Fundamentals of Nursing Q 483

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Clay-colored stools indicate:

  

     A. Upper GI bleeding

     B. Impending constipation

     C. An effect of medication

     D. Bile obstruction

    

    

Correct Answer: D. Bile obstruction

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Bile colors the stool brown. Any inflammation or obstruction that impairs bile flow will affect the stool pigment, yielding light, clay-colored stool. The liver releases bile salts into the stool, giving it a normal brown color. One may have clay-colored stools if they have a liver infection that reduces bile production, or if the flow of bile out of the liver is blocked. Yellow skin (jaundice) often occurs with clay-colored stools.

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Option A: Upper GI bleeding results in black or tarry stool. Melena is a black, tarry stool that is caused by GI bleeding. The black color is due to the oxidation of blood hemoglobin during the bleeding in the ileum and colon. Melena also refers to stools or vomit stained black by blood pigment or dark blood products and may indicate upper GI bleeding.

Option B: Constipation is characterized by small, hard masses. The problem may arise in the colon or rectum or it may be due to an external cause. In most people, slow colonic motility that occurs after years of laxative abuse is the problem. In a few patients, the cause may be related to an outlet obstruction like rectal prolapse or a rectocele. External causes of constipation may include poor dietary habits, lack of fluid intake, overuse of certain medications, an endocrine problem like hypothyroidism or some type of an emotional issue.

Option C: Many medications and foods will discolor stool – for example, drugs containing iron turn stool black; beets turn stool red. Blue feces may be caused by boric acid, chloramphenicol, or methylene blue. Causative diseases for clay feces may include alcoholic hepatitis, biliary cirrhosis, gallstones, sclerosing cholangitis, biliary strictures, or viral hepatitis. Causative medications for gray feces may include cocoa or colchicines. Potential causes for green stools may include spinach, Indomethacin, iron, or medroxyprogesterone.

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