Normal stools can vary in shades of brown, mostly due to diet. Pale or clay-colored stools are not normal. If your stools are pale or clay-colored, you may have a problem with the drainage of your biliary system, which is comprised of your gallbladder, liver, and pancreas.
Bile salts are released into your stools by your liver, giving the stools a brown color. If your liver is not producing enough bile, or if the flow of the bile is blocked and not draining from your liver, your stools will be pale or clay-colored.
Having pale or clay-colored stools once in a while may not be a cause for concern. If it occurs frequently, you may have a serious illness. You should see your doctor whenever you have pale or clay-colored stools in order to rule out illness and disease.
There are many possible causes of pale or clay-colored stools. Some of the common causes include:
Certain medications, such as nonsteroidal anti-inflammatory drugs (ibuprofen and naproxen), birth control pills, some antibiotics, and anabolic steroids can cause drug-induced hepatitis. Drug-induced hepatitis is a swelling or inflammation of the liver caused by medications. Drug-induced hepatitis and the related discolored stools usually go away within a few weeks after the medications are discontinued.
Viral hepatitis is a swelling or inflammation of the liver caused by viruses such as the hepatitis A, B, or C viruses. Hepatitis C often leads to liver disease.
Alcoholic hepatitis is swelling or inflammation of the liver caused by drinking excessive amounts of alcohol. Alcoholic hepatitis can lead to liver disease or liver failure.
Biliary cirrhosis is an inflammation or irritation of the bile ducts in the liver. The inflammation or irritation blocks the flow of bile to the intestines. The exact cause of biliary cirrhosis is unknown. There is no cure for biliary cirrhosis, and the disease is life-threatening. According to the National Institutes of Health, approximately 25 percent of people with biliary cirrhosis experience liver failure after 10 years of having the disease. (NIH)
Gallstones are hardened deposits in the gallbladder that can block the flow of bile. Medications can sometimes dissolve gallstones. You may need surgery to remove your gallstones if they are large or if they fail to go away after you take medications.
Sclerosing cholangitis is an inflammation or scarring of the bile ducts, which are the tubes that carry bile throughout the body. The exact cause of this disease is unknown, but genetic factors may be partially responsible. Your doctor may be able to repair the damage to your bile ducts using medications or surgery.
Structural Defects in the Biliary System
You may have been born with structural defects in your biliary system that prevent the flow of bile. Your doctor may be able to surgically repair the defects.
Gallbladder removal surgery can result in the narrowing of the bile ducts. This condition is known as biliary stricture. Your doctor may be able to correct the problems using surgery or a stent. A stent is a small tube that a surgeon places inside the ducts to keep them open so that bile can flow freely.
Benign (noncancerous) or malignant (cancerous) tumors in the biliary system can interfere with bile flow or can inflame the liver. Your doctor may be able to remove the tumor surgically. You may need radiation or chemotherapy treatments if the tumor is cancerous.
Cysts on the bile ducts can prevent the flow of bile. The cysts may go away without treatment, or your doctor may perform surgery to remove them.
One of the most common complications of pale or clay-colored stools is jaundice. This is due to a buildup of bile in your body. Jaundice is a yellowing of your skin or around the whites of your eyes. See your doctor immediately if you have signs of jaundice because it may also be a symptom of liver disease.
Your doctor will ask you questions to find out how often you have pale or clay-colored stools, other symptoms you may have, and to find out what medications you are taking. Your doctor may also perform tests to help diagnose the cause of your pale or clay-colored stools. Possible tests include:
- blood tests
- computed tomography (CT) scans: imaging scans that look inside your body
- magnetic resonance cholangiopancreatography (MRCP) (a special type of magnetic resonance imaging, or MRI, that captures detailed images of the biliary system)
- abdominal ultrasound: a test that uses sound waves to develop a picture of your organs
Once the underlying cause of pale or clay-colored schools is treated, your stools should return to a normal brown color. However, not all causes are curable, such as liver disease and some cancerous tumors. If the cause is incurable, you will continue to have pale or clay-colored stools.