Stools - pale or clay colored

Alternative names
Acholic stools

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).


Jaundiced (yellow) skin often accompanies clay-colored stools.

The liver excretes bile salts into the stool, giving it a normal brown color. Obstruction to the flow of bile out of the liver (you may see the word “cholestasis”), or liver infections like viral hepatitis, may produce clay-colored stools.

Common Causes
Possible causes for clay-colored stool result from problems in the biliary system, and may include:

  • Cancer or benign tumors  
  • Strictures (narrowings)  
  • Congenital anatomic problems (present at birth)  
  • Gallstones  
  • Cysts  
  • Medications  
  • Sclerosing cholangitis  
  • Biliary cirrhosis  
  • Protein or infectious infiltration  
  • Alcoholic hepatitis  
  • Viral hepatitis (A,B, or C)

The underlying cause should be investigated.

Home Care
Follow prescribed therapy.

Call your health care provider if

If clay-colored or pale stools, dark (bloody-looking) urine, or jaundice (yellowish discoloration of the skin and eyeballs) appears, contact your health care provider.

What to expect at your health care provider’s office
The medical history will be obtained and a physical examination performed.

Medical history questions documenting pale or clay-colored stools in detail may include:

  • Time pattern       o When did this first occur?       o Is every stool this way?  
  • Medications       o What medications are being taken?       o Have you changed medication in any way?  
  • Associated symptoms       o Is there any abdominal pain?       o Is there any jaundice?       o Has there been darkening of the urine?       o Is there diarrhea?       o Is there any fever, chills, or night sweats?

The physical examination will include emphasis on the abdominal region. The findings may indicate a need for surgery.

Your doctor may perform:

  • A full history, noting any medications or habits, such as heavy drinking or intravenous drug use  
  • Blood work, including liver function tests and tests for viruses  
  • Imaging studies, such as an abdominal ultrasound  
  • Endoscopy studies with a long, flexible scope passed through the mouth to the small intestine (ERCP, endoscopic retrograde cholangiopancreatography)

After seeing your health care provider:
If a diagnosis was made by your health care provider related to pale or clay-colored stools, you may want to note that diagnosis in your personal medical record.

Johns Hopkins patient information

Last revised:

Diseases and Conditions Center

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.