White, Pellet-Like Stools
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Try one of these related symptoms.
Mucus in stool
White stools
Light colored stool
Pale stool
White mucus in stool
Foamy stool
White stuff in stool
Brown poop with white spots
White strings in poop
White chunks in poop
About the Symptom
Pebble poop, or pellet-like stool, may occur when very hard stool breaks apart into smaller pieces. This is usually a result of constipation. Pale stools are not typical. This results from a blockage in bile drainage (digestive fluid). The blockage can occur anywhere within the gallbladder, the liver, or the pancreas. Pale stools are usually associated with jaundice (yellowing of the skin).
When to See a Doctor
Seek professional care if you experience any of the following symptoms
- White, pellet-like stools
Possible Causes
Generally, White, pellet-like stools can be related to:
- Physiological Defecation
Normal stool can vary in color. Greenish stools can be due to supplements. However, persistently black and shiny stool may be a sign of internal bleeding, which needs medical attention. White, clay-like stools can also indicate a liver problem.
- Biliary Tract Cancer
Cancer of the bile ducts is also known as "cholangiocarcinoma." It is a cancer that arises in the bile ducts inside the liver or in the ducts that connect the liver to the gall bladder and intestines. Risk factors include genetic conditions, a condition called primary sclerosing cholangitis, chronic liver disease, infection with liver worms (flukes), smoking, diabetes, and age >50. Patients often come to their physicians with abdominal pain, jaundice (yellow skin and eyeballs), itchiness, and weight loss.
Doctor's Diagnostic Questions
Your doctor may ask these questions to check for this symptom:
- Do you have pale, pebble-like stools?
- Have you noticed any changes in your stool color?
- Has your baby's stool lightened in color since they turned one month old?
- Are your stools white or clay-colored?
- Are your stools green?
Reviewed By:
Samantha Nazareth, MD (Gastroenterology)
Board-certified gastroenterologist. Experience managing gastrointestinal conditions (GERD, IBS, ulcerative colitis, Crohn’s, celiac disease, NASH) within healthcare organizations (three ambulatory surgical centers, single-specialty practice, multi-specialty practice and solo practice).
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Feb 6, 2025
Following the Medical Content Editorial Policy
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FAQs
Q.
Greasy, Foul, and Floating: Identifying Giardia and Parasite Stool
A.
Greasy, foul-smelling, floating stools that may be pale and loose, often with excess gas and bloating, are classic for Giardia because the parasite disrupts fat absorption, and blood or visible worms are uncommon. There are several factors to consider. See below to understand more, including how Giardia differs from other parasites, when to seek stool testing and treatment, red flags such as symptoms lasting more than a few days, dehydration, weight loss, or blood, and practical prevention steps.
References:
* Ankrah P, Ofori M, Afutu E, Abotsi RE, Boateng R. Giardia intestinalis: Pathophysiology, diagnosis, treatment, and prevention. Ann Clin Microbiol Antimicrob. 2021 Jul 2;20(1):50. doi: 10.1186/s12941-021-00465-3. PMID: 34215281.
* Garcia LS. Laboratory diagnosis of intestinal parasite infections. Clin Lab Med. 2016 Sep;36(3):415-442. doi: 10.1016/j.cll.2016.05.003. PMID: 27514115.
* Ajjampur SS, Devaraj C, Paulose AS, Sadanand CS, Ramani S, Subramanian S. Diagnostic accuracy of conventional parasitological techniques for the detection of intestinal parasites in faecal samples: a systematic review and meta-analysis. Parasit Vectors. 2023 Jul 21;16(1):285. doi: 10.1186/s13071-023-05899-y. PMID: 37474944.
* Kirk MD, Muenich H, Cates J, Ma J, Baker JM, Rzasa L, Dhingra R, Ravelo N, Vargo J, Beller M, Hughes C, Braddock J. Stool Consistency and the Risk of Enteric Infections. Emerg Infect Dis. 2021 May;27(5):1377-1385. doi: 10.3201/eid2705.204561. PMID: 33928828.
* Lalle M, Hijjawi N, Cacciò SM. Giardiasis: A Comprehensive Review. Microorganisms. 2022 Sep 23;10(10):1904. doi: 10.3390/microorganisms10101904. PMID: 36295713.
Q.
Is Your Poop Normal? Identifying IBS Stool Color, Shape, and Mucus
A.
There are several factors to consider: with IBS, stool often shifts from hard pellets or lumpy to loose or watery, may include small amounts of clear or white mucus, and color usually ranges from brown to light brown or yellowish due to changes in gut transit. Concerning signs include black tarry stool, bright red blood, gray or chalk-white stool, persistent pale stool with dark urine, or symptoms like unexplained weight loss, fever, nighttime diarrhea, anemia, vomiting, or new changes after age 50 that should prompt medical care; see below for fuller details, IBS subtypes, triggers, and guidance on next steps.
References:
* Lacy BE, Mearin F, Chang L, et al. Bowel Disorders. Gastroenterology. 2016;150(6):1393-1407. doi:10.1053/j.gastro.2016.02.031.
* Ford AC, Lacy BE, Talley NJ. Irritable Bowel Syndrome. N Engl J Med. 2017;376(25):2566-2578. doi:10.1056/NEJMra1607547.
