Yellow diarrhea: Causes Simplified By a Gut Doctor.

✅ Evidence-Based.

✅ By Dr. Farahat.

0- Yellow diarrhea: FAQ & Summary

 

Q1: What is the difference between yellow diarrhea and yellow stool?

A: Yellow diarrhea is different from yellow stools. Yellow diarrhea doesn’t only mean your stool is yellow, but also it means that you have frequent loose or watery stools (diarrhea).

Diarrhea means your poop is loose or watery Plus you have three or more loose stool motions per day.

“Generally speaking, Any severe diarrhea can lead to yellowish stool because of diarrhea itself. As your poop passes quickly through your colon before it acquires its normal brown color”.

Q2: What are the most common causes of yellow diarrhea? 

A: Our favorite scheme for yellow diarrhea is the time frame in which diarrhea happened:

1- Acute yellow diarrhea: .

  • Indigestion of a large fatty meal.
  • A gut infection with a protozoan called Giardia.
  • Stomach flu (viral Gastroenteritis). 
  • Other types of gastroenteritis or food poisoning.
  • Stress/Anxiety situations.
  • Recent Use of Medications.
  • Acute Hepatitis A (especially in children).
  • Recent binge drinking of alcohol.

 

2- Recurrent Acute yellow diarrhea:

  • Irritable bowel syndrome (especially diarrhea-predominant dominant)
  • Food sensitivities/intolerance.

 

3- Chronic yellow diarrhea:

  • Gall bladder diseases or removal.
  • Celiac disease.
  • Other types of severe food intolerance.
  • Bile Acid Diarrhea (BAD).
  • Chronic liver diseases/ liver Failure.
  • Chronic pancreatitis/Exocrine Pancreatic insufficiency. 

Q3: Why is my diarrhea yellow? .

A: Your stool Acquires its brown color for the breakdown of a substance called bilirubin inside your colon   . So, yellow diarrhea occurs due to either:

  • Not enough time for stool inside your colon to acquire its brown color: This means any form of severe diarrhea (regardless of its cause) can lead to yellow stool or diarrhea.
  • More fat in your stool: fat is yellowish in color, the presence of more fat can be due to either
    • More fat intake: as with the ingestion of large fatty meals.
    • Defective fat absorption: any condition that causes fat malabsorption leads to more fat in the stool. This is predominant with gallbladder, liver, pancreatic diseases, or bile acid diarrhea.
  • Yellowish foods: foods containing yellow pigments can lead to yellow stools.
  • High amounts of bilirubin: beyond the capacity of your colon to turn it into its brownish end-product. This is especially common with gilbert syndrome that affects 3 to 5% of people worldwide

Q4: When to see a doctor for your yellow diarrhea?

A: not all yellow diarrheas are something dangerous. A single attack of yellow diarrhea lasts for a day or a few days and is usually not a cause of concern. But you have to see a doctor if Your yellow diarrhea is:

  • Chronic or recurrent over a long period and you don’t have sufficient explanation or diagnosis.
  • Bloody stools / blackish stools.
  • Pus-filled stools.
  • Severe intolerable abdominal pain/ persistent vomiting.
  • High-grade fever.
  • Chronic diarrhea with weight loss.
  • Signs of dehydration: difficulty breathing, confusion, loss of consciousness, inability to urinate.
  • Acute diarrhea not responding to usual treatments for more than 3 days.

yellow diarrhea

1- Causes of Acute Yellow diarrhea: 

A- Large Fatty Meals/ Indigestion: 

Eating too much fat in a single meal may lead to trouble absorbing such amount. This leads to the passage of undigested fat into your stool causing an acute attack of yellow diarrhea after the fatty meal.

Symptoms:

  • Suspect if your yellow diarrhea started shortly after the ingestion of a high-fat meal.
  • The diarrhea is greasy, yellowish to grey in color.
  • No or mild abdominal cramps. 
  • Nausea may occur from the high-fat content inside your stomach, but usually no vomiting.
  • Lasts for a few hours to a maximum of 2 days and usually resolves spontaneously.
  • NOT associated with: fever, severe abdominal cramps, vomiting, mucus, nor bloody stool.

How to deal: 

  • If you are sure your diarrhea is related to fatty meals, then you have to decrease the amount of fat you eat.
  • Don’t cut fats completely, just eat fewer amounts.
  • Avoid or limit the use of unhealthy (saturated) fats such as:
    • Animal proteins are rich in fats.
    • Processed junk foods.
  • Try to shift to healthy (unsaturated) fat: 
    • Nuts and seeds.
    • Seafood and fish.
    • Olive oil.
    • Avocado.
  • See a doctor if you get yellow diarrhea after ingesting smaller amounts of fat. This is maybe a reflection of another problem such as bile acid diarrhea, gallbladder, or pancreatic diseases.

