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Definition
- A stool color other than brown, tan, yellow or green. Any shade of these is normal.
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 Kool-Aid or Jell-O that went in.
- 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
- 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, Fire Cheetos
- Medicines: red medicines (e.g., Amoxicillin), occasionally other medicines that turn red in the GI tract (e.g., Omnicef)
Black: - 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: - 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.
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