Symptoms of Liver Problems

National Health Service, U.K.: “Alcohol-Related Liver Disease,” “Cirrhosis.”

Pale Stools: Possible Causes and When to Seek Help

Pale stools are may suggest issues with your liver, gallbladder, or pancreas. If your bowel movements are a light clay color instead of brown, a healthcare professional can help you find the cause and recommend treatment.

Normal stools can vary in shades of brown, mostly due to your diet. Pale stools are not normal.

If your stools are pale or clay-colored, you may have a problem with the drainage of your biliary system, which includes your gallbladder, liver, and pancreas.

Bile salts are released into your stools by your liver, giving the stools a brown color. If your liver is not producing enough bile, or if the flow of the bile is blocked and not draining from your liver, your stools may become pale or clay-colored.

Having pale stools once in a while may not be a cause for concern. If it occurs frequently, you may have a serious illness. You should see your doctor whenever you have pale or clay-colored stools in order to rule out illness and disease.

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There are many possible causes of pale stools. Some of the common causes include:

Medications

Certain medications, such as the nonsteroidal anti-inflammatory drugs ibuprofen (Advil) and naproxen (EC-Naprosyn), birth control pills, some antibiotics, and anabolic steroids can cause drug-induced hepatitis. This is a swelling or inflammation of the liver caused by medications.

For most people affected, drug-induced hepatitis and the related discolored stools usually go away within a few weeks after the medications are discontinued.

Viral hepatitis

Viral hepatitis is a swelling or inflammation of the liver caused by viruses such as hepatitis A, B, or C viruses. Hepatitis C often leads to liver disease.

Your doctor can diagnose the type of hepatitis virus you have and help you figure out the best treatment plan for you.

Alcoholic hepatitis

Alcoholic hepatitis is swelling or inflammation of the liver caused by drinking excessive amounts of alcohol. Alcoholic hepatitis can lead to liver disease or liver failure.

To treat this form of hepatitis, you’ll have to stop drinking alcohol. Your doctor can help you if you’ve become dependent on alcohol. Alcoholic hepatitis can also cause malnutrition, so you may also need to be put on a special diet to get the vitamins and other nutrients you need.

Medications such as prednisone (Rayos) and pentoxifylline (Pentopak) can also treat liver inflammation.

In severe cases, a liver transplant may be needed.

Biliary cirrhosis

Biliary cirrhosis is an inflammation or irritation of the bile ducts in the liver. The inflammation or irritation blocks the flow of bile to the intestines. The exact cause of biliary cirrhosis is unknown. There’s no cure for biliary cirrhosis, and the disease can be fatal.

Treatment can help manage your symptoms and prevent complications. Commonly prescribed medications include cholestyramine (Questran), which treats itching, and ursodiol (Urso Forte), which aids in removing bile from the bloodstream.

Your doctor may also suggest taking vitamins A, K, E, and D, to replace the nutrients that are lost in the fatty stools. Calcium supplements can also help prevent loss of bone density.

In severe cases, your doctor may suggest a liver treatment.

Gallstones

Gallstones are hardened deposits in the gallbladder that can block the flow of bile.

Medications can sometimes dissolve gallstones. You may need surgery to remove your gallstones if they’re large or medication isn’t effective.

Sclerosing cholangitis

Sclerosing cholangitis is an inflammation or scarring of the bile ducts, which are the tubes that carry bile throughout the body. The exact cause of this disease is unknown, but genetic factors may be partially responsible.

Both medications and surgeries are possible treatments for sclerosing cholangitis. Commonly prescribed medications include:

• cholestyramine (Questran)
• prednisone (RAYOS)
• ursodiol (Urso Forte)
• azathioprine (Azasan)
• cyclosporine (Sandimmune)

Your doctor may also prescribe supplements for vitamins A, D, E, and K to replace what the body has lost. Your doctor may also prescribe antibiotics.

Common surgeries used to treat sclerosing cholangitis include:

• endoscopic balloon, which involves inserting a balloon at the end of a long tube into the bile ducts to open any narrowing
• biliary drainage catheter, which involves placing a drain in the narrowing of the bile ducts
• removal of the colon and rectum in severe cases
• liver transplant

Structural defects in the biliary system

You may have been born with structural defects in your biliary system that prevent the flow of bile.

After a physical exam, your doctor may order several tests to determine if you have structural defects. These tests include blood tests, scans, and X-rays.

