Stools - Unusual Color

Symptoms

DEFINITION

• A stool color other than brown or tan

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. 

Clues to Unusual Stool Colors

Red:

• Blood from lower GI tract bleeding
• Foods: red Jell-O, red or grape Kool-Aid, red cereals, tomato juice or soup, tomato skin, cranberries, beets, 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:

• Foods: green Jell-O, grape-flavored Pedialyte (turns bright green), green fruit snacks, spinach or other leafy vegetables. Dark green stools (e.g., spinach) may look black under poor lighting.
• Medicines: iron (e.g., in formula)
• Bile: Most dark green stools are normal and due to bile.  Bile-stained loose stools are seen with diarrhea illnesses and normal breastfed stools (especially during the first 2 months of life).  While bile is more commonly seen with diarrhea, it can also cause green formed stools.

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.

See More Appropriate Topic (instead of this one) If

• Looks like blood and child hasn't swallowed any red food, red medicine or Omnicef, see STOOLS - BLOOD IN
• Yellow eyes and under 1 month of age, see JAUNDICED NEWBORN

Should I Call?

WHEN TO CALL YOUR DOCTOR

Care at Home

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 almost always normal and due to bile.
   • While it is more commonly seen with diarrhea, sometimes it occurs with formed stools.
   • It usually only lasts for a few days, but it can recur.
   • 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.