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Clay Colored Stool

What Is Clay Colored Stool?

Clay colored stool happens when the stool or feces appears pale, putty or clay like. Normal stool usually appears in hues of brown or yellow, so stool that appears pale or clay-like reflects a problem in the biliary system.

Clay colored stool picture

Clay colored stools lack the yellow to golden tinge of normal stools

What Happens When A Person Has Clay Colored Stools?

Clay colored stool usually indicate that there is a problem with the biliary system. The bilary system is the system in the body responsible for digesting and absorbing fats. It is a system involving various organs and ducts. Organs associated with the biliary system include the liver, gallbladder, pancreas and the intestines. These organs participate in the transportation and production of a compound called bile. Bile is a dark green-yellowish fluid secreted by the gallbladder to digest fats. It originates from the gallbladder and is transported to the intestines by a network of ducts. Since bile is transported into the intestines, the presence of it gives the stool its characteristic color. If the stool is pale or appears clay-like, it indicates there is no bile reaching the small intestines and it reflects a possible obstruction or problem in its production and transport.

What Color is Clay Colored Stool?

Clay colored stool is usually white or light in color.

What Causes Clay Colored Stool?

Clay colored stool is a manifestation of a disease affecting the biliary system. A myriad of biliary conditions may cause a person to pass a pale or clay colored stool. Specific conditions that may cause this manifestation include:

Alcoholic Hepatitis

Involves inflammation of the liver caused by excessive alcohol intake, the inflammation from this condition can affect the production of bile; it can also block the flow of bile from the liver into the intestines. When there is not enough bile produced or when there is an obstruction blocking the transportation to the intestines, clay colored stools may result.

Strictures of the Bile Ducts

Another associated condition, which can cause the stool to be pale or clay colored, is biliary stricture. The condition involves the narrowing of the bile ducts preventing bile from entering the intestines. Bile ducts transport bile from the gallbladder down to the intestines. Biliary strictures can cause dangerous complications such as biliary cirrhosis, liver abscess and ascending cholangioma.


Another possible condition that can result in clay colored stool is the formation of stones in the gallbladder. The condition is called “gallstones” or “cholelithiasis”. Gallstones can occlude the opening of the gallbladder and can cause severe inflammation of the gallbladder. This inflammation gives rise to another condition called cholecystitis, causing retention of the bile inside the gallbladder.

Congenital Defects of the Gallbladder

Defects of the gallbladder present when a child is born can also lead to clay colored stool. Biliary atresia is a perfect example of a congenital defect involving the gallbladder. In this condition, the duct that connects the liver and the small intestine is blocked or absent. Without a duct connecting the liver (where the gallbladder is located) going to the intestines, bile cannot be transported. No bile reaches the intestines, and therefore the stool appears pale or clay colored.

Sclerosing Cholangitis

This is a condition characterized by progressive inflammation and eventually scarring of the bile ducts. The inflammation and the scarring occlude the flow of the bile to the intestines causing clay colored stools. The condition can also lead to liver failure, liver cancer and cirrhosis.


Certain medications can also cause the stool to appear white or clay-like. Medications like Bismuth subsalicylate (Kaopectate Pepto-Bismol) and other drugs for diarrhea, when taken in large doses can cause the stool to appear clay colored.

Associated Symptoms for Clay Colored Stools

Clay colored stool is already a symptom itself.  It is primarily associated with problems in the liver and the biliary system. Other symptoms may also accompany clay colored stools; these symptoms reflect problems in the biliary system. Associated symptoms are as follows:

  • Colic Pain or biliary pain
  • Severe and constant pain in the right upper quadrant
  • Pain radiating to the shoulder blades
  • Fever and chills
  • Nausea
  • Vomiting
  • Abdominal discomforts after eating
  • Chronic diarrhea
  • Jaundice or yellowish discoloration of the skin
  • Presence of dark urine
  • Drop in blood pressure and a fast heartbeat
  • Fatty stools
  • Constipation
  • Bitter fluid that comes up after eating
  • Indigestion and pain after eating fatty foods

Treatment for Clay Colored Stools

Since clay colored stool is a manifestation of an underlying condition, treatment is usually focused on managing the condition behind it.

1. Surgery

Surgery is done to remove or fix obstructions associated with the gallbladder. A common surgical procedure done is cholecystectomy or the removal of the gallbladder. The removal is necessary to prevent further damage to the surrounding organs such as the liver and the pancreas. Surgical procedures also fix or repair malformations and strictures in the bile duct. The repair helps facilitate the flow of bile into the intestines.

2. Bile Acid Dissolution Therapy

This procedure is used to treat patients with gallstones; it is an alternative option for patients who do not want to undergo surgery and have gallstones measuring less than 0.5 mm. The treatment involves oral intake of a solution that dissolves the gallstones. The treatment follows a 6 to 12 month course.

3. Dietary Modifications and other Treatment Approaches

In mild cases of gallbladder disease (especially if the case just involves fat malabsorption), dietary modifications and vitamin supplements are usually given. If the clay colored stool is caused by alcoholic hepatitis, interventions focus on decreasing or eliminating alcohol in the diet. Clay colored stool can also be caused by certain medications. In this case immediate discontinuation of the medication is employed. A myriad of conditions may cause a person to have clay colored stool; correct determination of the root cause is the key to effectively managing the condition.

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