Learn more from this article: Diarrhea after eating fatty foods.

B- Acute Gastroenteritis/food poisoning. 

Acute gastroenteritis is an infection of your intestines and stomach. Acute gastroenteritis causes yellow diarrhea by speeding up the passage of colon contents or by hindering fat absorption (especially with giardiasis).

The most common cause of gastroenteritis is Viral gastroenteritis (about 60%) from all case of acute diarrhea are due to stomach viruses such as:

  • Noroviruses.
  • Rotavirus.
  • Astrovirus (less common).

Bacteria are the second most common cause of acute diarrhea, also parasites especially giardiasis can lead to yellow diarrhea with foul-smelling, greasy stool.

Symptoms:

  • Diarrhea: bright brown or yellow diarrhea. May be greasy and foul-smelling with giardiasis.
  • Onset & Duration: usually acute, lasts for 1 to 4 days.
  • Fever: may be present, but it is usually low-grade. May be high with bacterial infections.
  • Nausea & vomiting: usually present, but not severe.
  • loss of appetite (anorexia).
  • Muscle aches and headaches.
  • Abdominal cramps: usually moderate to severe.
  • NOT associated with bloody stools or dysentery.

stomach flu, can cause yellow diarrhea

How to deal?

Yellow diarrhea due to acute gastroenteritis (especially giardiasis) is usually self-limiting conditions within a few days. You just have to:

  • Drink more fluids.
  • Eat frequent small meals and avoid heavy or fatty meals.
  • Try to eat bland foods (BRAT): Bananas,  Rice, Applesauce, and Toast.
  • Try to avoid: fats, caffeine, sugary foods, dairy, and alcohol.
  • See a doctor if: your diarrhea lasts for more than 3 days, or you have severe symptoms such as bloody stool, severe dehydration, intolerable abdominal pain, or persistent vomiting.

C- Stress/Anxiety-related diarrhea:

As with any type of diarrhea, speeding up your colon contents can lead to yellowish diarrhea. This speeding up not due to infection nor food intolerance all the time. 

Yellow diarrhea Maybe simple due to anxiety or stress situations such as exams, fears, or any stressful situations. This leads to fear response by your gut leading to attacks of yellow diarrhea

Stress/anxiety-related yellow diarrhea is different from Irritable bowel syndrome, as it occurs occasionally, related to stressful conditions and it is not as frequent as irritable bowel syndrome symptoms. 

It is a normal response from your body and you don’t have to be worried about it. Try to manage your anxiety condition and you will get rid of yellow diarrhea.

Avoid caffeine and alcohol as it may aggravate your yellow diarrhea with stress.

Only see a doctor if:

  • Yellow diarrhea is frequent even with small stressors such as talking to strangers or with usually daily work stress.
  • Diarrhea lasts a long time (days or weeks).
  • Any abnormal symptoms such as fever, vomiting, intolerable abdominal pain.

Learn more: anxiety as a cause of yellow stool.

D- Alcohol drinking may also cause yellow diarrhea.

Yellow diarrhea may be simply due to faulty drinking habits. But it is worse mentioning that in some persons, even small amounts of alcohol can cause yellow diarrhea. As alcohol irritates your digestive tract and speeds up things inside your intestines and colon

Another long term problem of alcohol is that it can affect your liver and pancreas. Chronic liver diseases or chronic pancreatic insufficiency can lead to yellow diarrhea.

If your yellow diarrhea often starts after drinking alcohol, especially with larger amounts, you have to stop it at all or restrict the amount you drink.

E- Some medications can cause Yellow diarrhea.

A good question to ask yourself, is there any recent medication intake before the onset of your yellow diarrhea? More than 700 drugs are linked to diarrhea . Some of them are extremely common in households and over-the-counter.

Most commonly, Laxatives, antibiotics, metformin, and drugs used to treat heartburn and gastritis.

1- Laxative overdose. 

They include: 

  • Lactulose-containing laxatives.
  • Docusate sodium.
  • Magnesium Oral solutions and magnesium-containing laxatives.

They can cause yellow diarrhea if taken in large doses. As they can speed up your intestines or draw water from your blood into your colon. 

Also, note that some Magnesium containing supplements that are not intended to be laxative can cause yellow diarrhea as a side effect. Always check your medications for magnesium.

