According to Yale gastroenterologist Anish Sheth, MD, the author of What’s Your Poo Telling You?, “what comes out tells you a lot about what’s going on inside.” Although there are several different factors determining what stool looks like, color is one of the most important indicators of an imbalance somewhere in the body. Ideally, a healthy bowel movement should be a medium brown color; however, a different hue or color does not necessarily indicate a problem.
Since feces’ color will naturally change with a varied diet, there is no need to panic when the color appears to be different. Instead, awareness of stool hue can help people recognize when a new color occurs frequently.
As an organ with so many responsibilities ranging from chemical production, digestive assistant, cholesterol manufacturing and detoxification, the liver can shed hints of its wellness in a bowel movement. When lasting for more than several evacuations, the following colors can be a sign of a potential liver imbalance:
• Red – Bright red or dark red in the stool can indicate bleeding somewhere in the gastrointestinal tract. Although eating beets or food with red food coloring can make bowel movements reddish, persistent red stool can signal stomach ulcers, hemorrhoids or bleeding esophageal varices. Esophageal varices are a complication of advanced liver disease, where a blockage of the liver increases pressure in the portal vein, causing blood vessels in the esophagus or stomach to rupture and bleed. Bleeding esophageal varices is a medical emergency and is usually accompanied by other symptoms such as vomiting of blood, low blood pressure and rapid heart rate.
• Black – Similar to red in the stool, a persistent black color in stool can indicate internal bleeding from esophageal varices. Stool that is black due to bleeding is also usually sticky or tarry. However, black stool can also be a result of taking a supplement with iron or a medication containing bismuth subsalicylate – like Pepto Bismol.
• Grey, Pale, Yellow or Clay-Colored – The liver releases bile into the stool, giving it a normal brown color. If there is inflammation or scarring in the liver that inhibits bile production, or if the flow out of the liver is blocked, bowel movements may appear to be grey, pale, yellow or clay-colored. On the other hand, using antacids that contain aluminum hydroxide or having a barium enema test can also turn feces a pale color.
• Greasy – While not necessarily a color, a greasy bowel movement will float and usually means there’s increased fat in the stools. Called steatorrhea, these stools can result from eating a high fat meal. However, if stools appear to be floating and greasy regularly, there may be an underlying disorder. Lipase, a digestive enzyme produced by the pancreas, and bile salts from the liver are needed to break down and absorb fat. Any condition that results in decreased lipase or bile salts can cause steatorrhea – including inflammation, scarring or a blockage in the liver.
Every bowel movement color listed above can be a passing, temporary, inconsequential occurrence. Regardless, if an abnormal palette persists for more than a day or two, keep a record of your stool’s hue and take it to your doctor. Although few consider bowel movement color to be a red flag of liver disease in and of itself, being aware of a persistent color change can be one of the first indications that your liver health should be evaluated by your physician.
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