White Poop – iHealthMama

What is White Poop?

Stool may change its color, but passing white poop should not be taken as normal. Having white poop indicates lack of bile and an individual should be examined promptly by a doctor. If there is lack of bile, it could mean a serious problem with the biliary system.

The liver produces bile, which is a digestive fluid, and this bile is stored in gallbladder. It is released from the gallbladder to intestine to perform its function. The normal color of stool is brown and it comes from bile. When the liver fails to produce bile or if there is obstruction of the bile ducts, your stool may have a light color or may look white and pale.

What’s the Normal Color of Stool?

In normal situations, the color of stool is brown, but its shades can change even when there is nothing wrong with the health of the body. While some stool color changes may not be of great concern, if you have white, clay-colored, pale, or simply light stool, it is a cause for concern. You should see a doctor immediately. The brown color of stool comes from a pigment known as stercobilin, which is produced when intestinal bacteria convert the bilirubin found in bile. Stercobilin is the substance or pigment that gives stool the brown color.^1,7

Causes of White Poop

If there is no bile being produced in the liver or if there is less than normal bile being excreted into intestine, the stool may appear gray, clay, pale, or white. It can be described as light colored stool. However, light-colored stool is different from bright yellow poop and it not mucus in poop, which is jelly like and translucent. There are different things that could cause white bowel movement and they include:^3,4,6,7

Obstructed biliary duct

An obstruction may occur in the biliary duct due to inflammation, gallstones, fibrosis, or pressure from outside, for example a pancreatic cyst. If this happens, it could cause cramping pain, especially in the right side of the upper abdomen.

Liver disease

When your liver is diseased, it may result in lack of bile. The liver may not be able to produce sufficient amount of bile salts. Liver disease may be caused by:

Fatty liver
Viral hepatitis
Alcohol liver disease
Hemochromatosis
Cirrhosis
Tuberculosis
In rare cases – liver metastases – where cancer growing in other parts spreads to the liver

When bile is prevented from flowing out from the liver, a condition known as cholestasis, it causes bilirubin to accumulate in the bloodstream. As the levels of bilirubin increase in blood, it tends to be deposited in tissues in various parts of the body and it may be seen in areas such as the skin, inner lining of a person’s mouth, the whites, and the eyes. These tissues will have a yellow color staining. When bilirubin is dumped in the tissues, it is referred to as jaundice, a very common symptom in ailments and diseases that affect the liver. This type of jaundice is given the name obstructive or cholestatic jaundice.

Bilirubin is a substance found in liver and is brownish yellow in color. It is produced after breakdown of red blood cells by the liver. The liver is responsible for excreting bilirubin So, a common symptom that occur along with pale and white stool is dark urine. The darkening urine is due to the excess bilirubin in your blood that has failed to be passed out with bile. Just the same way bilirubin is converted to stercobilin within the bowels, bilirubin on the other side, is converted to urobilin, but this time in the kidney. When urobilin is found in large amounts, it could make the urine to appear darker.

White Diarrhea

White poop can be in form of white diarrhea. When the flow of bile salts from the liver is impaired, something called cholestasis, it means it doesn’t reach the small intestine. Absorption of fat is thus prevented. Bile is moved to the intestine to aid in breakdown of fat so that it is absorbed in body.

So, if there is no bile getting to the intestine, fat will not be emulsified, and therefore not absorbed in body. The unabsorbed fat moves to the colon where it irritates it. This irritation may trigger diarrhea. A person with bile flow obstruction due to liver disease or obstructed bile ducts may have white diarrhea. This whitish, loose, sticky, greasy, floating, foamy, smelly stool or diarrhea is referred to as stearorrhea. Causes of white diarrhea include:⁴

Chronic or acute pancreatitis characterized by low appetite, nausea, and pain occurring in left upper or middle abdomen
Liver disease
Biliary duct disease
Pancreatic cancer characterized by weight loss and low appetite
Bowel infection including cholera, which brings about the characteristic white ‘rice water’ poop
Severe inflammation occurring in small intestine due to diseases like celiac disease, Crohn’s disease, tuberculosis, or serious food poisoning
Overgrowth of Candida within large intestine, and this may happen in people who have severely compromised immunity such as after chemotherapy or having AIDS.