Learn more Here

2- Antibiotics that can cause yellow diarrhea.

Many antibiotics can cause diarrhea as a side effect, and it can be:

  • Mild self-limiting loose stool.
  • Moderate to severe diarrhea that lasts for days (which is usually yellow diarrhea).
  • Severe bloody diarrhea (severe colitis).

The most common antibiotics that can cause yellow diarrhea:

  • Cephalosporins: such as ceftriaxone, cephalexin.
  • Penicillins as amoxicillin and ampicillin.
  • Clindamycin.

How to suspect antibiotic-associated diarrhea?

  • If you have a recent history of taking antibiotics prior to the onset of yellow diarrhea.
  • If you have a previous history of antibiotic-associated diarrhea.
  • If you are taking more than one antibiotic at the same time, it will increase the odds of yellow diarrhea.
  • Taking antibiotics for a long period (more than 2 weeks).

3- Recent Use of anti-Diabetes Mellitus drugs.

Some anti-diabetes drugs can lead to GIT disturbances and consequently yellow diarrhea. The most common medication to cause diarrhea is Metformin. 

Metformin is a very common anti-diabetes medication that is widely prescribed by doctors. So if you have a recent history of metformin intake, consult your doctor about the medications. 

And also not that Metformin can present in combination with other anti-diabetes medications under different names. Always consult your doctor about your anti-diabetes medication if you experience gut problems or yellow diarrhea.

4- Gastritis & GERD yellow stool is usually due to medications.

If you have Gastritis or GERD, you may experience yellow diarrhea. This occurs mainly not because of GERD itself But due to the medication you use.

These medications can decrease the acidity of your stomach. Decreased acidity can lead to the overgrowth of unwanted bacteria and organisms inside your intestine and colon. So, the chronic use of GERD and anti-ulcer medications can lead to yellow diarrhea. 

Common GERD medications that cause yellow diarrhea include:

  • Proton Pump Inhibitors: such as Esomeprazole (Nexium ®), Pantoprazole (Protonix ®), Omeprazole (Prilosec ®).
  • H2 Blockers: such as Famotidine, Ranitidine (Zantac ®) 

IMPORTANT NOTICE:

GERD and Yellow diarrhea are not solely attributed to medications. Another connection found between GERD and Yellow diarrhea is Psycnic stress such as anxiety and depression .

Usually, people with psychic stress or complaining from certain psychiatric diseases such as anxiety will have multiple functional GI diseases at the same time such as GERD, Chronic/recurrent diarrhea (maybe yellow), IBS, functional dyspepsia, and other.

5- Other Medications that can cause yellow diarrhea: 

  • Chemotherapy (anticancer medications).
  • Immunosuppressive drugs: such as Mycophenolate. Immunosuppressives used in people with auto-immune disorders such as systemic lupus, Rheumatoid Arthritis, Idiopathic Thrombocytopenic Purpura.
  • Others: for the complete list of medications that can cause yellow diarrhea, click  HERE and HERE.

F- Acute Hepatitis A .

Another cause of yellow diarrhea is the hepatitis A virus infection. It is a relatively common infection especially in third world countries, especially among children .

Hepatitis A usually causes yellow diarrhea, but it has a more distinctive feature which is jaundice (yellowish discoloration of skin and sclera).

It is acquired via the fecal-oral route by ingesting contaminated foods or drinks (considered one of the causes of food poisoning). And it is usually associated with:

  • Yellow diarrhea, jaundice.
  • Low-grade fever.
  • Abdominal colics.
  • Nausea and vomiting.

If you have jaundice or you suspect hepatitis A virus infection, consult your doctor immediately. 

2- Recurrent attacks of Yellow diarrhea.

A- Irritable Bowel syndrome.

Irritable bowel syndrome is a very common medical condition that affects 10-15% of people worldwide. A large subset of IBS patients may have IBS-predominant diarrhea .

It is OK for you if you are an IBS sufferer to experience yellow diarrhea during IBS flare-ups. No need to worry about your IBS yellow diarrhea as long as it comes and goes without any warning signs.

To have IBS, you must experience Recurrent abdominal pain at least one day per week for the last 3 months with symptoms onset more than 6 months. 

Your IBS may be diarrhea-predominant, constipation-predominant, mixed, or unspecified type. If are already have IBS with diarrhea or mixed type, you may experience watery diarrhea now and then and it is normal with your IBS.

