When certain poop colors are red flags, according to experts

Some poop colors can be a cause for concern. PHOTO/COURTESY: CNN
There isn’t a one-size-fits-all answer for how often you should poop, but when it comes to what color your stool should be, expert consensus is much narrower. And deviations from it can be a cause for concern.
“The
most common color is brown, shades of brown,” said Dr. Mark Corkins, division
chief of pediatric gastroenterology at the University of Tennessee Health
Science Center.
The
brown comes from the breakdown of bilirubin, a pigment created when old blood
cells break down in the liver, and bile, which is typically dark brown or green
and is made by the liver to aid in fat digestion, according to McGill
University’s Office for Science and Society.
When
bilirubin and bile are secreted in the small intestine during digestion, they
ultimately turn the poop brown.
This
physiological process is also the reason why green is the second most common
poop color.
Green
stools can mean food moved through the GI tract rapidly, so the green bile in
the poop is still in its original form and hasn’t broken down into brown,
according to Dr. Rena Yadlapati, professor of medicine in the division of
gastroenterology at the University of California San Diego.
“We
do see that sometimes with diarrhea or infections,” Yadlapati added. “But if
there’s good bulk to the stool and it’s green, it’s generally going to be
attributed to more of the dietary factors or maybe taking some iron
(supplements).”
Since
poop color is influenced by what you eat and drink as well, experts said, a
good rule of thumb for determining the cause of any unusual poop colors is recalling
what you ate or drank within the last 24 hours before you panic and call your
doctor.
Eating
a lot of tomato juice, beets or red gelatin or drinking a lot of energy drinks
with red dyes could make poop red, Corkins said.
Some
medications and supplements can affect the color of your poop as a side effect.
But if what you’ve consumed likely isn’t the cause, here’s what you should know
— and when to see a doctor.
Yellow
or orange stools can signal excess fat, especially if they also look greasy or
oily, Yadlapati said.
“Some
people will note that they’re associated with a bad smell, as well,” she added.
The
color “could indicate that there’s a poor absorption of fats, and that could be
from celiac disease, pancreatic conditions or certain infections.”
Celiac
disease is a chronic immune and digestive disorder in which eating the protein
gluten — found in breads and cereals — leads to damage in the small intestine.
Young
children tend to prefer orange and yellow vegetables — such as carrots — over
others, so their poop might be these colors for that reason, Corkins said.
“It’s
not dangerous,” he added. “Keratin is the yellow-orange pigment in there. Beta
carotene is a nutrient, but it just freaks everybody out when the stools come
out yellow or orange.”
When
patients report having black poop, “from the doctor’s perspective, what we’re
always looking for is that tarry black look, because that’s a warning sign,”
Yadlapati said.
“That
could mean that a patient is having melena.”
Melena
is a symptom of internal bleeding in typically the upper GI tract — the
esophagus, stomach and first part of the small bowel.
“When
you lose blood from there, as the blood is traveling along the digestive tract,
it turns black,” Yadlapati said.
“That
could be from things like ulcers (or) inflammation that’s leading to bleeding
polyps. What we don’t see as much, but what we worry about, is some type of
stomach cancer.”
Supplements
such as iron, or diarrhea medications with bismuth subsalicylate, can also make
stools black.
If
your poop is white or very pale, there might not be enough bile reaching your
digestive tract, Yadlapati said.
“This
could maybe indicate a more serious cause, like some kind of condition in the
liver, the bile ducts or the pancreas,” she added.
“At
the same time, certain medications like, for instance, barium — which is the
chalky fluid that patients drink when they’re getting certain X-rays — that
also can change the color of the stool to a pale white color.”
Red
poop is a bigger concern because “there’s maybe some bleeding from lower down,
so the colon or the rectum,” Yadlapati said.
Usually,
gastroenterologists think blood in poop is coming from lower in the colon or
rectum because poop red from blood would indicate the blood hasn’t yet had time
to change color.
“That
could be in the form of, sometimes, hemorrhoids, present with bright red blood
in the toilet paper or bright red blood in the toilet bowl, but not necessarily
mixed in with the stool,” she added.
Other
causes can include ulcers in the gastrointestinal tract produced from
medications or conditions such as ulcerative colitis or Crohn’s disease, or
arteriovenous malformation (AVM) polyps, which are little blood vessels that
tend to bleed, Yadlapati said. Colon cancer is a less common cause, but it’s
still a concern.
“If
you have red poop because of blood in the stool, honestly, that’s usually not
the only symptom you’re having,” Corkins said.
Red
poop unassociated with anything you recently consumed may also come with
stomach pain or fatigue.
“For
all these reasons,” Yadlapati said, “if you see red in the stool and it’s not
something that’s linked with something you just ate or medications that you
took, it is a reason to talk to the doctor.”
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