Children's Hospital Colorado

Stools - Unusual Color

Urgent or Emergency Care?

If you believe your child needs immediate attention and you have concerns for a life-threatening emergency, call 911. Not sure what counts as urgent and what's an emergency when your child is sick or injured? When it can't wait, know where to take your kids.

Help Me Decide

  • Stool color that is strange or different than normal
  • Normal stool colors are any shade of brown, tan, yellow or green
  • The only colors that may be caused by a disease are red, black and white
  • Dark green may look like black, but dark green is a normal color

Causes of Unusual Stool Color

  • 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 fluid that went in. Examples are Kool-Aid or Jell-O.
  • 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
  • Medicines. Red medicines (like Amoxicillin). Sometimes, other medicines that turn red in the GI tract (such as Omnicef)
  • Foods. See list below.

Foods That Can Cause Red Stools:

  • Red Jell-O, red or grape Kool-Aid
  • Red candy, red licorice
  • Red cereals
  • Red frosting
  • Beets
  • Cranberries
  • Fire Cheetos
  • Red peppers
  • Tomato juice or soup, tomato skin

Black:

  • Blood from stomach bleeding (stomach acid turns blood to a dark, tar-like color)
  • Foods. Licorice, Oreo cookies, grape juice
  • Medicines. Iron, bismuth (Pepto-Bismol)
  • Other. Cigarette ashes, charcoal
  • Bile. Dark green stools from bile may look black under poor lighting. Smear a piece of stool on white paper. Look at it under a bright light. This often confirms that the color is really 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 breastfed infants. It can be normal with both.
  • Green stools are more common with diarrhea. This is due to a fast transit time through the gut. However, formed stools can also be green.
  • Dark green stools may look black under poor lighting. Eating spinach can cause dark green stools.
  • Medicines. Iron (such as in formula)
  • Foods. See list below.

Foods That Can Cause Green Stools:

  • Green Jell-O
  • Grape-flavored Pedialyte (turns bright green)
  • Green fruit snacks
  • Spinach or other leafy vegetables

White or Light Gray:

  • Foods. Milk-only diet
  • Medicines. Aluminum hydroxide (antacids), barium sulfate from barium enema
  • Liver disease. Babies with blocked bile ducts have stools that are light gray or pale yellow.

Call Doctor or Seek Care Now

  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Stool is light gray or white and occurs 2 or more times
  • Strange color without a cause lasts more than 24 hours (Exception: green stools)
  • Suspected food is stopped and strange color lasts more than 48 hours
  • You have other questions or concerns

Self Care at Home

  • Strange stool color most likely from food or medicine
  • Green stools

Care Advice for Stools - Unusual Color

  1. What You Should Know About Unusual Stool Color:
    • Strange 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.
    • Here is some care advice that should help.
  2. Green Stools:
    • Green color of the stools is always normal. Most often, green stools are caused by bile.
    • Green stools are more common in formula fed than breastfed infants. But, they can be normal with both.
    • Green stools are more common with diarrhea. This is due to a fast transit time through the gut. However, formed stools may also be green. This is normal and nothing to worry about.
    • If your child takes iron, be sure your child is not taking too much.
  3. Avoid Suspected Food or Drink:
    • Don't eat the suspected food.
    • Don't drink the suspected drink.
    • The strange stool color should go away within 48 hours.
  4. Save a Sample:
    • If the strange stool color doesn't go away, bring in a sample.
    • Keep it in the refrigerator until you leave.
  5. What to Expect:
    • Remove the cause of the unusual color from the diet.
    • Then the stool should change back to normal color.
    • This should happen within 48 hours or 2 stools later.
  6. Call Your Doctor If:
    • Strange color without a cause lasts more than 24 hours
    • Suspected food is stopped and strange color lasts more than 48 hours
    • You think your child needs to be seen
    • Your child becomes worse

Disclaimer

The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

  • Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
  • Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
    • You can have a conversation with your child's doctor.
    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

If you think that your child is having a medical emergency, call 911 or the number for the local emergency ambulance service NOW!

And when in doubt, call your child's doctor NOW or go to the closest emergency department.

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