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My search of the literature leads me to believe that acholic (pale or white or gray or light yellow) stools can essentially ONLY reflect obstruction of the biliary [or some other related] duct.
However, I have met several patients who have reported acholic stools in the absence of jaundice or any other symptoms. Typically, they last just one or two days. I, myself, have had gray stools from time to time. Even as a fourth year medical student, it is essentially impossible for me to find anywhere in the medical literature that allows for this to be a normal variant. Can I ask why this might be?
In the absence of other symptoms or some obvious dietary abnormality or something (e.g. consuming nothing but bleached tapioca pudding for 2 weeks or something ridiculous like that), if a 35 year old patient comes to me with gray or light-yellow stools, should I be working them up? And for what?
Let's say they have had 2 days of a vague epigastric burning and acholic stools but no jaundice or other symptoms and a non-contributory history... does that change things?
Thanks so much in advance for your responses. I know people don't like to talk about stools... but look around on uptodate or gastroenterology books... it's easy to get the idea that acholic stools = obstruction every time... and that just doesn't jive with what I've seen clinically.
Thanks again.
However, I have met several patients who have reported acholic stools in the absence of jaundice or any other symptoms. Typically, they last just one or two days. I, myself, have had gray stools from time to time. Even as a fourth year medical student, it is essentially impossible for me to find anywhere in the medical literature that allows for this to be a normal variant. Can I ask why this might be?
In the absence of other symptoms or some obvious dietary abnormality or something (e.g. consuming nothing but bleached tapioca pudding for 2 weeks or something ridiculous like that), if a 35 year old patient comes to me with gray or light-yellow stools, should I be working them up? And for what?
Let's say they have had 2 days of a vague epigastric burning and acholic stools but no jaundice or other symptoms and a non-contributory history... does that change things?
Thanks so much in advance for your responses. I know people don't like to talk about stools... but look around on uptodate or gastroenterology books... it's easy to get the idea that acholic stools = obstruction every time... and that just doesn't jive with what I've seen clinically.
Thanks again.