats in the stool. Since there is little to no bile to emulsify the fats to allow the digestive enzymes to break it down further, the undigested fat will be found in the stool. This may also cause steatorrhea where the stool is greasy.

Blood tests:

  • White blood cells are elevated in pancreatitis, bowel inflammation
  • Pancreatic enzymes (lipase) in the blood may be elevated in pancreatic disease
  • Liver enzymes in the blood may be elevated  in liver, biliary duct disease
  • Bilirubin levels in the blood may be elevated since this bilirubin is not being passed out with bile.

Ultrasound of the abdomen may reveal gallstones in gallbladder, or rarely in biliary duct, swollen pancreas (in pancreatitis, pancreatic cancer or cyst), or abdominal tumor.

Treatment

Pale to white bowel movement is only a symptom of an underlying condition. Treatment has to be directed at the causative condition in order for the stool color to return to normal. The choice of treatment is therefore dependent on the final diagnosis. This may involve a combination of medication, surgery and dietary changes such as a low fat diet. Always consult with a medical professional about the treatment and management of pale bowel movement or white diarrhea.

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About Jan Modric (249 Articles)
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  • Hi Dawn. It is unfortunate that you have not seen a neurologist earlier. Remember that the progression of the disease can vary to some extent but do not be detracted by the possibility that not all your symptoms may be due to GBS. Fortunately you are consulting with a gastroenterologist soon. Let him/her first assess the possible cause of the gastrointestinal symptoms. The decision to administer immunoglobulins should be made by your doctor. It is against our comment policy to advise any specific treatment. Even if you cannot speak to these specialists immediately, consult with your family doctor in the interim.

  • esmerelda gallegos

    Hello for the past four days I’ve had server diarrhea. and I’m having upper abdominal pain I’ve been to the er and they said ulcers but my diarrhea is getting worse please help

  • Hi Esmerelda. Hopefully you did notify them about the diarrhea when you reported the abdominal pain. You need to go back to the ER or consult with your family doctor if you have not already done so. Diarrhea that is persisting and getting worse is a concern. Apart from hydrating yourself you may also need antibiotics if this is a bacterial or protozoal infection. Your upper abdominal pain could be ulcers but with the current diarrhea, it is very possible that it is all due to the same condition.

  • destiny

    Hello my husband for the past two days has had mushy all white or clay like stool as well as pain and hardness in his right tessticle we are not able to see his doctor for another two weeks based off of the apointmwnts . any advice?

  • Hi Destiny. White stool usually indicates a gallbladder or liver problem. Whether it is related to the testicular symptoms is difficult to say. You do not mention any other symptoms that may be indicative of a systemic infection. These symptoms could be quite serious and it is best that you see a doctor as soon as possible. If you can then it would be advisable to see a private doctor much sooner.

  • Jesse

    For about two years now. My stool is light brown or clay. Smells funny like spicy or sweet .Doesn’t float always sinks. Mushy like or runny. Passing lots of gas like 20 times a day. Stomach pains.Urine is usaully normal but smell strong sometimes. I’ve had two uti last year.

  • Hi Jesse. Not too sure what your question is. Stool is light brown in color and the odor can vary depending on what you may have eaten and then bacterial population in your colon. Stool is supposed to sink. If it floats then it may be a sign of fats in the stool known as steatorrhea. Urine does have an ammonia odor if that is what you are referring to and may be stronger if you are not drinking enough liquids or have a diet high is certain foods. UTIs are not uncommon among females (assuming that you are female). It is difficult to say what the cause of the stomach pain is considering that everything is pretty much ‘normal’. Rather speak to your doctor about your concerns.

  • Isabel Vabre

    Hello my 2 yr old for the pass 2days hestood has been really light like pastel yellow almost going in to white. One time it was a solid stool and today its just loose. Very concerned..

  • Zhack

    White poop can be caused also by eating only milk products.
    Few months ago I only ate 1kg of cheese and drank 1,5 liters of milk in the evening and in the following morning my poop was completely white. Once I started eating anything other than cheese again it turned back to normal.

