What Does It Mean If Your Stool Looks Clay-Colored?

Stool is typically some shade of brown. Sometimes, your stool (poop) might look lighter in color than usual. While the occasional appearance of clay-colored stool isn't typically a cause for concern, persistent paleness may be a sign something is wrong with you biliary system.

The biliary system is what creates, stores, and releases bile, a fluid that helps with digestion. The biliary system is what allows for the gallbladder, liver, and pancreas to drain. This drainage happens via bile ducts, tubes that carry bile from the organs to the small intestine.

If you take a look at your stool and notice it looks the color of clay, here's what to know.

What Does Clay-Colored Stool Look Like?

Normal stool color is usually brown because the liver releases bile salts into the stool, which interact with bilirubin—a yellow-brown pigment in bile that's made from the breakdown of red blood cells—to give stool its characteristic color. Bile salts play a crucial role in the digestion and absorption of fats, contributing to the brown hue of feces.

Clay-colored stool usually appears paler than normal brown stool. It may look light grayish-white, similar in color to the natural shade of clay or putty. This unusual stool color may indicate an issue with the biliary system and should be evaluated by a healthcare provider if it persists.

What Causes Clay-Colored Stool?

There are many potential causes for clay-colored stool. In some cases, stool can be the color of clay because of structural problems in the biliary system that have been present from birth. Or, there may be tumors of the liver, biliary system, or pancreas. Even certain medications can cause you to have clay-colored stool.

Other potential causes of clay-colored stool include:

Gallstones

Gallstones are small, solid particles that form in the gallbladder, an organ that stores bile produced by the liver. Gallstones form when there is a change in your bile, such as an increase in cholesterol or bilirubin or a decrease in bile salts. However, it is unclear what can prompt these changes.

If gallstones obstruct the bile ducts, stool can become clay-colored. A blocked bile duct means there can be a disruption to the flow of bile. With gallstones blocking bile flow, bilirubin doesn't reach the intestines in adequate amounts. Since bilirubin is what gives stool its brown appearance, a lack of bilirubin can result in pale or clay-colored stools.

Other symptoms of gallstones may include pain in the middle or upper abdomen, yellowing of the skin or whites of the eye (jaundice), and fever.

Biliary Cirrhosis

Biliary cirrhosis, also known as primary biliary cirrhosis, is a chronic liver disease that primarily affects the small bile ducts within the liver. With biliary cirrhosis, the ducts become inflamed, damaged, and scarred, leading to impaired bile flow.

This condition can cause clay-colored stools because the reduced bile flow results in insufficient bilirubin reaching the intestines, leading to pale or clay-colored stool.

Other symptoms of biliary cirrhosis may include:

• Tiredness
• Itchy skin
• Pain in the middle or upper abdomen
• Joint pain
• Yellowing of the skin

Cysts of the Bile Ducts

A cyst is a pouch or pocket of tissue that is filled with fluid, air, or pus and can form within any tissue of the body. They have many causes, such as infection or parasites. Some have no known cause.

When cysts block the bile ducts, they can disrupt the passage of bilirubin, leading to clay-colored or pale stools.

Symptoms are similar to other conditions that block or interfere with the bile ducts and may include:

• Nausea and vomiting
• Itchy skin
• Pain in the middle or upper abdomen
• Joint pain
• Yellowing on the skin

Sclerosing Cholangitis

Sclerosing cholangitis is a rare chronic liver disease characterized by inflammation, narrowing, and scarring of the bile ducts.

This condition can lead to blockages in the bile ducts, impairing the flow of bile from the liver to the intestines and resulting in various symptoms, including yellowing of the skin and whites of the eye, abdominal pain, and clay-colored stools.

Biliary Strictures

A bile duct stricture is a medical condition characterized by the narrowing of the bile ducts. This narrowing can occur due to various factors, such as inflammation, scarring, injury, or the presence of tumors.

Bile duct strictures can obstruct the normal flow of bile, leading to symptoms like jaundice, abdominal pain, and pale or clay-colored stools.

Hepatitis

Hepatitis is an inflammation of the liver. The liver plays a lot of roles, one of them being to produce bile. The damage hepatitis causes can disrupt bile production and flow, leading to pale or clay-colored stools.

