What are the differential diagnoses for greenish stool (feces)?

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Differential Diagnosis for Greenish Stool

  • Single Most Likely Diagnosis
    • Bile salt malabsorption: This condition is characterized by the inability of the small intestine to properly absorb bile salts, leading to an excess of bile in the stool, which can cause a greenish color. This is often seen in conditions like celiac disease, bacterial overgrowth, or Crohn's disease affecting the terminal ileum.
  • Other Likely Diagnoses
    • Viral gastroenteritis: Certain viruses can cause inflammation of the gastrointestinal tract, leading to changes in stool color, including greenish stools, due to the rapid transit of stool through the intestines and the presence of bile.
    • Food intake (e.g., green vegetables, food coloring): Consuming large amounts of green-colored foods or substances can temporarily change the color of the stool to green.
    • Giardiasis: An infection caused by the Giardia parasite can lead to malabsorption and changes in stool appearance, including greenish color.
  • Do Not Miss Diagnoses
    • Intussusception: Although rare in adults, this condition, where a part of the intestine slides into an adjacent part, can cause bowel obstruction and lead to changes in stool color, including greenish stools, due to the presence of bile and potential for ischemia.
    • Mesenteric ischemia: Reduced blood flow to the intestines can cause ischemia, leading to changes in bowel habits, including greenish stools, due to the release of bile and potential necrosis of the intestinal tissue.
  • Rare Diagnoses
    • Pseudomembranous colitis: Caused by Clostridioides difficile infection, this condition can lead to inflammation of the colon and changes in stool, including greenish color, though it's more commonly associated with diarrhea and abdominal pain.
    • Hirschsprung's disease (in children): A congenital condition characterized by the absence of ganglion cells in the distal bowel, leading to obstruction and potential changes in stool color, including greenish stools, due to the buildup of bile and intestinal contents.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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