Normal stool is usually brown or yellowish in color. This color is imparted to feces by bilirubin and iron that occur in high levels in stool. The yellowish-orange colored bilirubin occurs in the bowels and gets passed to feces when it passes through it.

Causes of Orange colored stool

Orange colored stool may occur due to a variety of causes. Some of the common ones are listed below.

1. Deficiencies in bile salts

The normal color of feces is given to it by bile salts that are naturally greenish-yellow in color. Bile combines with the enzymes present in the digestive tract and the resultant reaction is what makes stool yellow or brown in color. Thus, when bile salts are present in low amounts, or when the digested food cannot efficient mix with bile, then it can result in anomalies of feces color such as orange colored stool. Deficiency of bile salts may occur due to many causes, including,

• Deficient secretion of bile by the liver. This can occur due to varied liver diseases such as liver cirrhosis, hepatitis, liver scarring due to alcohol abuse, and other kinds of liver damage. These conditions may not only lower bile production but can also cause faster excretion of bile salts from the bowels and body. The combined effects may be marked by orange colored stool as well as other symptoms like ascites, jaundice, and widespread itching.
• Bile duct obstructions that restrict the free flow of bile from the liver and the gallbladder to the intestines. Blockages of the bile duct can arise due to conditions like gallstones, inflammation, tumors, and/or cysts. Gallstones develop from the fluid that is produced by the gallbladder.
• Presence of gallstones, cysts, etc., can also cause lowered bile absorption, deficient mixing of bile salts with stool, or decreased bile use by facilitating the rapid passage of bile across the bowels. This can then cause orange colored stools. Such rapid bile flow across the intestines can be observed in patients of SBS, Crohn’s disease, diarrhea, and IBS, etc.
• Gastroesophageal reflux disease, also known as GERD, is a digestive ailment wherein patients experience the reverse flow of digestive enzymes, stomach acid, and other juices from the stomach up to the esophagus and the throat. This can result in low levels of bile in the bowels, thereby preventing the mixture bile salts and digested food and causing orange colored stool. People with GERD may also experience symptoms like chest pain, sore throat, heartburn, and increased coughing, etc.

2. Certain types of Foods

• Eating foods that have excessive orange coloring can result in orange colored stools.
• Daily intake of certain foods, particularly foods with vitamin A or beta carotene, can result in orange colored stool. Some common foods with vitamin A or beta carotene are spinach, kale, fresh thyme, winter squash, carrots, cilantro, pumpkins, sweet potatoes, apricots, turnip greens, and collard greens.
• Foods with preservatives like carbonated drinks, jellies, sodas, junk foods, and artificial fruit juices, etc. contain artificial colorants. It is not possible for the body to absorb such artificial colorings and they get removed from the body along with the feces. Thus, increased intake of preserved food can result in orange colored stool.
• Escolar is a kind of fish that has excessive amounts of fat. It is known to have a digestive problem wherein the body cannot digest the waxes that are eaten by it as part of its normal daily diet. This wax is stored in the body in the form of oil. It is why the fish is so sticky to eat. The human body also does not have the ability to digest the fat from the fish. Hence, it gets eliminated from the body and causes orange colored stool.

3. Parasitic and other kinds of infections

• Certain kinds of harmless bacteria present in the body may also cause orange feces. They do not cause any other symptoms besides stool color changes.
• Infections by varied parasites can also result in orange colored stool. Associated illnesses are usually marked by nausea, vomiting, and/or diarrhea.

4. Medications and supplements

• Use of medicines with beta carotene, or antacids, or aluminum hydroxide containing medications can also cause orange colored stool.
• Another cause of orange feces is the intake of beta carotene or vitamin A supplements.

5. Other factors

• The use of varied diagnostic tests like CT scans, MRIs, or Nuclear Meds study can result in temporary remnants of dyes and contrasts which can then cause short term changes to stool color.
• Presence of conditions like fissures, piles, or hemorrhoids can cause stool to become orange during constipation.
• Cytotoxin and other such toxins which are administered during chemotherapy can also cause orange colored stool or feces of other colors.

Treatment of orange stool is dependent on the underlying cause. Minor or short term cases can be resolved with home remedies and diet changes. Patients must seek medical attention if orange colored stool persists and/or if it is accompanied by symptoms like vomiting, diarrhea, nausea, weakness, dizziness, and constipation, etc.