    (I love cheese)

  • Hi Isabel. Usually changes in stool like you’re describing is a cause for concern because it may indicate a problem with the liver/gallbladder and the secretion of bile into the intestines. This is even more serious if his urine is abnormally dark in color. However, if this occurred just once off and the stool has returned to a normal color then it may not be too much of a concern just yet. Nevertheless do not leave it unattended. This once off episode could be the sign of some underlying disorder which could worsen if it is left untreated.

  • RobertoKYR

    Please help:
    For a day ive had sort of diarrhea like yellow light brown..

  • Hi RobertoKYR. As you can see from this article on repeated diarrhea http://www.healthhype.com/recurrent-diarrhea-causes-of-repeated-bouts-of-diarrhea.html there are many possible causes of diarrhea. You will have to see a doctor and possibly need to have a sample of your stool tested to identify the cause. Diarrhea that lasts 2 to 3 days at most is not often a concern as it is mainly due to an acute infection that passes on its own in most instances. But if it persists then medical attention is necessary.

  • Tina Carr Trujillo

    Hello my symptoms include vomiting, soft runny whitish, chalky collored stool abdominal pain and nausea.. About the last 3 days wondering if this is somesort of flu or if I should see a dr. No fever or cough.?

  • Alaina Moore

    Is it normal to get white foamy stool while on adipex?

  • Hi Tina. Many of the symptoms could be due a range of common diseases such as a tummy bug but the white stools are worrying. This can be a sign of liver, bile duct or gallbladder diseases such as gallstones. You definitely should see a doctor if you have not already done so as further tests may be necessary. Even if your symptoms have resolved, speak to your doctor. Gallstones (if this was the cause) can recur.

  • Mary Hutson

    Hi Isabel, my 1 year old is currently experiencing this. What was your outcome?

  • Joe Zelk

    Hello, I am a 46 yr old male. 2 days ago i started having cramp in my upper abdomen they were minor at first but then over the next 24 hours became so painful I couldnt stand up straight. Been on nothing but water to try and stay hydrated but my urine is still very orange. The pain is less now but still constant. I have been burping on and off for 2 days. with nothing in my system but water could this be gas or should i be worried. I am leaing toward the latter. Please any advice would be great.

  • Priy

    Hello,
    I’m 14-19 Years old (I don’t like sharing personal infomation), Earlier today, I started my Period 1 week Early and my waste was normal In the morning, but after I went shopping, I went Diarrhea which was mainly brown but a few white patches in them. I don’t feel any nausea and I don’t have any other illnesses or allergies. I returned from a long Plane journey which took 27 hours in which I didn’t eat properly. Once I returned home, I ate normally but din’t sleep properly due to the sudden time change. Could I please have some advice on what I can do please, Thank you.

  • maz

    i have had diarrhoea for 3 days now. this morning it was with grey water. what is this?

  • Contra

    On day 3 after vomiting and relieving myself from food poisoning. Just began to poop again. Stool is a whitish color. Just wondering if it will clear up in a few days or if I should be concerned?

  • Hi Contra. This definitely needs to be assessed by a medical professional if it is still persisting. White diarrhea may be seen with conditions like cholera but this could also be a separate condition that arose as a complication to the food poisoning. Difficult to say for sure. Your doctor will have to assess you and possibly send a stool sample to the lab to diagnose the cause.

  • Mandy

    I discovered that a high dose of the anti-depressant Efexor does cause small, hard white circles almost like tiny balls in stool. I did get tested for other concerns but my doctor concluded that they are not harmful and related to the Efexor. I don’t know why it’s not on the side effects list but I do know quite a lot of people on a high dose get them. I suppose you’d call that “unabsorbed drugs”.

  • Hi Brittaney. Yes, this stool color could definitely be due to something you ate. If the discoloration occurs on successive bowel movements then you definitely need to have it investigated. Furthermore if any other symptoms arise then it also needs to be assessed by a medical professional. By now it should be evident whether it is an ongoing problem or just a once off incident.