Symptom Checker

Stools - Unusual Color

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.

See More Appropriate Topic (Instead of This One) If

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 Doctor Within 24 Hours (Between 9 a.m. and 4 p.m.) 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

Parent Care at Home 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

  1. Reassurance:
    • 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.
  2. Green Stools:
    • 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 seen with formed stools.
    • If you think it's due to iron medication, be sure your child is not taking too much.
  3. Avoid: Eliminate the suspected food or drink from the diet. The unusual color should disappear.
  4. Sample: For persistent unusual color, bring in a stool sample for testing. Keep it in the refrigerator until you leave.
  5. 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

And remember, contact your doctor if your child develops any of the “Call Your Doctor” symptoms.

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.

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