Stools - Unusual Color - Children's Hospital Colorado

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Conditions and Symptoms

Stools - Unusual Color

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Overview

Stool color that is strange or different than normal
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
Red food coloring
Beets
Cranberries
Fire Cheetos
Paprika
Red peppers
Rhubarb
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.

Should I Call?

Call Doctor or Seek Care Now

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

Contact Doctor Within 24 Hours

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

Contact 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 At Home

Care Advice for Stools - Unusual Color

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.
Normal stools are not always dark brown. Sometimes they are light brown, tan or yellow.
Here is some care advice that should help.

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.

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.

Save a Sample:

If the strange stool color doesn't go away, bring in a sample.
Keep it in the refrigerator until you leave.

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.

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

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

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