Dr. I. Farahat
10/04/2023
Yellow Watery Stool: Common Causes And Treatments
Our content is not intended nor recommended as a substitute for medical advice by your doctor. Use for informational purposes only.
Quick Insights:
- Usually, A single or few attacks of yellow watery stools are of little concern, they’re due to food or stress.
- Consult your doctor Only if :
- The yellow watery stool is persistent or prolonged for more than 3 days.
- Associated severe symptoms such as fever, dehydration, severe abdominal pain.
- Answering your question about what caused your stool to be watery and yellow depends on the time frame of this stool change: [ref]
- Acute onset: for a day or a few days.
- Persistent or chronic watery stools: all or most of your stool motions are watery and yellow for weeks or months.
- Intermittent attacks: you get attacks of watery yellow stools now and then, and your stool between attacks is normal.
- Also, defining the cause of yellow watery stool depends on other associated symptoms and your existing medical conditions or medications, for example:
- Irritable bowel syndrome with diarrhea may cause yellow watery stool.
- If yellow diarrhea is associated with fever and stomach cramps, the condition is mostly due to infection with gut bugs (stomach flu).
- Some other chronic gut conditions may cause yellow watery stools such as bile acid diarrhea, gallbladder, and liver diseases.
- Alcohol and food intolerance may also play a role.
- More fat (such as large fatty meals) or bile can cause yellow watery stools.
We will discuss the most common causes of yellow watery stools in detail. Read carefully to learn how to suspect and how to deal with such conditions according to the specific causes.
Summary of causes of yellow watery stools:
The pattern of watery yellow stools | Possible causes. |
Acute attacks of bright yellow watery stool:
| 1- infections (viral, bacterial, protozoa). 2- recent medication use such as laxatives, antibiotics, or metformin. 3- food intolerance or allergy. 4- stress-related diarrhea. 5- a large fatty meal & other foods causing yellow stool. |
| Intermittent or recurrent attacks of watery yellow stools: | 1- irritable bowel syndrome. 2- food intolerance or medications are also a cause. |
| persistent or chronic watery yellow stools for weeks, months, or years: | Usually associated with chronic medical conditions: 1- celiac disease. 2- other severe types of food intolerance. 3- Bile acid Diarrhea. 4- gallbladder, liver, or pancreatic diseases. 5- Inflammatory bowel disorders (Crohn’s & Ulcerative Colitis). |
1- Ingestion of a large fatty meal.
Fat needs a longer time to be digested. Eating too much fat in a single meal can lead to trouble absorbing such an amount. This leads to the passage of the undigested fat into your stool causing yellow (or pale) stool. and also it may lead to diarrhea. [source]
We discussed this issue in-depth here.
How to suspect?
- If your watery yellow poop started after ingesting a large fatty meal or is recurrent every time you eat too much fat.
- The condition may be associated with mild cramps, but no signs of infections such as intense abdominal pain or fever.
- It is usually self-limiting after you stop eating too much fat.
How to deal?
You DON’T have to stop eating fats completely. Just decrease the amount you eat and shift to the more healthy unsaturated fats present in:
- Seafood, fish.
- Olive oil
- Avocado.
- Nuts and seeds.
And try to limit the use of saturated (unhealthy) fats such as:
- Processed junk foods.
- Animal proteins are rich in fats.
Learn more from this article: Diarrhea after eating fatty foods.
2- Stress & anxiety can cause loose or watery stool.
Anxiety is very common. In the USA, the National Institue of Mental health (NIMH) states that anxiety affects approximately 18% of the population [ref].
Besides anxiety, there is another common cause of acute attacks or intermittent attacks is stress. When you got anxiety or become stressed, your stress hormones increase and your brain sends signals to your gut. This results in speeding up or motility of your colon.
Speeding up of colon contents leads to watery and yellow stool. Suspect if your stool changes are almost always related to stressful conditions or times such as exam days.
How to deal?
If your condition is mild, no need for seeking medical help and it will improve once the stressor goes away.
Anxiety is different from stress, and it means a continuous feeling of worries and uneasiness despite the absence of actual external stressors.
If you suspect having anxiety, consult your doctor or psychologist, as it may be the cause of your yellow watery stool.
3- Infection (gastroenteritis, stomach flu), a common cause of an ACUTE attack of watery yellow stool.
Infection with gut viruses, bacteria, or protozoa can cause acute yellow diarrhea. The condition is usually short for a few days. [ref]
A special protozoal infection is famous with yellow watery stool is Giardia lamblia.
How to suspect?
- Acute onset of severe abdominal pain (attacks of intense lower abdominal colics).
- Diarrhea (which may be yellow and watery) is usually more severe, regardless of meals.
- Nausea and vomiting may be present.
- Fever and chills can also occur.
How to deal?
- In most cases, it is mild & self-limiting disease, just drink plenty of fluids and eat small frequent meals.
- Try to eat bland foods (BRAT foods): bananas, potatoes, rice, applesauce, toast.
- Avoid foods that may cause stomachs upset such as caffeine, fatty or sugary foods.
- See your doctor if:
- Fever is high-grade.
- Bloody diarrhea.
- If you have other medical conditions such as HIV or diabetes.
- Signs of dehydration such as thirst, dry mouth, decreased urine, lethargy, or confusion.
- Too old people or too young infants should see a doctor.
Learn more about stomach flu [source1], [source2]
4- Foods that can trigger yellow watery stool (food intolerance or yellow foods)
Food intolerance is very common. It affects up to 20% of people. And it can lead to diarrhea or loose watery stool after infection of the offending food. Also, a food allergy can lead to the same condition. [ref]
The differences and the offending foods that can cause yellow watery stool are enlisted in the table below.
