See More Appropriate Topic (instead of this one):

• If NOT, try one of these: Jaundiced Newborn
• If NOT, try one of these: Stools – Blood In

Is this your child’s symptom

• The stool color is strange or different
• Normal stool colors are any shade of brown, tan, yellow or green
• The only colors that may be caused by a disease are red, black and white
• Dark green may look like black, but dark green is a normal color

Causes of Unusual Stool Color

• 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 fluid that went in. Examples are Kool-Aid or Jell-O.
• 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
• Medicines. Red medicines like Amoxicillin. Sometimes, other medicines that turn red in the GI tract such as Omnicef
• Foods. See list below.

Foods That Can Cause Red Stools:

• Red Jell-O, red or grape Kool-Aid
• Red candy, red licorice
• Red cereals
• Red frosting
• Beets
• Cranberries
• Fire Cheetos
• Red peppers
• Tomato juice or soup, tomato skin

Black:

• Blood from stomach bleeding stomach acid turns blood to a dark, tar-like color
• Foods. Licorice, Oreo cookies, grape juice
• Medicines. Iron, bismuth Pepto-Bismol
• Other. Cigarette ashes, charcoal
• Bile. Dark green stools from bile may look black under poor lighting. Smear a piece of stool on white paper. Look at it under a bright light. This often confirms that the color is really 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 breastfed infants. It can be normal with both.
• Green stools are more common with diarrhea. This is due to a fast transit time through the gut. However, formed stools can also be green.
• Dark green stools may look black under poor lighting. Eating spinach can cause dark green stools.
• Medicines. Iron such as in formula
• Foods. See list below.

Foods That Can Cause Green Stools:

• Green Jell-O
• Grape-flavored Pedialyte turns bright green
• Green fruit snacks
• Spinach or other leafy vegetables

White or Light Gray:

• Foods. Milk-only diet
• Medicines. Aluminum hydroxide antacids, barium sulfate from barium enema
• Liver disease. Babies with blocked bile ducts have stools that are light gray or pale yellow.

Call Doctor Now or Go to ER

• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

• You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

• Stool is light gray or white and occurs 2 or more times
• Strange color without a cause lasts more than 24 hours Exception: green stools
• Suspected food is stopped and strange color lasts more than 48 hours
• You have other questions or concerns

Self Care at Home

• Strange stool color most likely from food or medicine
• Green stools

Care Advice for Stools – Unusual Color

1. What You Should Know About Unusual Stool Color:
   • Strange 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.
   • Here is some care advice that should help.
2. Green Stools:
   • Green color of the stools is always normal. Most often, green stools are caused by bile.
   • Green stools are more common in formula fed than breastfed infants. But, they can be normal with both.
   • Green stools are more common with diarrhea. This is due to a fast transit time through the gut. However, formed stools may also be green. This is normal and nothing to worry about.
   • If your child takes iron, be sure your child is not taking too much.
3. Avoid Suspected Food or Drink:
   • Don’t eat the suspected food.
   • Don’t drink the suspected drink.
   • The strange stool color should go away within 48 hours.
4. Save a Sample:
   • If the strange stool color doesn’t go away, bring in a sample.
   • Keep it in the refrigerator until you leave.
5. What to Expect:
   • Remove the cause of the unusual color from the diet.
   • Then the stool should change back to normal color.
   • This should happen within 48 hours or 2 stools later.
6. Call Your Doctor If:
   • Strange color without a cause lasts more than 24 hours
   • Suspected food is stopped and strange color lasts more than 48 hours
   • You think your child needs to be seen
   • 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.

Copyright 1994-2015 Barton D. Schmitt, MD. All rights reserved.