Stool Color, Changes in Color, Texture, and Form

• The normal stool (poop, feces) usually is light to dark brown.
• Although changes in stool color or texture may be normal, most changes should be evaluated.
• The symptoms associated with stool color changes, if any, are the symptoms of the underlying cause of the change, for example, foods,drinks, or illnesses such as:
  • Diet(beets, diets rich in green vegetables, licorice)
  • Bismuth (for example, Pepto-Bismol)
  • Gallbladder disease
  • Celiac disease
  • Ulcerative colitis
  • Crohn's disease
  • Tumors
  • Diverticular disease
  • Cancers
  • Hemorrhoids
• Stool that is an unusual color may be due todiarrhea; bleeding in the intestine; intestine, pancreas, orliverdiseases; and medications
• Green stool or poop is a common stool color change. It may be due to bile pigment in the stool becausediarrhea彻底的肠道t移动食物过快he intestinal chemicals and bacteria can't break down the bile pigment to its normal brown color, or the green color may be due to certain foods like green, leafy vegetables or green food coloring.
• Red or black poop may be a sign of bleeding in the digestive tract (from theesophagus, stomach, small intestine, or colon) and should not be ignored.
• When stool color changes, what tests need to be done depends upon what cause is suspected for the stool color change. For example, gastrointestinal tractendoscopymay be required to evaluate red or black stools if bleeding is suspected.
• The treatment for stool color changes is the treatment of the underlying cause.

Changes in stool color alone do not cause symptoms. The underlying cause of the change in stool color, texture, or form is responsible for any symptoms.

Bowel movements are usually light to dark brown in color, and there is moderate variation among individuals with respect to stool color, quantity, and form. When these changes in stool do occur, it can mean that there may be an illness affecting the gastrointestinal (GI) tract or the entire body.

The stool (feces, poop) color is most commonly brown. When stool color changes, a person, parent, orcaregiveroften becomes concerned.

• The presence of thebilirubinin the bile (a breakdown product of thehemoglobininred blood cellsthat are normally destroyed after a useful life of several weeks) is generally responsible for stool color.
• Bilirubin concentration can vary the color of the stool from light yellow to almost black.
• Changes in the chemical structure of the bilirubin can cause stool to turn green or yellow.
• Yellow stool also may occur if the stool is dilute or a reduction in the amount of bilirubin produced by the liver.
• Bacteria and digestive enzymes in the intestine can act on the bilirubin and change its color.

Most stool-to-stool changes in color have little meaning. However, some changes, particularly if the changes are consistent over time and not present in only one stool may mean something needs to be investigated.

In most cases, poop color changes are not symptoms of the disease. Changes in stool color may be due to:

• Diarrhea may cause yellow-green stools.
• Some foods (beets, Jell-O, Kool-Aid, licorice, green leafy vegetables)
• A few over-the-counter (OTC) and prescription medications
• Diseases affecting the liver, pancreas, andintestines
• Bleeding from the intestinal tract

If stool passes through the intestine too quickly, there might not be enough time for bile to be digested and broken down to provide the normal brownish stool color. Normally, bacteria in the intestine chemically change bile to a greenish-brown color. It takes time for the bile to be fully changed in the intestine and become brown again, and if the transit time is short, for example, when a person has diarrhea, the stool remains green-colored.

Green stools may be a normal variant. Adietrich in green vegetables, especially spinach, or Iron supplements also may cause green poop, though iron often turns stool black.

There are a variety of reasons why stool will be yellow, greasy, and foul-smelling. It can be due to the intestine's inability to digest and absorb fat because of diseases of the intestinal lining (such as in celiac disease andcystic fibrosis) because the pancreas is unable to manufacture adequate digestive enzymes (such as withchronic pancreatitisorpancreatic cancerthat blocks the pancreatic duct), or there is not enough bile being delivered to the intestine (such as incancer of the liveror bile ducts that are blocked). The yellowness, greasiness, and foul smell are due to the undigested fat.

• The most common cause of bright red-colored stool in adults is bleeding fromhemorrhoids.
• In infants, the most common cause is ananal fissureor tear in the tissue surrounding the anus.
• Other causes for bright redblood in the stoolmay be more serious such as:
• Infections of the intestines
• Inflammatory bowel disease(Crohn's disease,ulcerative colitis)
• Diverticular bleeding
• Tumors
• Arteriovenous malformations (abnormal communications between arteries and veins in the wall of the intestine that rupture).
• Brisk bleeding from the ulcer in the esophagus, stomach, or duodenum also may cause stools to be red instead of black if there has not been enough time for the red blood cells to be digested.
• Red food coloring and beets can also give a reddish hue to the stool.

Black stools are a worrisome symptom because it may be due to a large amount of bleeding into thedigestive system, most often from the upper GI tract including the esophagus, stomach, and duodenum. Red blood cells are broken down by digestive enzymes in the intestine and turn the stool black. These stools tend to be tar-like (sticky) and foul-smelling.This can be a medical emergency; black tarry stools should not be ignored.

