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  • Stools – Unusual Color

    Definition

    • The stool color is strange or different
    • 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

    • 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 red 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 the stools to look like this.
    • 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.

    When to Call Us for Stools – Unusual Color

    Call Us Now (night or day) If:

    • Your child looks or acts very sick
    • You think your child needs to be seen urgently

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

    • You think your child needs to be seen, but not urgently

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns
    • 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

    Parent Care at Home If:

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

    Care Advice for Stools – Unusual Color

    What You Should Know:

    • 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.

    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.

    Avoid:

    • Don’t eat the suspected food.
    • Don’t drink the suspected drink.
    • The strange stool color should go away within 48 hours.

    Sample:

    • If the strange stool color doesn’t go away, bring in a sample.
    • Keep it in the refrigerator until you leave.

    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.

    Call Your Doctor If:

    • 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.
    • Your child becomes worse

    Disclaimer: This information is not intended 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.

    Author and Senior Reviewer: Barton D. Schmitt, M.D.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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