Should Your Child See a Doctor?
Stools – Unusual Color
A stool color other than brown or tan
- 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 Kool-Aid or Jell-O that went in.
Clues to unusual stool colors
- Blood from lower GI tract bleeding
- Foods: red Jell-O, red or grape Kool-Aid, red cereals, tomato juice or soup, tomato skin, cranberries, beets, red licorice, Fire Cheetos
- Medicines: red medicines (e.g., Amoxicillin), occasionally other medicines that turn red in the GI tract (e.g., Omnicef)
- Blood from stomach bleeding (stomach acid turns blood to a dark, tar-like color)
- Foods: licorice, Oreo cookies, grape juice
- Medicines: iron, bismuth (e.g., Pepto-Bismol)
- Other: cigarette ashes, charcoal
- Bile: Dark green stools from bile may look black under poor lighting. Smearing a piece of stool on white paper and looking at it under a bright light often confirms that the color is actually dark green.
- Foods: green Jell-O, grape-flavored Pedialyte (turns bright green), green fruit snacks, spinach or other leafy vegetables. Dark green stools (e.g., spinach) may look black under poor lighting.
- Medicines: iron (e.g., in formula)
- Bile: Most dark green stools are normal and due to bile. Bile-stained loose stools are seen with diarrhea illnesses and normal breastfed stools (especially during the first 2 months of life). While bile is more commonly seen with diarrhea, it can also cause green formed stools.
White or light gray
- Foods: milk-only diet
- Medicines: aluminum hydroxide (antacids), barium sulfate from barium enema
- Liver disease: Young infants with blocked bile ducts have stools that are light gray or pale yellow
See more appropriate topic (instead of this one) if
When to Call Your Doctor
Call your doctor now (night or day) if
- Your child looks or acts very sick
Call your doctor within 24 hours (between 9 a.m. and 4 p.m.) if
- You think your child needs to be seen
Call your doctor during weekday office hours if
- You have other questions or concerns
- Stool is light gray or whitish and occurs 2 or more times
- Abnormal color is unexplained and persists over 24 hours (EXCEPTION: green stools)
- Suspected food is eliminated and abnormal color persists over 48 hours
Parent care at home if
- Unusual stool color probably from food or medicine and you don't think your child needs to be seen
- Green stools
Home Care Advice for Unusually Colored Stools
- Unusual 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
- Green color of the stools is almost always normal and due to bile
- While it is more commonly seen with diarrhea, sometimes it occurs with formed stools
- It usually only lasts for a few days, but it can recur
- If you think it's due to iron medication, be sure your child is not taking too much
- Eliminate the suspected food or drink from the diet. The unusual color should disappear.
- For persistent unusual color, bring in a stool sample for testing. Keep it in the refrigerator until you leave.
Call your doctor if
- Unexplained color persists over 24 hours
- Suspected food is eliminated and the abnormal color persists over 48 hours
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
- Benaroch R. Red-colored stool. Consult Pediatr. 2007;6:365.
- Borowitz SM, Hayden GF. In plain sight: the macroscopic stool examination. Contemp Pediatr. 1990;7:115-121.
- Chen S, Chang M, Du C, et. al. Screening for biliary atresia by infant stool color card in Taiwan. Pediatrics. 2006;117(4):1147-1154.
- Middleton J. Green-colored stool. Consult Pediatr. 2007;10:580.
- Nelson JS. Red stools and Omnicef. J Pediatr. 2000; 136: 853-854.
This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.
Last Review Date: 8/1/2010
Last Revised: 10/1/2010 4:09:09 PM
Content Set: Pediatric HouseCalls Symptom Checker
Version Year: 2011
Copyright 1994-2011 Barton D. Schmitt, M.D.