* Blake MR, Raker JM, Whelan K. Validity and reliability of the Bristol Stool Form Scale in healthy adults and patients with IBS: a systematic review. Int J Nurs Stud. 2020;105:103552. doi:10.1016/j.ijnurstu.2020.103552.
* Grundmann O, Chung SM, Yoon B, et al. The Bristol stool form scale and irritable bowel syndrome-insights into a potential path to diagnosis. World J Gastroenterol. 2020;26(39):6033-6047. doi:10.3748/wjg.v26.i39.6033.
* Chey WD, Kurlander J, Eswaran S. Irritable Bowel Syndrome: A Clinical Review. JAMA. 2015;313(9):949-958. doi:10.1001/jama.2015.0955.
Q.
Pale or Clay-Colored Stool: Causes, Symptoms, and When to See a Doctor
A.
Pale or clay-colored stool usually means too little bile reaches the intestines, most often due to problems with the liver, gallbladder, bile ducts, or pancreas; a single pale stool can be harmless, but repeated episodes with dark urine, yellow skin or eyes, itching, upper right abdominal pain, greasy stools, or weight loss deserve attention. See a doctor if it lasts more than a few days or keeps recurring, and seek urgent care for severe pain, sudden jaundice, or feeling very unwell; there are several factors to consider, and key details on causes, warning symptoms, evaluation, and treatment options are outlined below.
References:
* Wang DQH. Evaluation of Adult Cholestasis. Clin Liver Dis. 2018 Feb;22(1):169-183.
* Lee JK, Kim DW, Jeong SW. Acute Cholangitis. Clin Endosc. 2021 May;54(3):370-379.
* Neoptolemos JP, Michl P, Costello E, et al. Pancreatic cancer: a review of current concepts and future developments. Lancet. 2018 Jul 14;392(10141):198-209.
* Sakai Y, Tsuyuguchi T. Diagnosis and Management of Bile Duct Obstruction. Dig Dis. 2019;37(4):254-261.
* Karthikeyan P, Ravindra P. Evaluation of Jaundice and Acholic Stool in Newborns. Indian J Pediatr. 2017 Mar;84(3):209-216.
Q.
"Sewer" Smelling Stool? The Truth About Sulfur Bloat and What’s Happening in Your Colon
A.
A strong rotten-egg or sewer odor usually comes from hydrogen sulfide gas made when gut bacteria ferment poorly digested protein or sulfur-rich foods, and it can also signal bacterial imbalance like SIBO or slowed gut motility. There are several factors to consider. See the complete guidance below for specific relief steps, what to track, and when to see a doctor if symptoms persist or appear with red flags like weight loss, blood, or greasy floating stools.
References:
* Wallace, J. L., & Wang, R. (2015). Hydrogen sulfide: a novel gasotransmitter in the gastrointestinal tract. *American Journal of Physiology. Gastrointestinal and Liver Physiology*, *309*(8), G615–G626.
* Carbonero, F., & Goulet, O. (2018). Microbial metabolism of sulfur compounds in the human gut. *Cellular and Molecular Gastroenterology and Hepatology*, *5*(2), 173–180.
* Pitcher, A. L., & Carbonero, F. (2021). Sulfate-reducing bacteria and hydrogen sulfide production in the human gut: a systematic review. *Journal of Functional Foods*, *86*, 104711.
* Triantafyllou, K., & Tarasouli, A. (2016). Intestinal hydrogen sulfide production: Food and microbiota. *Annals of Gastroenterology*, *29*(4), 437–444.
* Ahmed, A., & Carbonero, F. (2020). Faecal volatile organic compounds and their relation to diet, gut microbiota and disease: a systematic review. *Journal of Functional Foods*, *68*, 103853.
Q.
Taking Metamucil at Night? This Is the #1 Mistake That Backfires
A.
Taking Metamucil right before bed is the most common mistake; with less water intake and slower overnight gut motility, psyllium can thicken and sit longer, leading to hard pellet-like stools, bloating, cramping, or reflux-like discomfort. For best results, take it in the morning or midday with a full glass of water, stay upright, and leave 2 to 3 hours before lying down; there are several factors and exceptions to consider, plus red flags that may need medical attention, so see the complete guidance below.
References:
* Butt KJ, O'Malley T, Johnson JL. Psyllium: an updated review. Ann Pharmacother. 2016 Mar;50(3):209-14. doi: 10.1177/1060028015622031. PMID: 26690460.
* Jalanka J, Vapaatalo H, Salminen S, et al. Psyllium fibre in metabolic diseases and gastrointestinal disorders: a narrative review. Nutr Rev. 2023 Nov 2;81(11):1538-1550. doi: 10.1093/nutrit/nuad042. PMID: 37190038.
* Lambeau KV, McRorie JW Jr. Fiber supplements and clinically proven health benefits: How to recognize and recommend an effective fiber therapy. J Am Assoc Nurse Pract. 2017 Apr;29(4):S5-S16. doi: 10.1002/2327-6924.12447. PMID: 28436215.
* McRorie JW Jr, Fahey GC Jr. Psyllium: a useful therapeutic tool? Clin Exp Gastroenterol. 2017 Apr 26;10:111-125. doi: 10.2147/CEG.S134421. PMID: 28458513.
* Zarros A, Pousti R, Faghih H, et al. Psyllium Husk-Fiber Supplement and Its Health Benefits. J Diet Suppl. 2023;20(4):427-447. doi: 10.1080/19390211.2023.2173499. PMID: 36725225.
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