Symptoms That may Accompany White Poop

Passing white poop can come with other symptoms. These include: ^4,6

Cramping or abdominal pain
Changing stool consistency
Diarrhea
Indigestion
Constipation
Unusually foul-smelling stool
Bloating, distension, and swelling of the abdomen
Gas
Nausea occurring with or without vomiting.

The above symptoms may occur along with white poop and are associated with the digestive tract.

There are also other symptoms related to body systems found elsewhere in body, which could accompany white poop and they include:

Fever
Itchy skin
Fatigue
Weakness or loss of strength
Easy bleeding and bruising
Unexplained loss of weight or not gaining weight
Yellow skin, eyes, and skin – something known as jaundice.

A person may have white poop due to other causes such as:

Having food supplements that contain excessive amount of calcium
Overdosing antacids that contain calcium
Barium enema – which is a diagnosis procedure in which fluid is used to allow bowel to be more visible on X-ray images.

Diagnosis of White Poop

Diagnosis of white poop may involve many tests and examination. The tests are aimed at finding out what might be causing the blockage in flow of bile in bile ducts. The test may help check the health of the liver. Here are some of the tests that a doctor may order:^2,5

Blood tests

They can help determine if the liver is functioning properly. Blood tests help find out what could be affecting the liver. They look for things like liver inflammation, virus particles, antibodies and other elements that may indicate some form of liver disease.

In blood test, if the doctor suspects that blockage of bile ducts may be culprit for white poop, they may order blood tests to check for:

Increased liver enzymes
Increased alkaline phosphatase level
Increased bilirubin level

Liver biopsy

This procedure is done by removing a tiny tissue of the liver using a thin needle and the tissue is examined under a microscope.

Imaging tests

These may be done to help detect liver disease and find out if there is scarring of the liver. Image tests may also help detect if the biliary ducts are obstructed or blocked. The imaging tests include:

Magnetic resonance cholangiopancreatography (MRCP)
Magnetic resonance imaging (MRI)
Ultrasound
Endoscopic retrograde cholangiopancreatography (ERCP)
Computerized tomography (CT)

A blocked biliary duct may also alter results of tests such as:

Urine bilirubin
Lipase blood test
Gallbladder radionuclide scan
Amylase blood test
Prothrombin time (PT)

Treatment of White Poop

In treating cases of white poop, a doctor will aim to address the problem that is causing the change in poop color.^2,8

If biliary duct blockage is occurring due to stones, they may be expelled using an endoscope in an ERCP procedure
Surgery may be needed to help bypass the blockage. If gallstones are causing the blockage, the gallbladder could be removed.
Antibiotics may be prescribed if there is an infection, which is causing the biliary duct to inflame and block
Where cancer has caused blockage of biliary duct, the duct may be widened through a procedure known as endoscope or percutaneous dilation
If white pool is caused by liver disease, and the liver disease is caused by vital hepatitis, treatment may vary depending on the type of the hepatitis. For hepatitis A and E, a patient may need to stop taking alcohol and have bed rest. Antiviral medications may be administered. Hepatitis B can be treated using medications such as adefovir dipivoxil and lamivudine. In severe cases, a liver transplant may be done if a patient suffers from hepatitis B, C, or D that cause liver failure.

Reference List

Liver: http://www.innerbody.com/image_digeov/card10-new2.html
Diagnosing Liver Disease. http://www.liver.ca/liver-disease/diagnosing-liver-disease/
Why Is My Poop White In Color? https://www.curejoy.com/content/what-causes-white-poop/
Pale, Clay, Gray Stool or White Bowel Movement and Diarrhea. http://www.healthhype.com/white-pale-clay-gray-bowel-movement-is-it-normal.html
Bile Duct Obstruction: Exams and Test. http://www.nytimes.com/health/guides/disease/bile-duct-obstruction/overview.html
What is white poop? https://www.healthgrades.com/symptoms/white-stool
White poop: Should I be concerned? http://www.mayoclinic.org/white-stool/expert-answers/faq-20058216
Hepatitis: Symptoms, Diagnosis, Treatment & Prevention. https://medlineplus.gov/magazine/issues/spring09/articles/spring09pg25.html