If your face is the mirror of your soul, your feces holds the mirror to your health. Jokes apart, the color of your stool is a good indicator of your health in general and the digestive system in particular. You need to be particularly attentive if the color of your poop is anything but a healthy brown. This brown color is an indicator of a robust biliary system (part of the digestive system) that comprises the organs (liver, pancreas, gallbladder and the bile ducts) that create and store bile and release it into the duodenum or the small intestine. The brownness of the poop is from the bile salts that get released into the stools by the liver.1
So your stool is more white than brown these days and you’re worried? The whiteness or the paleness of the stool should not be ignored. Here’s the reason why. The pale yellow, white or clay-colored stools point toward a problem with the drainage of the biliary system. There could be an obstruction somewhere in the system–liver, gallbladder, pancreas or the bile ducts being the suspects.2
And it’s not good news.
Why Is My Poop White Or Pale?
There are many health disorders–minor to serious–that can result in your stool turning pale or white.
Jaundice As The First Sign
Most health anomalies related to the biliary system manifest as jaundice. Jaundice, with dark urine and pale stools along with certain other chemical changes in the body, is often the first sign that all is not alright with the biliary system.3 Especially in the case of obstruction in the flow of bile, the stool becomes pale yellow or white.4
Liver Diseases With Pale Stool As Symptom
Almost 50 percent of all liver diseases do not show any symptoms. The symptoms are mostly non-specific like fatigue or occasional itching. Some other symptoms include jaundice, dark urine, and pale stools, among others.5
Hepatitis is a much-dreaded liver disease that is often viral. It could also be alcohol or drug-induced. One of the main symptoms of hepatitis is jaundice and pale stool is a telltale sign of it.
Viral hepatitis: A type of hepatitis, viral hepatitis is the inflammation of the liver caused by a virus. Several different viruses–hepatitis A, B, C, D, and E–cause viral hepatitis.
All of these viruses cause acute or short-term viral hepatitis. The hepatitis B, C, and D viruses can cause chronic hepatitis, and the infection can take long to go away. Sometimes the infection can even stay lifelong. Chronic hepatitis can lead to cirrhosis, liver failure, and sometimes even liver cancer.6
Alcoholic hepatitis: If you have jaundice, right upper quadrant pain, fever, tachycardia, and tender and enlarged liver and a history of an average daily consumption of 80 g of ethanol for over 5 years, chances are that you have alcohol-induced hepatitis. It may not take 5 years for your habit to result in hepatitis–the duration of excessive drinking before the disease begins could vary from 3 months to 36 years. Although clinical jaundice is present in 40 percent to 60 percent cases, hyperbilirubinemia, which indicates an elevated level of bilirubin in the blood, is present in all cases. This is because jaundice becomes visible only when the bilirubin level is about 2 to 3 mg/dL (34 to 51 μmol/L). In hyperbilirubinemia too, the pale stool is a feature.7
Drug-induced hepatitis: Relatively rare among all other hepatitis, drug-induced hepatitis is often the result of a medication gone wrong. Apart from medications, certain vitamins, herbal remedies and even food supplements could prove to be toxic for your liver, resulting in hepatitis.8
Autoimmune hepatitis: When the body’s own immune system attacks the liver causing it to get inflamed, it is called autoimmune hepatitis. About 70 percent of those get affected are women. There are two types of autoimmune hepatitis–type 1 that mostly affects young women and is accompanied with other autoimmune diseases and type 2 that affects children up till the age of 14.9
A rare progressive disorder characterized by inflammation, thickening, and abnormal formation of fibrous tissue in the bile ducts that carry bile from the liver, sclerosing cholangitis is a serious condition of the liver that could become liver cirrhosis and even require a liver transplant in the long run. The obstruction of the bile flow takes the natural brown shade away from the stool, making it look pale.10
Bile Duct Abnormalities
Narrowing Or Bile Duct Strictures
In the case of bile duct strictures or narrowing of the bile duct, the bile fails to travel down the system to drain into the intestine. The lack of bile results in pale stools. Moreover, bile that has no way to flow backs up in the liver and spills over into the blood resulting in obstructive jaundice.11
Primary biliary cirrhosis or primary biliary cholangitis is a condition where the bile ducts in the liver get damaged. The condition is long term and leads to a gradual buildup of bile in the liver that results in the scarring of the organ or cirrhosis. Jaundice, along with dark urine and pale stools, are some of the symptoms.12
Can Gallbladder And Pancreatic Disorders Lead To Pale Stools?
Gallstones, the small stones in the gallbladder usually made of cholesterol, is a very common ailment. The presence of gallstones can lead to many gallbladder complications like the inflammation of the gallbladder or acute cholecystitis, infection of the bile ducts or acute cholangitis, and jaundice, all of which have pale stools as one of the symptoms.13
Pancreatitis is the inflammation of the pancreas that could be acute or chronic. In both cases, blocked pancreatic or bile duct is a symptom which can lead to oily or fatty stools that are clay-colored or pale.14
Pancreatic insufficiency is a condition associated with pancreatitis or cystic fibrosis in which there is a shortage of digestive enzymes to break down food. Certain gastrointestinal diseases, such as stomach ulcers and Crohn’s disease, and autoimmune disorders such as systemic lupus erythematosus (SLE) also lead to pancreatic insufficiency which may result in the malabsorption of fat from food. This can result in increased fat in stool resulting in stools becoming pale, bulky and foul-smelling.15
Could You Be Born With It?
