Stools - Unusual Color
- A stool color other than brown, tan, yellow or green. Any shade of these is normal.
- 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 GI passage time is very rapid. Stools often come out the same color as the Kool-Aid or Jell-O water that went in.
- The only colors we worry about are red, black (not dark green) and white.
Clues to Unusual Stool Colors
- "Bloody stools": 90% of red stools are NOT caused by blood
- Blood from lower GI tract bleeding
- Foods: red Jell-O, red or grape Kool-Aid, red cereals, red candy, red frosting, tomato juice or soup, tomato skin, cranberries, beets, red peppers, red licorice
- Medicines: red medicines (e.g., Amoxicillin), occasionally other medicines that turn red in the GI tract (e.g., Omnicef)
- Blood from stomach bleeding (stomach acid turns blood to a dark, tar-like color)
- Foods: licorice, Oreo cookies, grape juice
- Medicines: iron, bismuth (e.g., Pepto-Bismol)
- Other: cigarette ashes, charcoal
- Bile: Dark green stools from bile may look black under poor lighting. Smearing a piece of stool on white paper and looking at it under a bright light often confirms that the color is actually dark 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 breast fed infants, but normal with both.
- Green stools are more common with diarrhea (rapid transit time), but also seen with formed stools.
- Foods: green Jell-O, grape-flavored Pedialyte (turns bright green), green fruit snacks, spinach or other leafy vegetables. Dark green stools (e.g., after eating spinach) may look black under poor lighting.
- Medicines: iron (e.g., in formula)
White Or Light Gray:
- Foods: milk-only diet
- Medicines: aluminum hydroxide (antacids), barium sulfate from barium enema
- Liver disease: Young infants with blocked bile ducts have stools that are light gray or pale yellow.
See More Appropriate Topic (instead of this one) If
- Looks like blood and child hasn't swallowed any red food, red medicine or Omnicef, see STOOLS - BLOOD IN
- Yellow eyes and under 1 month of age, see JAUNDICED NEWBORN
WHEN TO CALL YOUR DOCTOR
Call Your Doctor Now (night or day) If
- Your child looks or acts very sick
- You think your child needs to be seen urgently
Call Your Within 24 Hours (between 9am and 4pm) If
- You think your child needs to be seen, but not urgently
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Stool is light gray or whitish and occurs 2 or more times
- Abnormal color is unexplained and persists over 24 hours (EXCEPTION: green stools)
- Suspected food is eliminated and abnormal color persists over 48 hours
Patient Home Care If
- Unusual stool color probably from food or medicine and you don't think your child needs to be seen
- Green stools
HOME CARE ADVICE FOR STOOLS - UNUSUAL COLOR
- Unusual 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.
- Green color of the stools is always normal and usually caused by bile.
- Green stools are more common in formula-fed than breast-fed infants, but normal with both
- Green stools are more common with diarrhea (rapid transit time) but also formed stools.
- If you think it's due to iron medication, be sure your child is not taking too much.
Avoid: Eliminate the suspected food or drink from the diet. The unusual color should disappear.
Sample: For persistent unusual color, bring in a stool sample for testing. Keep it in the refrigerator until you leave.
Call Your Doctor If:
- Unexplained color persists over 24 hours
- Suspected food is eliminated and the abnormal color persists over 48 hours
- 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.
Last Reviewed: 9/15/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.