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Gray or pale stools represent a cascade of medical conditions originating from the biliary system. When there is not enough bile in your stools, it will present with a pale gray discoloration. Read more to figure out what conditions could be causing this.

As we have seen in our exploration of stool colors already, if you do not see normal brown-colored stools after defecating, this could be an indication that there is something wrong. Causes of black stools can be both dangerous from things like internal bleeding or from benign sources like the diet we eat or medications we take [1]. If you find that you are having gray-colored stools, however, this is a medical irregularity that diet alone cannot account for. Here, we will explore some of the most likely causes of gray stools and what you need to do in order to manage it. 

Liver Dysfunction 

Stools will appear gray or pale because of the absence of bile salts. This can occur anywhere along the biliary system of our body but one of the most likely places for this to occur would be in our livers [2]. The liver produces bile salts in order to help us dissolve fatty foods that we may ingest throughout the day. With a normal diet, this process occurs seamlessly but when we consume large quantities of fatty foods or have an underlying liver pathology, the efficiency of this process deteriorates. 

Any pathology of the liver can interfere with the production of bile so be aware that the list I am about to present is only the "tip of the iceberg" of what could be wrong [3]. Some of the most common causes of liver pathology include conditions like hepatitis, chronic alcoholism and liver metastatic cancer. All of these will not only produce frequent bowel movements, they are likely to all present with pale stools as well. 

Hepatitis is a condition best described as inflammation of the liver from a viral origin. There are many different types of hepatitis but the most benign would be Hepatitis A and E while the most worrisome would be B and C. Hepatitis A and E are commonly contracted after traveling to developing countries and will resolve in time without any long-term complications. Hepatitis B and C, however, can be caught after risky sexual intercourse, IV drug use or even after getting a tattoo. These are very difficult diseases to treat and can lead to liver failure or cancer in a short amount of time. [4]

Pancreatic Dysfunction 

Another organ that is essential for the processing of fatty foods would be the pancreas. Dysfunction in this organ can also lead to pale stools. Just like in the liver, one of the possible causes would be from alcohol consumption. If you consume too much alcohol, it acts as a toxin that damages everything that it comes into contact with. The liver and the pancreas are two organs that are usually the first to experience the effects of alcohol. Patients will experience severe abdominal pain and have pale colored stools until the pancreas (or liver) are able to self-heal and regenerate. [5]

A more sinister and worrying condition could also be pancreatic cancer. This is one of the worst forms of cancer that exists and almost all patients ultimately diagnosed with pancreatic cancer will die within the year. The reason that this is such a deadly cancer is that it is very hard for doctors to visualize the pancreas on simple ultrasound or even computed tomography (CT) imaging because the intestines block the image on the screen. Tumors will only be found by chance if a patient is having some other type of operation or if symptoms start to indicate that pancreatic cancer is occurring. Some of the most noticeable symptoms of pancreatic cancer would be a yellowing of the skin (jaundice) and the presentation of pale stools. [6]

Thankfully, it is a very rare form of cancer and ranks as the 11th most common type of cancer worldwide but that does not mean much if you are one of the patients suffering from the disease [7]. Family history and alcohol consumption can predispose you to this type of cancer so consult with a doctor to determine screening tests appropriate for you. 

Gallbladder Issues 

When it comes to another potential cause of gray stools, gallbladder issues could also be a potential source of this event. When patients suffer from gallstones, it is quite possible for the stones to obstruct the opening of the gallbladder to prevent the release of bile salts into the intestines. The gallbladder is a very important organ in the digestion of fats and is the site of storage for bile acid that is produced by the liver. 

You can begin to suspect that you may have gallstones if you find that you have upper abdominal pain, especially after eating a fatty meal. You may feel nausea, can vomit after meals, have frequent bowel movements and will most likely also have pale stools. Risk factors for this condition in medicine are referred to as the "4 F's." These would be female, fat, fertile and over 40 but males can also present with gallstones. Go to your family doctor and have an ultrasound examination in order to determine if you are actually suffering from gallstones. [8]

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