The presence of hypochromic, clay-colored stools usually derives from hepatic, cholecistic or pancreatic pathologies. Normally, the presence of bile pigments gives the stool the characteristic brown color. In any case, hepatocellular degeneration or biliary obstruction can interfere with the formation or release of these pigments in the intestine, leading to clay-colored stools. These stools are usually associated with jaundice and dark urine.
After asking the patient when he noticed clay-colored stools, identify signs and associated symptoms, such as abdominal pain, nausea and vomiting, asthenia, anorexia, weight loss and dark urine. Does the patient have problems digesting heavy or fat meals? Easily develop hematomas? Next, review the history of cholecistic, hepatic or pancreatic diseases. Have you ever been treated with biliary tract surgery? Have you recently performed diagnostic tests with barred contrast medium? The barred contrast medium determines the emission of light stools for several days). Also, inquire about the use of antacids, because large quantities can result in a clearing of the stool. Write down a history of alcoholism or exposure to other hepatotoxic substances. After evaluating the general appearance of the patient, check vital parameters, skin and eyes for the presence of jaundice. Then, examine the abdomen, evaluating respectively the presence of distension and the presence of peristalsis in the auscultation. Perform percussion and palpation to identify masses and rebound tenderness. Finally, take samples of urine and faeces for laboratory tests.
Sign of frequent onset of this pathology, the clay-colored stools can be associated with jaundice, pruritus, anorexia and weight loss, pain on the upper abdomen, hemorrhagic diathesis and palpable mass.
Usually, the evacuation of clay-colored stools follows the onset of an unexplained itching that worsens in the evening, weakness, asthenia, weight loss and vaginal abdominal pain; these characteristics may be present for years. Signs and associated symptoms may include jaundice, hyperpigmentation and signs of malabsorption, such as nighttime diarrhea, steatorrhea, purpura, lumbar and bone pain due to osteomalacia. The patient may also develop painful hepatomegaly with hard parenchymal consistency, hematemesis, ascile, edema, and xanthomas on the palms, soles of the feet and elbows.
Characterized by fibrosis of the bile ducts, this chronic inflammatory pathology can lead to the evacuation of clay-colored stools, chronic or intermittent jaundice, pruritus, pain in the upper right quadrant of the abdomen, chills and fever.
Calculations of the biliary tract may result in the evacuation of clay-colored stools when they obstruct the common bile duct (choledocholithiasis). However, if the obstruction is intermittent, the stools may alternatively appear, normal and clay-colored. Associated symptoms may include dyspepsia and, in the case of severe and sudden obstruction, biliary colic. D Pain, located at the upper right quadrant, intensifies in several hours, can radiate to the epigastrium or scapula and is not relieved by the administration of antacids. Pain is associated with tachycardia, agitation, nausea, vomiting, pain in the upper quadrant of the abdomen, fever, chills and jaundice.
Before hypochromic feces is evacuated in this disease, the patient usually complains of weight loss, weakness and anorexia. In the late stages, the development of a hard hepatomegaly can occur, with modularity, jaundice, pain in the upper right quadrant of the abdomen, ascites, declining edema and fever. During auscultation, if the tumor mass affects a large part of the liver, you may hear a whiff, a buzz or a rub.
In viral hepatitis, the appearance of clay-colored stools marks the beginning
of the jaundice phase and is usually followed by the onset of jaundice over a
period of 1-5 days. Associated signs include slight weight loss and dark urine,
as well as the persistence of some signs of the phase preceding the appearance
of jaundice, such as anorexia and painful hepatomegaly. During the icteric phase,
the patient may become irritable and develop pain in the upper right quadrant of
the abdomen, splenomegaly, enlarged cervical lymph nodes and intense itching.
Once the jaundice disappears, the patient continues to complain of asthenia,
flatulence, abdominal pain or pain and dyspepsia, although the appetite usually
returns to normal and the hepatomegaly disappears. The post-clinical phase
generally lasts from 2 to 6 weeks, with complete recovery over 6 months.
In non-viral cholestatic hepatitis, there is the presence of clay-colored stools,
with other signs of viral hepatitis.
The obstruction of the common bile duct, associated with this insidious tumor, can cause the presence of clay-colored stools. Associated classic manifestations include abdominal or back pain, jaundice, pruritus, nausea and vomiting, anorexia, weight loss, asthenia, weakness and fever. Other possible effects are diarrhea, skin lesions (especially on the lower limbs), emotional lability, splenomegaly and signs of gastrointestinal bleeding. Auscultation can highlight a breath in the periumbilical area and the upper left quadrant of the abdomen.
This inflammatory disorder can cause the appearance of clay-colored stools, dark urine and jaundice. Usually, it also causes the onset of intense epigastric pain that radiates to the back and worsens in a supine position. Associated findings may include nausea and vomiting, fever, abdominal pain and tenderness, peristalsis and crackles at the pulmonary bases. In severe pancreatitis, findings include marked psychomotor agitation, tachycardia, slimy and cold skin, sweaty extremities.
Prepare the patient for diagnostic tests, such as samples for transaminase and
bilirubin assays, ultrasound, CT and stool analysis.
index of gastroenterology