There are several types of hepatitis, each with a different cause. For instance, alcoholic hepatitis results from excessive alcohol consumption while viral hepatitis is from an infection. Meanwhile, autoimmune hepatitis is a rare form of hepatitis in which the immune system mistakenly attacks healthy liver cells. All these types can have clay-colored stool as a symptom.

Other symptoms of hepatitis may include:

• Fever
• Nausea and vomiting
• Dark urine
• Joint pain
• Yellowing of the skin
• Fatigue

When to See a Healthcare Provider

If your stools deviate from their usual brown color for a few days, consider reaching out to your healthcare provider. The change could signify an underlying issue that requires attention, and seeking medical advice early could be essential for proper evaluation and potential treatment.

Diagnosis

Your healthcare provider will conduct a thorough physical examination and inquire about your medical background and symptoms. They may also inquire about the following:

• When your symptoms initially appeared
• Whether every stool is discolored
• What your current medication regimen is
• If you have any additional symptoms

Your provider may also order several diagnostic tests, including:

• Blood tests, which may include assessing liver function and checking for viruses that affect the liver
• Endoscopic retrograde cholangiopancreatography (ERCP), a diagnostic test that integrates upper gastrointestinal endoscopy and radiographic imaging
• Imaging of the liver and bile ducts, such as an abdominal ultrasound, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) scan
  

How Is Clay-Colored Stool Treated?

The key to getting stool back to a normal color is addressing the condition causing the change in the first place. The treatment for clay-colored stool depends on the underlying cause. To properly address the issue, you'll need to receive a diagnosis. Here are some general approaches your healthcare provider may take once a diagnosis is made:

Lifestyle Changes

Lifestyle modifications may be recommended to manage certain conditions causing the clay-colored stool. For example, treatment for alcoholic hepatitis includes alcohol cessation. A well-balanced diet including fiber-rich foods, fruits, and vegetables is recommended for people with sclerosing cholangitis and hepatitis. Your healthcare provider may also recommend vitamin supplementation to ensure proper nourishment.

Medications

In some cases, medications may be prescribed to alleviate symptoms or address the underlying condition. For example, if small gallstones are causing the clay-colored stool, you might be prescribed medication to dissolve the stones. These medications can include Actigall (ursodiol) or Chenix (chenodiol).

Surgeries and Procedures

Surgeries or procedures may be necessary to treat conditions like gallstones or other reasons for bile duct obstructions. They can help remove blockages or address structural issues.

For example, with gallstones, you might need to have your gallbladder removed through a surgery called a cholecystectomy. If you're having an ERCP, the healthcare provider may be able to take out the gallstones with an endoscope (a tool with a light at the end). If a tumor is causing the blockage, you may need a procedure to widen the duct.

In severe cases of advanced liver disease or alcoholic hepatitis, a liver transplant may be the necessary treatment option.

How to Prevent Clay-Colored Stool

Preventing clay-colored stool involves preventing the conditions that cause it. That means maintaining a healthy liver and gallbladder. Sometimes you can't prevent certain conditions. But some conditions, like gallstones, may sometimes be preventable.

In the case of gallstones, you can do the following to prevent them and the clay-colored stool they may cause:

• Consume a balanced diet rich in fruits, vegetables, and lean proteins
• Minimize fatty food
• Minimize alcohol intake
• Stay hydrated
• Exercise regularly
• Manage an optimal weight for you

You can also prevent some cases of viral hepatitis by getting a hepatitis A or B vaccine.

A Quick Review

Sometimes stool can look clay-colored, or pale. If your stool is clay-colored for several days, that may indicate an underlying health issue. Gallstones, hepatitis, or liver diseases are some of the possible causes of the change in stool color. Normal stool is brown because of the interaction between liver-released bile salts and bilirubin. Clay-colored stool results when this process is disrupted.

Diagnosis of the underlying cause of the clay-colored stool involves physical examinations, medical history, and tests such as blood tests or imaging. Treatment depends on the diagnosis and may include medications, surgery, procedures, and lifestyle changes. Early intervention is vital for managing and addressing this symptom effectively. If your stool color remains abnormal for several days, talk to a healthcare provider.