Differential Diagnosis for Grey Stools
- Single most likely diagnosis
- Biliary obstruction: This is the most likely diagnosis because grey stools are often associated with a lack of bile pigments, which are responsible for the normal brown color of stool. Biliary obstruction can prevent bile from reaching the intestines, resulting in grey or clay-colored stools.
- Other Likely diagnoses
- Pancreatic insufficiency: This condition can lead to malabsorption of fats and fat-soluble vitamins, resulting in pale or grey stools.
- Liver disease: Certain liver conditions, such as cirrhosis or liver failure, can affect bile production and result in grey stools.
- Medication side effects: Some medications, such as antacids or antibiotics, can cause changes in stool color, including grey stools.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Hemorrhage: Although less likely, a massive gastrointestinal hemorrhage can cause grey or black stools (melena) due to the digestion of blood.
- Intestinal ischemia: Reduced blood flow to the intestines can cause changes in stool color, including grey stools, and is a medical emergency.
- Rare diagnoses
- Gilbert's syndrome: A rare genetic disorder that affects the liver's ability to process bilirubin, resulting in pale or grey stools.
- Dubin-Johnson syndrome: A rare genetic disorder that affects the liver's ability to transport bilirubin, resulting in chronic jaundice and grey stools.
- Primary biliary cirrhosis: A rare autoimmune disease that affects the bile ducts and can cause changes in stool color, including grey stools.