But if you experience recurrent attacks of yellow diarrhea and you suspect IBS, you should consult your doctor to confirm the diagnosis of your IBS, and until this happens, you can learn about How is IBS diagnosed in this interesting article.

irritable bowel syndrome

B- Food allergy/food intolerance.

Food allergy and food intolerance are very common conditions and over-looked by many doctors and patients. A large subset of people who are diagnosed with IBS may have underlying food intolerance causing their IBS-like symptoms.

The most common symptoms of food intolerance are diarrhea with can be yellow diarrhea. In the table below, you can learn about the difference between food intolerance and food allergy.

Food intolerance

Food allergy

Affects 15-20% of the population

Affects nearly 2-5% of adults

Difficulty digesting certain types of food (not immune-mediated allergy). 

An immune-mediated reaction to certain foods or food components.

Causes “recurrent acute” or “chronic” attacks of diarrhea (which can be yellow diarrhea).

Usually causes acute attacks related to the ingestion of offending food. It also can cause yellow diarrhea.

Intestinal symptoms: diarrhea, extensive gas, bloating, and abdominal pain

Intestinal symptoms are the same

No extra-intestinal symptoms

Extraintestinal symptoms like rashes, urticaria, swollen lips or face or severe life-threatening allergic reactions.

The severity of your symptoms is proportional to the amount you eat from the offending food.

Even trace amounts of the offending food can produce severe symptoms.

Common offending foods:

  • Lactose intolerance (dairy products).
  • Fructose malabsorption.
  • Alcohol intolerance.
  • FODMAP intolerance (as with People with IBS).

Common offending foods: (examples)

  • Raw meat, seafood.
  • Nuts, peanut
  • Mustard.
  • Rice
  • Some vegetables and fruits.

 

3- Causes of chronic Yellow diarrhea.

If you came here searching for a cause of your yellow stool, mostly you are experiencing either acute or recurrent attacks. However, yellow diarrhea can be chronic. This “chronic” form of yellow diarrhea is usually due to chronic disease or organ malfunction. 

And it will be always associated with more significant symptoms such as Jaundice, chronic abdominal pain, or history of gallbladder stones.

The causes enlisted here cause chronic yellow diarrhea.if you already know you have any of the below conditions, then it will be the cause of your yellow diarrhea.

A- Gallbladder diseases/Stones:

Many gallbladder conditions can lead to yellow diarrhea, such as:

  • Non-calcular Cholecystitis: inflammation of your gallbladder without stones inside it.
  • Calcular Cholecystitis: inflammation due to gallstones?
  • Gallbladder sludge
  • Gall bladder removal.
  • Other rare gallbladder diseases such as biliary atresia, primary biliary cholangitis.

Symptoms suggesting gallbladder disease:

  • Pain in the upper right quadrant of your abdomen.
  • chronic or recurrent attacks of yellow diarrhea or greasy stools (especially occurs after the ingestion of high-fat meals)
  • Nausea, or vomiting. 

If you had your gallbladder removed, you may experience some yellow diarrhea. But if you don’t know if you have any gallbladder problems or not, please consult your doctor especially if you experience any of the symptoms mentioned above.

The key to avoiding gallbladder/post-cholecystectomy yellow diarrhea is to avoid fatty meals.

gallbladder related diarrhea

B- Celiac Disease.

The typical form of celiac disease is severe chronic diarrhea associated with anemia and weight loss. Its due sensitivity to a protein called “gluten” present in wheat and barley.

Usually, it presents in early childhood, with chronic severe diarrhea (which can be yellow) related to wheat-based foods. 

The main treatment relies on cutting all gluten from food and eating a gluten-free diet.

Learn more about celiac disease.

C- Inflammatory Bowel disease (Crohn’s and Ulcerative Colitis).

Also, this disorder doesn’t cause simple yellow diarrhea, as the condition is more chronic and severe and may be associated with Mucus and blood in the stool, severe abdominal pain, and weight loss.

Learn more about Inflammatory bowel disease.

D- Bile Acid Diarrhea.

Another underestimated medical condition associated with defective bile reabsorption by your intestines. The bile secreted into your intestine remains inside and traps water and leads to chronic yellow diarrhea. 

Symptoms:

  • Yellow/Golden diarrhea: especially after eating fatty meals.
  • Severe Urgency to poop: which may lead to stool leakage especially in older ages.
  • More frequent in obese people.
  • Bloating and indigestion present in many people with BAD (Bile Acid Diarrhea).

Bile acid diarrhea is a chronic condition that requires intervention from your doctor to reliably diagnose and treat it.