Your doctor may be able to surgically repair the defects. The type of defect will determine the type of surgical procedure the doctor will use.

Biliary stricture

Gallbladder removal surgery can result in the narrowing of the bile ducts. This condition is known as biliary stricture.

Your doctor may be able to correct the problems using surgery or a stent. A stent is a small tube that a surgeon places inside the ducts to keep them open so that bile can flow freely.

Tumors

Benign (noncancerous) or malignant (cancerous) tumors in the biliary system can interfere with bile flow or inflame the liver.

Your doctor may be able to remove the tumor surgically. If the tumor is cancerous, you may need radiation, a therapy that uses X-rays or gamma rays to destroy cancerous cells. You may also need chemotherapy, which involves powerful drugs that kill cancer cells.

Cysts

Cysts on the bile ducts can prevent the flow of bile.

The cysts may go away without treatment, or your doctor may perform surgery to remove them. The surgery is done laparoscopically and with small incisions and less discomfort than common surgery.

One of the most common complications of pale stools is jaundice. This is due to a buildup of bile in your body. Jaundice is a yellowing of your skin or around the whites of your eyes.

See your doctor immediately if you have signs of jaundice because it may also be a symptom of liver disease.

Brightly colored stools in children are usually caused by colorful foods like breakfast cereal. However, pale, white, or clay-colored stools in children can be caused by something more serious. Some of the causes are:

• a milk-only diet
• barium sulfate from barium enema
• antacids
• blocked bile ducts or liver disease

You should contact your doctor any time your child’s stool changes color, especially if they haven’t had any brightly colored foods or if the stools are pale, white, or clay-colored. Only your doctor can determine the exact cause and provide the proper treatment.

If the cause is a food or medication, removing it from the child’s diet will clear up the condition. If the cause is liver disease or a blocked bile duct, this can be life threatening and may require surgery or medications.

Your doctor will ask you questions about the accompanying symptoms and medications you’re taking. Your doctor may also perform tests to help diagnose the cause of your pale stools. Possible tests include:

• blood tests, to check for infections and jaundice
• computed tomography (CT) scans, to see if you have any swelling of your liver or bile ducts
• magnetic resonance cholangiopancreatography (MRCP), a special type of magnetic resonance imaging (MRI) that captures detailed images of the biliary system
• abdominal ultrasound, to develop a picture of your organs

Once the underlying cause of pale stools is treated, your stools should return to a normal brown color.

However, some causes, such as liver disease and some cancerous tumors, are incurable. If the cause is incurable, you’ll continue to have pale or clay-colored stools.

Some of the causes of pale stools are not preventable, but others are. Some forms of hepatitis have vaccines for prevention. Alcoholic hepatitis can be prevented by not drinking alcohol in excess.

If the cause is unknown, work toward having healthy bowel movements by eating a balanced diet that is high in fiber.

Last medically reviewed on June 9, 2022

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• How radiation therapy is used to treat cancer. (2019).
  cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/radiation/understandingradiationtherapyaguideforpatientsandfamilies/understanding-radiation-therapy-what-is-radiation-therapy
• Primary biliary cholangitis (PBC). (2022). /
  liverfoundation.org/abouttheliver/info/pbc
• What is viral hepatitis? (2020).
  cdc.gov/hepatitis/abc/
• Stools – unusual color. (2022).
  seattlechildrens.org/conditions/a-z/stools-unusual-color/

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Symptoms of Liver Problems

There are more than 100 different liver diseases. They have different causes, including:

• Infection
• Too much alcohol
• Medications, illegal drugs, or toxins
• Obesity
• Cancer

Even though there are different diseases and different causes, many liver conditions damage the liver in similar ways. Because of this, they can look similar and cause similar symptoms.

Acute vs. Chronic

2/13

Sometimes liver damage or even liver failure and related symptoms will be acute, or come on quickly. This can happen if you take too much acetaminophen or other medicines. Herbal supplements, viruses, and autoimmune conditions also can cause this. But most of the time, liver diseases and liver failure are chronic. This means they happen gradually as the liver is damaged slowly over time. In this case, symptoms can come on more gradually too.

Early Liver Disease Symptoms

3/13

You might not notice early symptoms. If you do, it might be hard to know what’s causing them. That’s because early signs of liver trouble are vague, like:

• Belly pain
• Not feeling hungry
• Tiredness or lack of energy
• Diarrhea

You may just feel generally sick or unwell and not know why.