Certain health anomalies which are congenital that obstructs your biliary system can also result in white poop. Here are some:
Gilbert’s Syndrome: This disorder sees a slight buildup of bilirubin in the body resulting in occasional jaundice.16
G6PD Deficiency: A genetic disorder that occurs mostly in men, G6PD deficiency has jaundice as one of its symptoms.17
Bile duct cysts: If you’re born with cysts in your bile duct, that’s another reason for white poop.18
Can Certain Cancers Cause Poop To Turn White?
Conditions Unrelated To Biliary System That Make Your Poop White
Steatorrhea: Also called fatty diarrhea, it results from your body’s inability to absorb or completely process fat from food resulting in fatty, bulky stools which are pale yellow to white in color.22
Giardiasis: This is an infection, mainly of the small intestine, caused by the parasite Giardia lamblia. Loose, pale and greasy stools are one of the symptoms of the infection.23
Thalassemia: This is an inherited blood disorder in which the body makes an abnormal form of hemoglobin. Many people with thalassemia develop liver-related issues like hepatitis through blood transfusion.24
Glandular fever/infectious mononucleosis: A type of viral infection mostly affecting young adults, glandular fever often has jaundice as one of its symptoms.25
Sickle cell anemia: A form of sickle cell disease, a serious disorder in which the body makes sickle-shaped red blood cells, sickle cell anemia or HbS is often accompanied by jaundice.26
Yellow fever: Spread by infected mosquitoes, yellow fever is found in tropical and subtropical areas of South America and Africa. Jaundice is one of its symptoms.27
Celiac disease: A digestive disorder, celiac or coeliac disease has steatorrhea as one of its symptoms.28
What Does White Poop In Infants Mean?
Baby poop comes in all shades, smells, and textures. Most often these are normal and not a matter to worry about. But in certain cases, poop color sends important clues about problems in the gastrointestinal tract or liver. White stools in babies, however, shouldn’t be taken lightly. There maybe a blockage in the liver preventing the bile from flowing properly, a condition that could be life-threatening. This is mostly biliary atresia and needs immediate attention.29
Hyperbilirubinemia is one of the most common conditions that occur in newborns. Among many variables, ABO incompatibility is found to be a major risk factor for hyperbilirubinemia.30
White poop is no laughing matter. There can be many causes for it. It needs to be taken with all seriousness, the root cause identified and treated at the earliest.
|↑1||Pancreas. Medical University of South Carolina.|
|↑2||Bowel Motions. ACT government.|
|↑3||Beckingham, I. J., and S. D. Ryder. “Investigation of liver and biliary disease.” British Medical Journal 322, no. 7277 (2001): 33.|
|↑4||Obstructive Jaundice. Institute of Reconstructive Neurobiology.|
|↑5||Liver Disease: Frequently asked questions. UoI Health Care.|
|↑6||Hepatitis A through E. National Institute of Diabetes and Digestive and Kidney Diseases.|
|↑7||Basra, Gurjot, Sarpreet Basra, and Sreeram Parupudi. “Symptoms and signs of acute alcoholic hepatitis.” World J Hepatol 3, no. 5 (2011): 118-20.|
|↑8||Symptoms of Drug-Induced Hepatitis. Stanford Health Care.|
|↑9||Autoimmune Hepatitis. American Liver Foundation.|
|↑10||Primary Sclerosing Cholangitis. NORD.|
|↑11||Bile Duct Strictures. Centre for Pancreatic and Biliary Disease, University of Southern California.|
|↑12||Primary Biliary Cirrhosis. NHS.|
|↑14||Chronic Pancreatitis. The National Pancreas Foundation.|
|↑15||Pancreatic Insufficiency. EEPIA.|
|↑16||Gilbert’s Syndrome. NHS.|
|↑17||Glucose-6-phosphate dehydrogenase deficiency. NIH.|
|↑18||Choleodochal Cyst Symptoms and Diagnosis. Seattle Children’s Hospital.|
|↑19||Signs and Symptoms of Bile Duct Cancer. American Cancer Society.|
|↑20||Liver Cancer. British Liver Trust.|
|↑21||Pancreatic Cancer Symptoms. Cancer Research UK.|
|↑22||Cheifetz, Adam S., Alphonso Brown, Michael Curry, and Alan C. Moss. Oxford American handbook of gastroenterology and hepatology. Oxford University Press, 2011-Pg 234.|
|↑23||Giardisis fact sheet. NSW Health.|
|↑24||Prati, Daniele, Alberto Zanella, Patrizia Bosoni, Paolo Rebulla, Elena Farma, Claudia De Mattei, Carmen Capelli et al. “The incidence and natural course of transfusion-associated GB virus C/hepatitis G virus infection in a cohort of thalassemic patients.” Blood 91, no. 3 (1998): 774-777.|
|↑25||Glandular Fever. NHS.|
|↑26||Sickle Cell Anemia. NHLBI.|
|↑27||Yellow Fever. CDC.|
|↑28||Coeliac Disease. NHS.|
|↑29||Biliary Atresia. NIH.|
|↑30||Kalakheti, B. K., R. Singh, N. K. Bhatta, A. Karki, and N. Baral. “Risk of neonatal hyperbilirubinemia in babies born to ‘O’positive mothers: A prospective cohort study.” Kathmandu University Medical Journal 7, no. 1 (2009): 11-15.|