What Causes Pale Poop (Acholic Stool)?

Occasional changes in stool (poop) colors usually occur as a result of the food you eat. A persistent change in the color of your stool could also indicate an underlying health condition and shouldn’t be overlooked. 

Typically, your stool color is some shade of brown, which is due to the presence of a yellow-brown pigmented substance called bilirubin that helps break down fat during digestion. However, problems with your liver or biliary system can affect your poop color, leading to pale or clay-colored poop (medically known as acholic stool).

What Does Pale Poop Look and Feel Like?

Pale poop looks paler than your usual brown poop. It can also be described as clay-colored, white, grey, or light-colored. This discoloration often happens due to a lack of bile pigment in your body. 

Depending on the specific underlying cause of your condition, pale poop may be accompanied by other symptoms, such as:

• Changes in urine color
• Diarrhea
• Jaundice
• Fever
• Muscle weakness
• Abdominal pain
• Nausea and vomiting
  
• Itchy skin
• Swelling in the legs
• Loss of appetite and unexplained weight loss

Common Causes

Several biliary conditions, liver disease, gallbladder problems, and other health concerns can cause your poop to look pale.

Biliary Obstruction

Biliary obstruction refers to an impairment or blockage to any of the ducts that carry bile from the liver to the gallbladder (where bile is stored) or from the liver to the small intestine (where bile helps aid digestion).

When normal bile flow becomes obstructed, it may cause symptoms like jaundice (the yellowing of the eyes and skin), nausea or vomiting, pain, and pale poop.

Bile Acid Synthesis Disorders (BASDs)

BASDs are a group of rare metabolic conditions that cause problems in the synthesis of bile acids, which promote the flow of bile from the liver.

When your body does not produce normal or functional bile acid, it can lead to the malabsorption of fat-soluble vitamins and suppression of bile flow. These can result in complications like liver scarring, liver failure, and neurological (brain-related) conditions. 

Pale or clay-colored poops due to the suppression of bile flow, excess fat in stools (medically known as steatorrhea), and diarrhea are common symptoms that may occur with this condition.

Gallstones

Gallstones are hard deposits that form inside the bladder, typically made of cholesterol or bilirubin. Their size may range from as small as a grain of sand to something larger, such as a golf ball.

Researchers aren't exactly sure why gallstones form, but excess cholesterol and bilirubin in the bile can trigger stones to form. Gallstones can obstruct the bile duct, impairing the flow of bile, thereby causing you to pass poop that appears pale. 

Bile Duct Cysts

Bile duct cysts are pockets or pouches filled with fluid that may form in the bile ducts. The cysts can block the flow of bile, leading to pale stool. They are also linked to other complications, such as an increased risk of developing biliary tract cancers.

Liver Diseases

The hepatic (liver) system is greatly interconnected with the biliary system. Since liver cells are responsible for producing bile, liver dysfunction can affect normal bile production and cause pale poops.

Liver conditions that may cause pale-colored stool include:

• Alcoholic hepatitis: Alcoholic hepatitis is the swelling or inflammation of the liver caused by excessive alcohol consumption. It is related to alcoholic liver disease and leads to symptoms like pale poop, jaundice, an enlarged liver, and malaise (a general feeling of being unwell). 
• Viral hepatitis: This is also the inflammation of the liver, but this case of hepatitis occurs due to infection. Depending on the virus, hepatitis infections can be grouped into different types, including hepatitis A, B, C, D, and E. While hepatitis A and E typically cause short-term infections, B, C, and D viruses can cause long-term damage that affects your liver and biliary health. 
• Liver cirrhosis: This progressive condition causes liver scarring and irreversible liver damage when scar tissues replace the healthy liver tissues, causing the liver not to function normally. When bile secretion becomes affected, pale poop can occur, along with other symptoms like confusion, swelling in the lower legs, dark-colored urine, and unexplained weight loss.