Yellow Skin or Eyes (Jaundice)

4/13

As the liver gets more damaged, you may notice clearer signs of a problem. Your skin may look yellow along with the whites of your eyes. Doctors call this jaundice. This happens when too much of a yellow substance from your red blood cells called bilirubin builds up. Normally, your liver would clear the bilirubin out. But a damaged liver can’t keep up, so levels rise.

Itchy Skin

5/13

If you have lasting liver problems, you may feel itchy. This happens even though you don’t have a rash or anything on your skin. The itchiness can make it hard to do things like sleep. It keeps up even if you scratch. If you have this, ask your doctor if there’s medicine that can help.

Swollen Belly (Ascites)

6/13

If your liver is scarred, it can block blood flow to your liver and raise the pressure in blood vessels around it. This makes fluid seep out and collect in your belly. There may be a little fluid and swelling or a lot. Your belly may get very large and your belly button might push out. Sometimes ascites gets infected and needs antibiotics. If there’s a lot of extra fluid with nowhere to go, you may need to have it drained with a tube.

Swollen Legs or Ankles

7/13

In some people with ascites, legs and ankles also swell as fluid builds up. It might help to eat less salt or take medicine that makes you pee more.

Pale Poop and Dark Pee

8/13

Your liver is the reason that healthy poop looks brown. The brown color comes from bile salts made by your liver. If your liver doesn’t make bile normally or if the flow from the liver is blocked, your poop will look pale like the color of clay. Pale poop often happens along with yellow skin (jaundice). The extra bilirubin that makes your skin look yellow also can make your pee unusually dark.

Fatigue and Confusion

9/13

Many people with liver disease suffer from lingering fatigue. This might happen because of toxins building up since your liver isn’t clearing them like it should. The buildup of toxins in your body and bloodstream also can affect brain function. You might get confused or find it hard to concentrate. You might forget things or notice other changes as liver disease affects your brain.

Nausea and Vomiting

10/13

Your stomach might get upset early on if you have liver disease. As the disease and damage to your liver go on, raised toxin levels can make this worse. Lingering nausea or throwing up often are a sign of liver problems. If your liver is failing, you also may have blood in your vomit or poop.

Bruising Easily or Bleeding

11/13

If your liver is failing, you may notice you get bruises more easily. If you get a cut or nosebleed, it may not stop like it should. While people with advanced liver disease are prone to bleeding, they also are more likely to get blood clots.

Red Palms and ‘Spider Webs’

12/13

You may have red marks from blood vessels under your skin that look like spider webs. Doctors call these spider naevi. They often happen on the cheeks, nose, and neck. One study in people who were alcoholics found that these are a strong indicator of liver problems. People with these spider-like marks also often have reddened palms (palmar erythema). Blotchy red palms are another symptom of advanced liver disease.

Catching Liver Disease Sooner

13/13

It’s possible you could have liver disease without knowing it. Lots of people with liver problems don’t seem sick. As damage to the liver gets worse, symptoms will start. If the damage has gone too far, there might not be any way to fix it. But knowing what to look for could help to catch liver problems early. That way you’ll have a chance to stop more damage and let your liver heal before it’s too late.

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American Liver Foundation: “The Progression of Liver Disease.”

Mayo Clinic: “Acute Liver Failure,” “Liver disease,” “Cirrhosis.”

National Health Service, U.K.: “Alcohol-Related Liver Disease,” “Cirrhosis.”

Scientific Reports: “Pruritus is common in patients with chronic liver disease and is improved by nalfurafine hydrochloride.”

Mount Sinai: “Stools – pale or clay-colored.”

Hopkins Medicine: “Common Characteristics of Liver Disease.”

Canadian Journal of Gastroenterology: “Fatigue in liver disease: Pathophysiology and clinical management.”

Hawaii Pacific Health: “Love Your Liver: Look for These 8 Signs of Organ Damage.”

Merck Manual: “Liver Failure.”

Journal of Translational Science: “Hemostasis, bleeding and thrombosis in liver disease.”

The Australasian College of Dermatologists: “Spider Naevi.”

Galicia Clinica: “Diagnostic accuracy of spider naevi for liver disease detection in alcoholics.”

Case Reports in Dermatology: “Erythema Palmare Hereditarium (‘Red Palms’, ‘Lane’s Disease’).”

Patient: “Palmar Erythema.”

American Journal of Clinical Dermatology: “Palmar erythema.”