Bloodfromnosebleedsor from dental procedures ormouthinjuries can be swallowed and may be the cause of blackstool通常,但出血量不是substantial enough to do this.

Light-colored or clay-colored stools are often seen with diseases of the liver or bile ducts. The pale stool may be caused bypancreatic cancerthat blocks the bile ducts. Lack of bile causes stool to lose its brown color and leaves it appearing pale.

Maroon colored stools are often due to bleedingintheGI tract. The source of bleeding for red stools is the upperGItract (esophagus,stomach,duodenum), while thecolonis the source for bright red blood. Maroon stools, which is caused by partialdigestionof the blood in theintestineoften arises from thesmall intestine(jejunum,ileum) andproximalcolon, but the color also depends in part on how rapidly the blood travels through the intestines. The faster the stool moves through the GI tract, the brighter red the color. This can be an emergency.

In children withintussusception, where one portion or the intestine telescopes into another part, causing a temporaryobstruction, stools may be described as currant jelly in color and consistency.

Mucus in the stool may be normal, and it may cover segments of formed feces. However, it also can occur in people withinflammatory bowel diseaseorcancer. Mucus associated with blood and/orabdominal painshould not be ignored and requires medicalattention. People withirritable bowel syndrome(IBS) also can have mucus in the stool.

The most common medications that change the color of stool are the drugs that turn the stool black and includeironand bismuth (contained in Pepto-Bismol and Kaopectate). Nevertheless, a large number of other drugs have been associated with changes in the color of stool to black or other colors. Practically, the importance of this fact is that the any new drugs ordietary supplementsneed to be considered as the cause of any change in stool color.

Most stool floats because it contains an excessive amount ofgas. By itself, it is normal and has little meaning. Changes in diet can lead to the stool that floats, but as an isolatedsymptom, no action needs to be taken, and often it resolves spontaneously. The stool does not float because of an increased amount offat. (Fat in stool causes oil droplets in thetoiletbowl.)

Anyconditionthat causes increased amounts of gas to form in the intestines theoretically may lead to floating stool, especially in conditions where there ismalabsorptionof nutrients such aslactose intolerance,celiac disease, cystic fibrosis, andshort bowel syndrome.

People have their own size, shape, and stool consistency. It is the change in stool pattern that matters more than the absolute size and shape of the stool. Narrow stool, sometimes called pencil-thin, may occur occasionally and is of no concern. People withirritable bowel syndrome(IBS) may develop thinner stools.

Nevertheless, a person with "normal" stools that has a new change in the diameter, length, width (caliber) of the bowel movement should consulthis/herhealthcare professional. This may be asignof a narrowed or scarred colon, perhaps due to atumor, but the health care professional may want further information about accompanying symptoms or tests.

It is not unusual to have two or even three stools in the morning. The first stool will usually have a more solid form because it has been in the colon (wherewateris absorbed) the longest. The second stool will be looser, and if there is the third stool, it will the loosest. Another change in stool form that often requires evaluation is thedevelopmentof looser or firmer than normal stools. At one end of the spectrum isconstipation另一端是腹泻,但即使change does not reach these levels, consistent, milder changes in either direction need to be evaluated.

Most often, people will contact theirprimary carehealth care professional with questions about the color of their stool. These include health care professionals who care for infants and children. Depending upon the cause of the stool color change, certain specialists may need to be involved. For example, for red or black stool due to bleeding, agastroenterologistmay be needed to perform an endoscopy, to look for a bleeding source in the stomach or intestine. Gastroenterologists are the specialist that helps manage other diseases of the intestinal tract, including Crohn'sdisease,pancreatitis, andceliac disease, that can cause color changes because of poorabsorptionof nutrients from the diet.

In most cases, a diagnosis, if any, cannot be made by stool color alone.

Thepatientand thedoctorneed to consider other symptoms, pastmedical history, dietary changes, and medications to help decide what has caused the stool to change color. Physical examination will be important to help decide the significance of the stool color.

Stool may be tested to look for blood, fat, orinfection. Blood tests may be necessary depending upon theclinicalsituation. Depending on the change in color, it may be necessary to evaluate thepancreas, liver or GI tract.

Aside from black, red, or maroon stools that may mean bleeding is a possibility, and require urgent assessment and treatment, most color changes are not an emergency. The significance is determined based on other symptoms that might be present.

Women who arepregnantoften note changes in their bowel pattern. Stool can turn black because of iron and vitaminsupplements. Iron can also turn stool greenish. As theuterusenlarges and increases pressure within thepelvis,constipationmay occur andhemorrhoidscan develop and cause blood in the stool.

If there is no underlying problem, stool color changes are often due to changes in the diet and will resolve in a couple of days. If this is not the case and changes persist, it is appropriate to contact your health care professional and seek medical attention.

Contact your doctor if you have stool color changes and have associated symptoms such asvomiting, diarrhea,fever, orabdominal pain.

重要的是要记住,每个人都是different and changes in bowel habit be it color, size, frequency, or consistency (hard or soft) may be normal for one person or a sign of a potential problem for another.