Certain Medications

Certain medications can cause acute (short-term) or chronic (long-term) injury to the liver, especially if you have to take medications for long durations. This phenomenon is also called drug-induced hepatotoxicity. Medicines that may cause damage to the liver include:

• Cardiovascular medications like statins
• Certain herbal and dietary supplements, including anabolic steroids
• Antibiotics like amoxicillin-clavulanate
• Nonsteroidal anti-inflammatory drugs (NSAIDs)

Drug-induced hepatotoxicity is one of the most common causes of acute liver failure and can cause symptoms similar to liver disease, biliary disease, and cancer of the liver. When the biliary system is affected, a common symptom that may occur is pale poop.

Tumors

Tumors—both cancerous or benign (harmless)—that affect the liver, biliary system, or pancreas may disrupt bile acid production or bile flow, leading to various symptoms such as pale stool. 

People who drink alcohol or live with medical conditions like chronic inflammation of the bile duct, diabetes, and inflammatory bowel disease (IBD) are at a higher risk of developing bile duct tumors. Aside from pale stools, other symptoms of bile duct tumors and cancer include dark urine, itchy skin, nausea, and abdominal pain.

When to Contact a Healthcare Provider

You may notice occasional changes in the color or consistency of your poop, perhaps due to a medication you took or something you ate. This may not be a cause for alarm. 

Consider seeing a healthcare provider if the pale stool persists for several days, especially if symptoms like jaundice, dark urine, abdominal pain, and fever accompany it. These symptoms often indicate underlying concerns that may be affecting your hepatic and biliary systems.

During your appointment, your healthcare provider will most likely ask you questions about your symptoms and your personal and family medical history. You can also expect them to conduct a thorough physical exam and order additional tests such as:

• Blood tests to check liver function and assess signs of infection
• Imaging studies (like CT scans, abdominal ultrasounds, and MRIs) to get images of the bile ducts and liver and detect any abnormalities
• Endoscopic retrograde cholangiopancreatography (ERCP), which involves using an endoscope to look at the pancreatic and bile ducts for inflammation, infection, disease, or damage

Treatment Options

If you receive a diagnosis that pinpoints the cause of your pale poop, the next step is to start proper treatment. Your exact treatment plan can vary and may include medications, surgeries, and lifestyle changes.

Medications

Your healthcare provider may prescribe medications for some underlying conditions.

Small-sized gallstones, for instance, may be treated using medications like Chenix (chenodiol) and Actigall (ursodiol), while infections like hepatitis C may need direct-acting antiviral medications.

You may also need medications to relieve accompanying symptoms like diarrhea, nausea, and fever.

If certain medications are causing your pale poop, your healthcare provider may recommend discontinuing them or prescribing alternative medications to you to help alleviate your symptoms.

Medical Procedures and Surgeries

Sometimes, surgeries or other medical procedures like shock wave lithotripsy (a procedure that uses shockwaves to make gallstones smaller) may be necessary to treat underlying conditions that are causing blockages or structural issues in your bile ducts, liver, and gallbladder.

If your pale poop is due to gallstones or tumors, you may also need surgery to remove them.

For severe liver diseases, you may need a liver transplant to help improve your poop and overall liver health.

Lifestyle Changes

In some cases, lifestyle changes can be enough to treat pale poop and get your stool back to its typical brown color. Your provider may suggest these changes to improve your bowel health:

• Avoid or quit smoking
• Eat more fruits, vegetables, plant proteins, and fiber
• Manage blood sugar, obesity, and lipid levels

How To Prevent Pale Poop

Doing things that minimize your risk of developing liver and bile duct conditions can help prevent pale poop. Consider these preventative strategies:

• Increase your intake of vitamins A and B
• Practice safe sex
• Avoid sharing needles to reduce your risk of hepatitis
• Do not consume contaminated foods and drinks
• Limit alcohol use
• Avoid smoking
• Ask your provider for support with managing underlying conditions like obesity and diabetes
• Reduce intake of highly processed and sugary foods
  

A Quick Review

Pale poop looks different from your typical brown poop color and may look gray, clay-colored, or beige. Several underlying health conditions that affect your liver, bile ducts, and gallbladder can reduce the amount of bilirubin (a substance that produces a yellow-green pigment) and lead to pale poop.

While changes in poop color can happen from time to time if you eat certain foods, pale poops for several days can be a cause for concern and require support from a healthcare provider.