The normal color of stool varies from a light brown or tan to dark brown color. Sometimes there are variations, with even odd colors like yellow and black feces, due to a host of conditions. However, most of us would not expect human stool to be very pale in color or even white. This is not common but can occur and sometimes the reason for this pale to white stool is very serious.
Why is stool white?
In order to understand why stool can sometimes appear white, it is important to first understand why stool is brown in color. Red blood cells are constantly broken down in the body as it is replaced by new ones. As a result of this breakdown, a compound known as bilirubin is formed. This bilirubin is temporarily stored in the gallbladder as bile and excreted into the bowels.
Some of the bile is then reabsorbed into the bloodstream and passed out by the kidneys while the rest is degraded in the bowels by bacteria. It results in in the yellowish-brown chemical known as stercobilinogen which gives the stool its typical brown color. Without stercobilinogen, stool may appear pale in color or even white.
Read more about yellow bowel movement.
Causes of Pale to White Bowel Movement
Since pale stool or white feces is related to bilirubin, the problem usually lies with either the liver from where the bile is formed, the gallbladder where bile is stored or with the bile ducts that carry the bile into the bowel. However, it is important to understand that stool can be tainted white or pale by ingested substances that are not broken down or absorbed in the gut.
- Hepatitis is inflammation of the liver that can occur with infections (especially viruses), excessive alcohol consumption, toxins and in less common cases with autoimmune diseases.
- Cirrhosis is a condition where there is scarring of the liver due to long term liver damage. It eventually culminates in liver failure. Hepatitis is one possible cause and it is often seen with long term alcoholism.
- Liver failure where the liver’s ability to conduct its functions is impaired and declining to the point where it will eventually lead to death. This is seen with chronic hepatitis and cirrhosis.
- Liver cancer is where there is malignant growth in the liver. It may arise in the liver, like heptocellular carcinoma, or may spread to the liver from another site of origin (secondary cancer).
- Gallstones is one of the more common gallbladder problems. If the stone(s) become lodged in the ducts, it can prevent bile from being released into the bowels.
- Cholecystitis is where the gallbladder becomes inflamed often due to gallstones. It is often a complication of large gallstones or other causes of bile duct blockages.
- Gallbladder cancer is where a malignant tumor arises in the gallbladder or elsewhere and then spreads to the gallbladder.
Read more about gallstones.
Bile Duct Problems
- Biliary atresia is a condition present from birth where the bile duct has developed abnormally and the bile drainage is affected to varying degrees.
- Biliary stricture is a narrowing of the bile duct that can arise with a number of different causes. Depending on the severity the bile outflow is affected.
- Sclerosing cholangitis is a condition where the persistent inflammation of the bile ducts eventually become permanently narrowed due to the development of scar tissue.
- Bile duct cancer is a malignancy in the bile duct system. It can arise on its own or may be related to liver, gallbladder or even pancreatic cancer. Sometimes a distance cancer can spread to the bile ducts.
- Pancreatitis is inflammation of the pancreas. It often arises with activation of the digestive enzymes that then causes injury and inflammation of the pancreatic tissue. This may extend to the bile ducts.
- Pancreatic cancer can also lead to white stool although this is not a common symptom. It is more likely to occur in people with chronic pancreatitis.
- Antacids, especially those containing aluminum hydroxide, when consumed in very large quantities.
- Barium which may be consumed for certain diagnostic investigations like x-ray.
White “Rice Water” Diarrhea
If diarrhea occurs for any reason in the backdrop of the conditions mentioned above then it is possible for white diarrhea to be seen. However, where white diarrhea is more likely to arise is with cholera. This type of diarrhea is also known as rice water diarrhea, due to its milky appearance that resembles rice water. Cholera is a severe bacterial infection caused by Vibrio cholerae. The bacteria may be found in contaminated water or food and is often seen in regions where there are poor sanitary and hygienic practices. Cholera can be deadly and needs immediate medical treatment. A person can become dehydrated in a very short period of time with cholera and this can result in death.
Is White Feces Dangerous?
White feces is not a disease on its own but a sign of an underlying disease. Due to the nature of the conditions that may cause white diarrhea, it can be serious and even dangerous. It is important to note that the white feces itself is not the danger but rather the conditions tht cause it can lead to serious and even deadly outcomes. Some conditions like gallbladder cancer is more dangerous but even in less serious conditions the outcome can still be serious if bile cannot be excreted for long periods.
When bilirubin cannot be passed out in the stool, the kidney can work to increase its bilirubin excretion. Therefore a person with white stool may find that their urine is darker than normal. However, eventually the bilibuin will accumulate in the body and give rise to other complications. The most common symptom is jaundice as the bilirubin is deposited in the skin and mucous membrane linings like that of the eyes and inside the mouth. The accumuulation of bilirubin in other organs may not be visible immediately but is often more serious. For example, bilirubin accumulation in the brain can cause brain tissue damage and even lead to death.