Stools that are pale, or clay- or putty-colored may result from problems in the biliary system (the drainage system of the gallbladder, liver, and pancreas).

The liver releases bile salts into the stool, giving it a normal brown color. You may have clay-colored stools if you have a liver infection that reduces bile production, or if the flow of bile out of the liver is blocked.

Yellow skin (jaundice) often occurs with clay-colored stools due to the buildup of bile chemicals in the body.

Possible causes for clay-colored stools include:

• Alcoholic hepatitis
• Biliary cirrhosis
• Cancer or noncancerous (benign) tumors
• Cysts of the bile ducts
• Gallstones
• Medications
• Narrowings (strictures) of the bile ducts
• Sclerosing cholangitis
• Structural problems in the biliary system that are present from birth (congenital)
• Viral hepatitis

There may be other causes not listed here.

Call your health care provider if your stools vary from the normal brown color.

The doctor will perform a physical exam and ask questions about your medical history and symptoms. Questions may include:

• When did the symptom first occur?
• Does the discoloration affect every stool?
• What medicines do you take?
• What other symptoms do you have?

Tests that may be done include:

• Blood tests, including tests to check liver function and for viruses that might affect the liver
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Imaging studies such as an abdominal ultrasound or CT scan

Berk PD, Korenblat KM. Approach to the patient with jaundice or abnormal liver test results. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 150.