Are These Stools Acholic?
Discussion
Color can be difficult to discern and communicate. Stooling is an important part of overall health and an important harbinger of potential illness. Stooling consistency and color changes with food, environment, medication, and health conditions.
For neonates and young infants, some hepatobiliary problems may not be seen at birth but in the next few days to weeks. This includes Alagille syndrome, biliary atresia and cystic fibrosis. It is not uncommon for these patients to have prolonged jaundice and therefore the diagnosis may be delayed with some presenting with increased jaundice, acholic stool and poor feeding. In older children causes of white/pale/clay-colored/grey stool may be easier to determine. Patients with underlying health problems usually have a different history (i.e. potential infectious hepatitis or medication exposure, increasing scleral icterus, poor eating, fever, etc.) and usually different physical examination. For a well-appearing child without concerning history or physical examination findings, the most common cause is a misperception or reporting of the change.
The differential diagnosis of acholic stools includes:
Biliary disease
Liver
Alagille syndrome
Biliary atresia
Cystic fibrosis
Cirrhosis, end-stage liver disease
Infectious hepatitis
Drug-induced hepatitis
Tumors
Gallbladder
Anatomical problems
Biliary stricture
Gallstones
Sclerosing cholangitis
Tumors
Pancreas
Pancreatitis
Tumor
Foreign bodies – crayons, paint, to...
Source: PediatricEducation.org - Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
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