Questions Your Doctor May Ask - and Why!
During a consultation, your doctor will use various techniques in his assesment of the symptom: Pale stool.
These may include a physical examination or other medical tests.
Your doctor may ask several questions when assessing
your condition. It is important to remember that your consultation is a two-way process and any extra information
you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
- How long have you had the pale stool?
Why: to determine if acute or chronic.
- Have there been any previous episodes of jaundice?
- Past medical history?
Why: some medical conditions may cause obstructive or cholestatic jaundice including gallstones, cancer of the pancreas, cancer of the bile duct, strictures of the bile duct; sclerosing cholangitis is a cause of jaundice and may be associated with ulcerative colitis; Primary biliary cirrhosis may be associated with Sjogren's syndrome, scleroderma and rheumatoid arthritis; Steatorrhea (fatty, pale colored, extremely smelly stools that float in the toilet and are difficult to flush away) is due to excess fat in the stool and are characteristic of malabsorption of nutrients which may be due to celiac disease, chronic pancreatitis, previous gastrectomy and cystic fibrosis.
- Past Surgical history?
Why: e.g. certain anesthetics such as halothane may cause cholestatic jaundice; gastrectomy may cause steatorrhea (fatty, pale colored, extremely smelly stools that float in the toilet and are difficult to flush away due to excess fat in the stool and are characteristic of malabsorption of nutrients).
- Medications?
Why: many medications may cause cholestatic jaundice including isoniazid, methyldopa, halothane, ketoconazole, niacin, nitrofurantoin, disulfiram, rifampin, testosterone, propylthiouracil, oral contraceptives, mercury.
- Dietary history?
Why: e.g. recent consumption of shellfish may suggest Hepatitis a infection that can cause cholestatic jaundice with pale stool.
- Family history?
Why: e.g. Gilbert's syndrome, Dubin-Johnson syndrome, Rotor syndrome.
- Alcohol history?
Why: may suggest risk of alcoholic hepatitis or cirrhosis which may cause cholestatic jaundice with pale stools.
- Intravenous drug use?
Why: increase the risk of hepatitis B and hepatitis C infection that can cause cholestatic jaundice with pale stools.
- Sexual history?
Why: to determine risk of hepatitis B infection that may cause jaundice with pale stools.
- Travel history?
Why: to determine if travel is to areas with an increased risk of Hepatitis A infection, yellow fever, malaria, dengue fever, Ebola virus, Marberg virus.
- Occupational history?
Why: e.g. exposure to hazards or animals (e.g. toxoplasmosis, leptospirosis, Q fever).
- Possible poisoning?
Why: e.g. carbon tetrachloride is a cleaning chemical that causes liver damage if inhaled or swallowed.
Questions your doctor may ask about related symptoms:
Sometimes, other symptoms may be present and may help your doctor analyse
your condition. These may include:
- Symptoms of jaundice?
Why: e.g. yellowing if skin, yellowing of the sclera of the eyes and dark colored urine. If pale stool is present with yellowing of the skin and sclera and dark urine, this suggests obstructive or cholestatic type jaundice such as gallstones, cancer of the pancreas, cancer of the bile duct, strictures of the bile duct, pancreatitis, some medications, recurrent jaundice of pregnancy, sclerosing cholangitis, viral hepatitis, cirrhosis of the liver and alcoholic hepatitis.
- Abdominal pain?
Why: In a person with jaundice and pale stool may suggest common duct stones, sclerosing cholangitis, pancreatic cancer, bile duct cancer, pancreatitis, viral or alcoholic hepatitis.
- Itching of the skin?
Why: If pale stool is present with itching of the skin, this suggests obstructive or cholestatic liver disease such as viral hepatitis, alcoholic hepatitis, recurrent jaundice of pregnancy, primary biliary cirrhosis, common bile duct gallstones, cancer of the bile ducts, cholangitis, pancreatitis, biliary stricture, some medications.
- Weight loss?
Why: If weight loss is associated with jaundice and pale stool may suggest pancreas or bile duct cancer; if weight loss and pale stool without jaundice must consider steatorrhea.
- Diarrhea, and if so what is the nature of the stools?
Why: e.g. fatty, pale colored, extremely smelly stools that float in the toilet and are difficult to flush away is called steatorrhea due to excess fat in the stool and are characteristic of malabsorption of nutrients which may be due to celiac disease, chronic pancreatitis, previous gastrectomy and cystic fibrosis. Pale colored diarrhea stools may also occur with Giardia and viral hepatitis.
- Fever?
Why: In a person with jaundice and pale stool may suggest cholangitis, viral hepatitis, pancreatitis or severe alcoholic hepatitis.
- Fever, right upper quadrant pain or tender liver?
Why: these findings would suggest viral hepatitis, cholecystitis, infectious mononucleosis, leptospirosis, ascending cholangitis, hepatic vein thrombosis and toxic hepatitis.
- Symptoms of primary biliary cirrhosis?
Why: e.g. earliest symptom is itching all over but is most marked on the palms and soles. Later may develop jaundice with pale stools and enlarged liver and spleen.
- Symptoms of Giardia small bowel infection?
Why: e.g. watery diarrhea, nausea, reduced appetite, abdominal pain and abdominal distention. Stools may later become steatorrhea (fatty, pale colored, extremely smelly stools that float in the toilet and are difficult to flush away). Weight loss may occur if the illness is prolonged.
» Next page: Types of Pale stool
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