Consult your doctor if you suspect your watery yellow stool is related to certain foods from the below list.
| 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. |
| It causes “recurrent acute” or “chronic” attacks of diarrhea or watery stool (which can be yellow). | Usually causes acute attacks related to the ingestion of offending food. |
| 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:
| Common offending foods: (examples)
|
BONUS: Some other foods may cause yellow stool (not watery) because of their yellow color, such as:
- Sweet potatoes.
- Carrots.
- Tumeric.
- Other yellow pigment-containing foods.
5- Medications that may cause yellow loose stools or diarrhea.
More than 700 drugs can lead to diarrhea [Ref]. the more severe diarrhea becomes, the more watery and yellowish is your stool.
Common medications that may lead to watery loose stools or diarrhea:
- Laxatives: especially if abused in large doses. Examples include senna, docusate sodium, and lactulose.
- Magnesium-containing supplements and laxatives.
- Some antibiotics such as penicillins, clindamycin, cephalosporins & others.
- Metformin: a very common anti-diabetes drug.
- Chemotherapy.
- Immunosuppressive drugs such as mycophenolate.
- Gastritis and GERD mediations: such as proton pump inhibitors and H2 blockers: Esomeprazole (Nexium ®), Pantoprazole (Protonix ®), Omeprazole (Prilosec ®), and ranitidine (Zantac ®).
This is NOT a complete list of drugs causing diarrhea. Learn more here and here.
Consult your doctor if you recently used any medications before the onset of watery yellow stools.
6- Irritable bowel syndrome, diarrhea attacks.
Irritable bowel syndrome is a chronic functional GI condition. The main feature of IBS is recurrent abdominal pain that is associated with defecation and stool changes.
IBS affects about 15% of the population, many people don’t know they have irritable bowel syndrome. Diarrhea predominant IBS flareups can lead to yellow watery stool.
The infographic below shows you how to suspect the presence of irritable bowel syndrome. You can also learn how is IBS diagnosed here.
Also, we previously discussed the causes of IBS yellow stool, check the article here to learn more.
If you suspect the presence of IBS, consult your doctor to confirm the condition.
If you are already diagnosed as an IBS patient, you can learn about the most effective strategies to control your IBS here.
7- Other medical conditions [less common, lead to Persistent or chronic watery stools or diarrhea].
Celiac disease.
Celiac disease is a chronic gut condition characterized by inflammation of your gut lining. It occurs due to sensitivity to a protein called “Gluten” present in wheat and rye.
Symptoms include:
- Chronic diarrhea.
- Abdominal cramps.
- Anemia, easy fatigue.
- May be associated with other autoimmune problems such as autoimmune thyroiditis or type one diabetes.
Suspect celiac disease if you persistently have diarrhea or other symptoms enlisted above. Also, if you have one of your first or second-degree relatives with celiac disease if increases the odds of getting celiac disease.
Treatment usually relies mainly on restricting gluten in the diet and going entirely on a gluten-free diet.
Bile acid diarrhea.
- A relatively common and under-diagnosed condition. [ref]
- Caused by problems in the processing of secreted bile acid inside your intestine leading to diarrhea.
- It usually occurs after eating fatty foods usually associated with severe urgency and soiling accidents.
- Diagnosis is quite difficult, treatment by a bile acid binder drug called cholestyramine may improve the condition.
Gallbladder problems.
According to Dr. Michael from mayoclinic.org, watery yellow diarrhea can occur in up to 20% of people undergoing gallbladder surgery. It is usually self-limiting, mild (usually after meals). In certain patients, it may last for years. [ref].
Also, chronic gallbladder inflammation or gallstones can lead to recurrent watery yellow stools.
If you have a cholecystectomy operation or experiencing symptoms of cholecystitis (right hypochondrial pain, nausea) please consult your doctor.
Liver problems.
People with acute or chronic liver conditions have problems handling the yellow pigment bilirubin. Excess bilirubin in blood or stool may lead to yellow watery stools.
These liver problems may include:
- Acute hepatitis: such as Hepatitis A virus.
- Chronic Hepatitis: as with chronic alcoholism or Non-Alcoholic Steatohepatitis.
- Liver cell failure: post-hepatitis.
- A common genetic condition that affects more than 5% of the population is called gilbert syndrome. [learn more]
Pancreatic problems.
Acute or chronic pancreatic diseases leading to its inflammation may lead to watery and yellow stool. Destruction of pancreatic tissue leads to defective production of its digestive enzymes that help digestion of fats, carbohydrates, and proteins.
The deficiency of these enzymes leads to malabsorption (mainly fat malabsorption) causing yellow watery stool.
Diarrhea due to pancreatic insufficiency is usually late, and the destruction of more than 90% of pancreatic tissue is needed to result in yellow watery diarrhea [ref].
Also, the condition is associated with chronic pain in the upper part of your abdomen. Consult your doctor if you suspect or have a history of any pancreatic issues.
Inflammatory Bowel Disease (IBD)
Inflammatory bowel disease is a chronic condition characterized by:
- Chronic diarrhea with watery yellow or reddish (bloody) stool.
- Chronic abdominal pain.
- Weight loss and fever may occur.
It is due to inflammation and ulceration of your colon (ulcerative colitis) or any part of your digestive tract (Crohn’s disease).
Learn more about inflammatory bowel diseases here.
- Evidence-based
- Written by a doctor.
MD, Associate Lecturer of Gastroenterology and hepatology. An IBS sufferer, gut health enthusiast and writer.
Dr. I. Farahat
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