Why and what does light color mean?

One of the indicators of the state of the digestive system is the color of the feces, the normal brown color of which is due to the presence of the final products of the cleavage of unbound bile yellow pigment bilirubin - strobobilinogens (L-urobilinogens). Quite bright feces can indicate a number of diseases, some of which are potentially life threatening. So, doctors advise not to ignore such a symptom as a pale-colored (hypochyolous) stool, observed for quite a long time.

Causes of feces of light color: dietary and pathological

First of all, the reasons for the light color of stool can be related to the nature of the food. So, light feces in an adult is possible when eating too fatty foods or a significant amount of dairy products. In the first case, the development of achiolia is due to the fact that lipase (an enzyme of the intestine) can not cope with the splitting of fats, as evidenced by fatty light feces (steatorrhea). And since not everyone has enough production of hydrolytic gastrointestinal enzymes for digesting milk protein (casein), the result of their lack and becomes light feces from milk. And if you eat too much cottage cheese, in which there is more casein than whole milk, then most likely there will be light feces from cottage cheese or light streaks in the feces (particles of undigested casein). Those who sit on a kefir diet may temporarily have a light feces after kefir.

When observing a ketogenic diet with a low carbohydrate content and a significant increase in fat intake in the stool, a protein may appear - heterogeneous light inclusions in the feces.

A completely natural phenomenon, not related to pathologies, is light feces during breastfeeding of a child, as well as light feces in a child whose diet is dominated by dairy products and white porridge (rice, manna, and oats cooked on milk).

Pathologic causes of hypochole stool doctors see in the problems of the functioning of the biliary system (liver, gall bladder and its ducts), as well as in negative changes on the part of the pancreas.

When the passage of bile through the ducts is blocked - which often happens with inflammation of the gallbladder (cholecystitis), inflammation of the bile duct (sclerosing cholangitis), the formation of stones (cholelithiasis) - stagnation of bile  (cholestasis) occurs  with the development of mechanical jaundice. In such situations, light feces and abdominal pains are combined. A light feces with cholecystitis can accompany frequent vomiting of bile.

In most cases, light feces after removal of the gallbladder are the result of constriction of the bile ducts (biliary stricture).

A smaller amount of strobobilin in the feces with a simultaneous increase in the level of direct bilirubin in the urine - light feces and dark urine - is characteristic of patients with viral hepatitis-A (Botkin's disease) B, C, D, E. Even without pronounced yellowness of the skin, light stool and pain in the right hypochondrium, as well as light feces and temperature most often indicate a liver damage by one of these viruses and a violation of its work.

With pancreatic inflammation (pancreatitis) and the associated deficiency of pancreatic enzymes, symptoms such as diarrhea and light feces are yellowish-gray or light gray feces, as well as light feces and abdominal pain.

Disorders of intestinal peristalsis, light fluid feces, light feces with impregnations not fully digested food, light brown feces with foam or light green feces with an acidic odor are included in the list of symptoms of  chronic non-ulcerative colitis.

In many respects similar signs are observed when:

• cirrhosis of the liver;
• biliary cirrhosis (inflammation or irritation of the bile ducts in the liver);
• cystic fibrosis of the pancreas or liver;
• enzyme deficiency associated with  malabsorption syndrome;
• intolerance to gluten (celiac disease), when patients have light feces and flatulence;
• Crohn's disease (mucous light feces with blood);
• cancer of the head of the pancreas or a malignant tumor of the liver;
• cancer of any localization (due to a reduction in the synthesis of erythropoietin and a decrease in the level of erythrocytes in the blood);
• congenital Gilbert syndrome associated with a deficiency of the hepatic enzyme uridine diphosphate-glucuronyl transferase; among the symptoms of nausea and vomiting, light feces and pain in the right upper quadrant, diarrhea or hard light feces, loss of appetite and fatigue.

Light liquid feces with mucus, light feces with foam, and fetid light green feces - against a background of nausea with vomiting, painful spasms in the intestines and an increase in temperature - often occurs with dysentery (damage caused by Shigella bacteria), salmonella (caused by Enterobacteria Salmonella enterica) or giardiasis. And such parasitic invasions as ascariasis and abdominal paragonimosis (dystomatosis) can lead to blockage of the bile ducts by fibrotic cysts that form around the colonies of larvae of these nematodes.

For rotavirus infection (intestinal flu), in addition to respiratory symptoms, liquid light feces are characteristic after rotavirus. There is nausea, vomiting, diarrhea and foamy light feces after enterovirus.

There is light feces after lead poisoning (with the development of toxic sideroblastic anemia), phosphates or arsenic.

Pathologies, in which there is a light feces, almost white, are listed in the publication -  White feces in an adult and a child

Why there is a light feces during pregnancy, for more details see -  Changing color of feces during pregnancy

If there is a light feces after taking alcohol (more precisely, excessive use), then it's all about the damage to hepatocytes and the development of acute alcoholic hepatitis.

[1], [2], [3], [4], [5]

Pathogenesis and risk factors

The pathogenesis of loss of normal color of feces is known: a decrease in the level of sterbilin (an oxidation product of L-urobilinogens). And risk factors include: nutritional disorders, inflammation or damage to liver cells, problems with the gallbladder and its ducts, imbalance of the major peptide gastrointestinal hormones (produced in the duodenum and jejunum) or pancreatic enzymes.

Specialists note that in the absence of cholestasis, the level of bile pigments can be reduced as a result of deviations in the blood composition with a decrease in the number of red blood cells. After all, bile pigments are formed by the natural disintegration of red blood cells and the release of hemoglobin - during the process of successive transformation of the heme into biliverdin, biliverdin into bilirubin, and bilirubin into L-urobilinogen.

In turn, the etiology of reducing the level of red blood cells has several causes: from a lack of nutrients (with protein starvation) and blood loss of various etiologies (this is explained by light feces after childbirth) to a high dose of ionizing radiation and prolonged intoxication of the body. In addition, a low level of erythrocytes is noted when:

• anemic conditions;
• myelodysplastic syndrome;
• congenital deficiency of the blood enzyme G6PD (glucose-6-phosphate dehydrogenase);
• an increased level of proteins in the blood (which can be caused by hyperthyroidism, kidney failure in their chronic inflammation, increased secretion of adrenal cortex hormones, malignant tumors, etc.).

The process of oxidation of hemoglobin leads to the formation of green pigment chelegoblobin, which in the course of further metabolism is transformed to bilirubin (binding to glucuronic acid, cleaved by the liver and secreted with bile). However, if the chyme passes through the stomach and intestine too quickly, the hologlobin enters the large intestine, causing light green feces.

Another option - when there is greenish light feces with dysbacteriosis - is due to the fact that, passing through the intestine, bilirubin is not significantly oxidized to sterocilinogen, as it is not exposed to the microbiota present in it (obligate intestinal microflora) - due to the death of beneficial bacteria .

Light feces and medications

Special attention is paid to medicines as a risk factor for the appearance of hypochloric stool in patients.

First of all, this concerns numerous complaints of light feces after antibiotics, in particular, a group of penicillins, tetracycline and cephalosporins, as well as sulfonamides. This side effect of antimicrobial agents is explained by their effect on such useful intestinal bacteria as Bifidobacterium, Lactobacillus, destructors-saprophytes, etc.

Non-steroidal anti-inflammatory drugs (Ibuprofen, etc.), oral contraceptives and anabolic steroids can cause acute and  chronic drug hepatitis.

In most patients, light feces with diabetes are the result of side effects of hypoglycemic medications taken. For example, when using sulfonamides (derivatives of sulfonylurea - Gliklazid, Glikvidona, Glimepirida, etc.) - there may be side effects in the form of nausea, vomiting, diarrhea, cholestatic jaundice and  drug hemolytic anemia. And the use of antidiabetic drugs group of inhibitors of α-glucosidases (Acarbose or Miglitol) is often accompanied by severe dyspepsia due to poor digestion of carbohydrates, which begin to be broken only in the intestines, causing light feces and flatulence.

There are also many antacids in this plan that neutralize the acid of gastric juice. Thus, the light color of the stool after Phosphalugel appears due to the presence of aluminum phosphate in the given agent, which adsorbs cholic and chenodeoxycholic acid of bile, as a result of which the emulsification of incoming fats decreases.

Intestinal sorbent Enterosgel is a hydrogel of methyl silicic acid, and the light color of the stool after Enterosgel is a consequence of the adsorption of bilirubin. A light feces after Motilium, which is used for better digestion with sluggish bowel work, can be caused by magnesium stearate (which increases the formation of mucus in the stomach and acts as a laxative). In addition, adsorbents are produced and intestinal intolerant components such as polyvinylpyrrolidone (povidone) and microcrystalline cellulose are excreted unchanged.

When diarrhea is recommended, take Loperamide (Imodium), which acts on opioid receptors and reduces intestinal peristalsis. At the same time from Loperamide, light feces appear in connection with the inhibition of the production of hydrochloric acid in the stomach and the deterioration in the digestion of food.

If you take a drug of plant origin Sinupret when you cough, then Sinupret light feces may appear due to the action of the auxiliary substances that make up its composition. In 100 ml of drops Sinupret contains 29 g of alcohol-aqueous extract of medicinal plants, and in the same amount of syrup - only 10 g; the remaining (auxiliary) ingredients include: glycolic wax, povidone, thickeners and stabilizers (talc, potato starch and corn dextrin), silicon dioxide, magnesium oxide, etc.

Consequences and complications

One of the most common complications of a light stool is jaundice - with yellowing of the skin and eye proteins. And the consequence is most often a serious decrease in the functions of the liver and gallbladder.

[6], [7], [8], [9], [10]

Diagnosis of light feces

Diagnosis of diseases that cause this symptom necessarily begins with an anamnesis and complete information on the accompanying symptoms and medications that the patient takes.

Analyzes include:

• fecal analysis (clinical coprogram) with determination of the level of sterbilin;
• analysis of feces for intestinal bacteria, nematode larvae and helminths;
• clinical blood test;
• biochemical blood test for the level of bilirubin, cholesterol, bile acids, liver and pancreatic enzymes;
• a blood test for immunoglobulins;
• general urine analysis and urinalysis for urobilinogens;

Instrumental diagnosis of pathologies in which light feces is observed may include:

• abdominal ultrasound (gallbladder, liver, pancreas);
• X-ray of the intestine;
• radioisotope scanning (scintigraphy) of the gallbladder, liver and bile ducts;
• cholangiography;
• computer tomography of the digestive and biliary systems;
• magnetic resonance cholangiopancreatography.

[11], [12], [13], [14]

Differential diagnostics

Differential diagnosis - based on the results of analysis and instrumental examination - should reveal the real etiology of this symptom.

[15], [16], [17], [18]

Treatment of light feces

No one cures bright feces: it is necessary to treat not the effect, but its cause. And it is clear that treatment for stones in the gallbladder will be quite different than with non-ulcerative colitis or pancreatitis.

Within one publication, it is simply impossible to cover the methods of treating all mentioned pathologies.

How to treat inflammation of the gallbladder, described in detail in the material -  Chronic cholecystitis

What medicines and alternative remedies are used for liver damage with the hepatitis virus, for details, see -  Hepatitis B Treatment

Also read:

• Drugs for acute and chronic pancreatitis
• Treatment of Giardiasis

Prevention

Experts argue that many problems with the gallbladder, liver and intestines can prevent proper prevention. However, cirrhosis of the liver or autoimmune biliary cirrhosis can be fatal. Congenital syndromes and enzymopathies are not preventable. But some forms of hepatitis have vaccines.

Read more:

• Prevention of hepatitis A
• Prophylaxis of dysentery
• Enteroviral infections Treatment and prevention

Forecast

When the main cause causing light feces is treated, the stool should return to a normal brown color. However, some causes, such as liver disease and some cancers, are incurable.