From the Guidelines
Green and pasty stools in toddlers are most likely caused by dietary factors, particularly the consumption of excessive fruit juice, which can lead to malabsorption of carbohydrates and an osmotic load in the gastrointestinal tract, resulting in diarrhea and altered stool color and consistency. This is supported by a study published in Pediatrics in 2017 1, which found that the malabsorption of carbohydrate in juice, especially when consumed in excessive amounts, can result in chronic diarrhea, flatulence, bloating, and abdominal pain. The study also notes that fructose and sorbitol, commonly found in fruit juices, are particularly implicated in this process.
Some common causes of green and pasty stools in toddlers include:
- Dietary factors, such as consuming green vegetables, food dyes, or iron supplements
- Infections, such as gastroenteritis, which can speed up intestinal transit time and alter stool color and consistency
- Food intolerances, particularly lactose intolerance, which can cause green, loose stools due to improper digestion
- Certain medications, especially antibiotics, which can disrupt gut bacteria and alter stool color and consistency
It's essential to note that while occasional green stools are not usually concerning, parents should monitor for additional symptoms like fever, significant diarrhea, blood in stool, or signs of dehydration. If these occur, or if green stools persist beyond a week, medical evaluation is recommended, as outlined in the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1. Treatment typically involves addressing the underlying cause, whether through dietary adjustments, probiotics to restore gut flora after antibiotics, or medical intervention for infections.
From the Research
Causes of Green and Pasty Stools in Toddlers
- Gastrointestinal infections, viral and bacterial, can cause changes in stool color and consistency, including green and pasty stools 2.
- Acute diarrhea, which is common in children under five years of age, can also lead to changes in stool appearance 2.
- The use of antibiotics can disrupt the balance of gut bacteria, potentially causing changes in stool color and consistency, including green and pasty stools 3, 4.
- Probiotics, which are nonpathogenic microorganisms that exert a positive influence on the health or physiology of the host, may be affected by the conditions of the gastrointestinal tract, potentially impacting their efficacy in toddlers 5.
- Dehydration due to gastroenteritis can also cause changes in stool color and consistency, and is a common cause of dehydration in children 6.
Potential Factors Contributing to Green and Pasty Stools
- Dietary factors, such as the introduction of new foods or changes in feeding habits, may contribute to changes in stool color and consistency.
- Underlying medical conditions, such as gastrointestinal infections or inflammatory bowel disease, may also cause changes in stool appearance.
- The use of probiotic preparations, which can be affected by the conditions of the gastrointestinal tract, may also play a role in changes in stool color and consistency 5.