The normal stools appear brown to yellowish brown in colour, mainly due to the presence of the coloured pigments which come from bile. In some of the systemic conditions, the stools appear pale or clay coloured and are known as acholic stools. Such problems generally arise due to problems in biliary system.
This condition can arise due to many possible causes, some of which are listed here:
- Jaundice: Jaundice is the commonest cause of acholic stools. This is the medical term describing the yellowish discolouration of the skin. Bilirubin is the yellowish pigment which is formed in the liver due to the destruction and breakdown of RBCs. Jaundice is caused generally due to obstruction in the flow of bile to the gastrointestinal system. Due to this, the stools appear pale in colour.
- Alcoholic Liver Disease: The individuals who have a chronic habit of alcohol abuse develop this condition. The breakdown of alcohol in the body produces many toxic chemicals which can lead to cell damage and injury, resulting in inflammation of the liver cells. This can even lead to permanent damage to the liver cells, known as liver cirrhosis. This condition reduces the efficacy of liver cells and thus decreases the bile production resulting in acholic stool.
- Biliary obstruction: This is generally caused due to the obstruction of the bile ducts or can also be a result of pathologies of liver, gallbladder, small intestine or pancreas. Majority of the cases are a result of gallstones.
- Gallstones: Gallstones is the name given to the hard deposits in the gall bladder. These stones may consist of salt, bilirubin or cholesterol. Due to the presence of gallstones, the flow of bile to the intestines is obstructed. This results in acholic stools. Other symptoms include nausea, vomiting and fever.
- Hepatitis: It is normally due to viral infection of the liver but can also be caused due to some other reasons like secondary reactions of some substances or autoimmune hepatitis. Liver has many important functions to perform and hepatitis results in a compromise with these functions. Thus, it also reduces the production of bile by breakdown of RBCs. Commonly there are 5 types of hepatitis virus which can be a cause for hepatitis. The other symptoms of this condition, apart from pale stool, include loss of appetite, fatigue and unexplained weight loss.
- Cirrhosis: This is the condition where scarring of liver occurs. This scarring is due to chronic exposure of liver to toxins like chemicals and alcohol. This chronic scarring result in cirrhosis, which makes it difficult for the liver to perform the basic functions. Other symptoms include loss of appetite, weakness and weight loss.
- Acute pancreatitis: Acute pancreatitis is the condition of inflammation of pancreas which is sudden in onset. The reason for pancreatitis can include viral infections, obstructions and immune system reactions. The symptoms include pain after some time of consuming food, nausea, vomiting and fever. Jaundice like symptoms diarrhoea and excessive sweating.
- Cystic Fibrosis: Cystic fibrosis is a genetic disorder with recessive hereditary characteristic. This condition affects the cells which produce sweat and digestive juices. This can result in life threatening condition. The fault in the gene causes mucus glands to produce and secrete thicker mucus which clogs the tracts of the flow of mucus. The symptoms vary widely on the basis of severity of the disease. Cystic fibrosis results in blockage of pancreatic flow also and can result in oily and acholic stools as well.
- Pancreatic Cancer: Pancreas is a very vital organ of the digestive system which is required for the proper digestion of fats, carbohydrates and proteins. Cancer of pancreas results in disturbance of these normal functions. The other associated symptoms are loss of appetite, abdominal pain, jaundice and unexplained weight loss
- Chronic pancreatitis: All the conditions affecting the pancreas, gall bladder and liver can be a cause for acholic stools. Chronic pancreatitis is another such condition wherein the pancreas has been inflamed for a longer period of time. This condition can seriously affect the regulation of blood glucose level. This condition can cause permanent damage and scarring to the pancreatic tissues. Stones and cysts can also develop in your pancreatic ducts, obstructing the flow of pancreatic juices.
- Thalessemia: Thalessemia is a genetic disorder where the red blood cells are produced in a defective structure. The altered red blood cell causes greater destruction of red blood cells and thus causes anaemia. Any form of major Thalessemia will result in anaemia and jaundice. This also results in acholic stools. Poor appetite and frequent infections are also common. Thalassemia major can cause severe anaemia in infant below 2 years of age, resulting in life threatening condition.
Acholic stool is not a disease in itself but a symptom and presentation of some other underlying disease. Therefore, the treatment plan depends upon the underlying condition.