What is white stool?
Although the color of stool can be affected by different foods and medications, it is typically brownish due to digestion of bile salts, digestive agents made by the liver and stored in the gallbladder.
A reduction or absence of bile salts can cause the stool to become a pale clay-like color. Bile salt production can be reduced due to severe liver disease such as hepatitis or cirrhosis. The passage of bile salts into the intestines can be prevented by blockages of the bile ducts inside or outside of the liver due to inflammation, gallstones, or external compression. Pain, especially in the right upper abdomen, fever, nausea, itching, and yellowing of the skin and whites of the eyes (jaundice) can also occur with these conditions.
Medications containing aluminum hydroxide can turn the stool white, as can barium, a white substance sometimes used to help show the digestive tract on X-ray.
Stool is not normally white and you may require emergency treatment in some situations. Seek immediate medical care (call 911) for serious symptoms such as severe abdominal pain, high fever, significant vomiting, seizures, changes in mental status, or sudden behavior changes. Symptoms of dehydration such as decreased urination, increased thirst, fatigue, and light-headedness, also require immediate medical care.
Seek prompt medical care if you have white stool unless a specific cause, such as prolonged antacid use or a recent barium study, can be identified. White stool can be associated with a serious medical condition.
What other symptoms might occur with white stool?
White stool may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Conditions that affect the stool may also involve other body systems.
Digestive tract symptoms that may occur along with white stool
White stool may accompany other symptoms affecting the digestive tract including:
Abdominal pain or cramping
Abdominal swelling, distension or bloating
Abnormally foul-smelling stools
Changes in stool consistency
Nausea with or without vomiting
Other symptoms that may occur along with white stool
White stool may accompany symptoms related to other body systems including:
Bone or joint pain
Easy bleeding or bruising
Weakness (loss of strength)
Yellowing of the skin and whites of the eyes (jaundice)
Serious symptoms that might indicate a life-threatening condition
In some cases, white stool may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
Change in level of consciousness or alertness, such as passing out or unresponsiveness
High fever (higher than 101 degrees Fahrenheit)
Not producing any urine, or an infant who does not produce the usual amount of wet diapers
Severe abdominal pain
What causes white stool?
Stool is normally brown due to the digestion of bile salts, which are made by the liver and stored in the gallbladder. When the amount of bile salts is significantly reduced or they are absent, the stool can be pale or even whitish. Liver disease can interfere with the production of bile salts, and anything that blocks the bile ducts can prevent bile salts from reaching the intestines.
White stool can occur with certain medications and barium, which is sometimes used in X-ray studies of the digestive tract.
Bile salt-related causes of white stool
White stool may be caused by conditions that decrease the amount of bile salts that reach the intestines including:
Biliary atresia (a condition present at birth involving abnormal bile duct development)
Biliary cirrhosis (inflammation of bile ducts in the liver)
Biliary stricture (narrowing of the common bile duct)
Cirrhosis (scarring of the liver due to chronic liver damage)
Cancer or tumors of the liver, the bile ducts, gallbladder, or pancreas
Hepatitis (liver infection or inflammation)
Sclerosing cholangitis (bile duct inflammation and scarring)
Other causes of white stool
White stool can also be caused by other conditions and certain substances including:
Aluminum hydroxide (ingredient in antacids such as AlternaGEL, Alu-Tab, Amphojel, as well as some formulations of Maalox and Mylanta)
Barium (white substance that can be swallowed or used in an enema to help outline the digestive tract on X-ray)
Serious or life-threatening causes of white stool
In some cases, white stool may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:
Questions for diagnosing the cause of white stool
To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your white stool including:
How long have you been having white stool?
How would you describe your stool?
Have you had white stool before?
Do you have any other symptoms?
What medications are you taking?
Because white stool can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including: