Stools – Unusual Color
Is this your child’s symptom?
- 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.
When to Call Us for Stools – Unusual Color
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
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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
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Self Care at Home
- Strange stool color most likely from food or medicine
- Green stools
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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
And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.