Clay-Colored Stool

The color of the stool can provide a lot of useful information about a person’s health. If the stools turns the color of clay, this is not a sign of good health. On the contrary, as you will have the opportunity to see below, it can be a symptom of a serious medical condition. In the majority of the cases, the biliary system disease is the main culprit behind the appearance of such symptoms.

In healthy individuals, the stool has a brown color, the diet being the decisive factor. When the stool is pale in color, resembling the color of the clay, it might signify that the biliary system is not functioning as it should (there may be a blockage at the level of the bile ducts or the bile might not be produced in sufficient quantities). If the stools are also greasy, this means that the body does not absorb the fats in a correct and healthy manner.

In the medical world, the clay-colored stool is known as acholic. Identifying the underlying cause behind such modifications is more than essential, as this is the only way to recommend an adequate treatment. The sooner the necessary treatment is taken, the sooner the color of the stool will return to normal.

Causes of Clay-Colored Stool

These are the most common causes that can lead to the appearance of the clay-colored stools:

Hepatitis (non-infectious, alcoholic)

  • Chronic inflammation of the liver due to the alcohol abuse
  • Moderate drinking over a prolonged period of time can also lead to such problems
  • May lead to organ insufficiency (liver failure)
  • Associated symptoms include:
    • Jaundice
    • Fluid accumulation at the level of the abdomen (ascites)
    • Clay-colored stool
    • Nausea and vomiting
    • Loss of appetite
    • The abdomen becomes painful or tender (especially to the touch)
    • Weight loss

Biliary cirrhosis

  • Irritation and inflammation of the liver bile ducts
  • The bile is blocked from getting to the intestines
  • No exact cause has been identified for the appearance of this health problem
  • Can become a life-threatening condition, as it leads to organ insufficiency (liver failure)
  • Associated symptoms:
    • It is possible that the patient does not present any symptoms
    • Dry mouth and eyes
    • Itchiness at the level of the skin
    • Fatigue
    • Jaundice
    • Abdominal pain
    • Clay-colored stool
    • Pain at the level of the bones or muscles
    • Water-retention (the ankles and feet may appear as if swollen)


  • The bile pigment mixes with cholesterol, leading to the appearance of the gallstones
  • Risk factors for the appearance of gallstones include:
    • Diet
    • Decreased movements at the level of the gallbladder
    • Genetics
    • Being overweight (or body weight in general)
  • Associated symptoms:
    • It is possible that the patient does not present any symptoms
    • Intense pain or discomfort at the level of the abdomen
    • Pain can radiate to other parts of the body, such as the right shoulder or the back
    • Clay-colored stool

Bile duct cysts

  • The formation of the bile duct cyst can prevent the regular flow of the bile
  • Unknown cause
  • Associated symptoms:
    • In babies
      • Jaundice
      • Paleness of the skin
      • Clay-colored stool
      • Mass in the upper right side of the abdomen
      • Enlarged liver
    • In adults
      • Abdominal pain
      • Pain located in the upper right quadrant
      • Jaundice
      • Infection at the level of the bile duct.

Bile duct tumors

  • Malignant or benign tumor
  • Inflammation of the liver – flow of bile prevented/reduced
  • Associated symptoms:
    • Jaundice (sign of bile obstruction)
    • Weight loss
    • Loss of appetite
    • Itchiness at the level of the skin
    • Pain on the right side of the abdomen (upper quadrant)
    • Fever (sign of infection)
    • Clay-colored stool
    • Extensive hemorrhage in case of cuts or lacerations

Biliary stricture

  • Often seen in patients who have undergone surgical intervention for gallbladder removal
  • This actually refers to the narrowing of the bile ducts
  • Associated symptoms:
    • Fever/chills (or both)
    • Itchiness at the level of the skin
    • Jaundice
    • Nausea and vomiting
    • Pain on the right side of the abdomen (upper quadrant)
    • Clay-colored stool

Medication (side-effect – drug-induced hepatitis)

  • Potential medication:
    • Naproxen
    • Ibuprofen
    • Antibiotics
    • Anabolic steroids
    • Contraceptives
    • Pepto Bismol (high quantities)
    • Anti-diarrheal drugs
  • Associated symptoms:
    • Clay-colored stool
    • Other symptoms specific for each medication.

Viral infection – hepatitis (A, B or C)

  • Inflammation of the liver
  • Chronic or acute
  • May lead to permanent liver damage
  • Associated symptoms:
    • May not cause any symptoms (until the later stage of the disease)
    • Dark color of the urine
    • Abdominal pain
    • Loss of appetite
    • Weight loss
    • Jaundice
    • Clay-colored stool
    • Flu-like symptoms (in the initial, infectious stage)
    • Fatigue

Other causes

  • Sclerosing cholangitis
    • The bile ducts are either scarred or inflamed
  • Birth defects
    • Structural abnormalities at the level of the biliary system (the regular bile flow is restricted).

Diagnosis of Clay-Colored Stools

These are the most common methods used for the diagnosis of the underlying disorders:

  • Medical history
    • When did the symptoms occur for the first time
    • Are all the stools the same color (differences)
    • What kind of medication you are currently taking
    • What other symptoms are present
    • Did you suffer from any surgical intervention
    • Were you treated for similar problems before
  • Physical assessment
    • Palpation of the abdomen
      • Identification of pain or tenderness at the level of the abdomen
      • Observation of excessive fluid in the abdomen
  • Blood test
    • Liver enzymes
    • Complete blood count
    • Leucocyte levels (sign of infection if elevated)
  • Imaging studies – identification of the root cause of the problem (and its specific location)
    • Abdominal X-ray
    • CT scan
    • MRI
  • Magnetic resonance cholangiopancreatography (this investigation is also known as endoscopic retrograde cholangiopancreatography)
    • Similar to the MRI investigation
    • Captures detailed images of the biliary system
  • Abdominal ultrasound
    • Allows for the visualization of the liver and the biliary system.

Clay-Colored Stool Treatment

In order for the color of the stool to improve, the underlying cause has to be successfully treated. In some situations, when the person suffers from a chronic or incurable condition, it is not possible to cure the underlying cause. Symptomatic treatments might alleviate the symptoms experienced by the patient, in some cases improving the color of the stool as well (temporary effect). If the patient suffers from cancer, the treatment includes chemotherapy and radiation therapy. For those who suffer from liver insufficiency, the liver transplantation remains the only hope of survival. Gallbladder stones require surgical intervention, the patient being advised to change their diet, in order to promote the beneficial healing of the gallbladder.


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