Green Stool in Children After Gastroenteritis Recovery - Pediatrics

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Green stools after gastroenteritis?


Hello, doctor.
My daughter was taken to the emergency room on May 8 due to fever and vomiting, and she was diagnosed with gastroenteritis.
She experienced dehydration and vomiting, so she received IV fluids.
Upon discharge, the doctor advised that for the next two days, she could only eat congee, white toast, and plain steamed buns, and she was instructed to stop formula milk.
During a follow-up visit on May 10, the doctor diagnosed her with only gas and diarrhea (her stools were still yellow), but she was allowed to resume a normal diet and drink formula milk.
Therefore, she started having formula twice a day (210 cc each time).
Although she stopped having diarrhea on May 12, her stool color changed to green.
As of May 13, she has had green stools for two consecutive days.
I would like to know if this is related to gastrointestinal issues (possibly due to malabsorption after gastroenteritis)? How long might the green stool condition last, and should we return for a follow-up examination? Thank you for your patience in reading my questions.

Tone's F, 0~9 year old female. Ask Date: 2016/05/13

Dr. Xiao Kaiwen reply Pediatrics


As long as the stool is not watery diarrhea, contains mucus or blood, is gray, black, or hard, it is generally considered normal.
Greenish stool can sometimes be caused by a higher iron content in formula milk, which does not have significant effects and can be monitored.

Reply Date: 2016/05/13

More Info


Green stool in children, especially following a bout of gastroenteritis, can be a source of concern for many parents. However, it is essential to understand that changes in stool color can be influenced by various factors, particularly after an illness that affects the gastrointestinal (GI) tract.

Firstly, gastroenteritis, which is often caused by viral or bacterial infections, can lead to significant changes in bowel habits and stool characteristics. When a child experiences gastroenteritis, the body may not absorb nutrients and bile salts effectively, leading to alterations in stool color. In your case, the transition from yellow to green stool after the resolution of diarrhea is not uncommon and can be attributed to several factors.

One primary reason for green stool is the rapid transit of food through the intestines. When food moves quickly through the digestive system, bile, which is naturally green, may not have enough time to break down completely, resulting in green-colored stool. This can happen after an episode of gastroenteritis, where the intestines may still be recovering and may not be functioning at their optimal pace.

Additionally, the introduction of certain foods or medications can also influence stool color. For instance, if your child has resumed formula feeding, some formulas contain iron, which can lead to greenish stools. Iron supplements or medications like Dimethicone, which is often used to relieve gas, can also contribute to changes in stool color. In your case, if your child has recently started consuming formula again, this could explain the shift in stool color.

Regarding the duration of green stool, it typically resolves as the child's diet stabilizes and the digestive system returns to normal function. If the green stool persists for more than a few days, or if you notice other concerning symptoms such as abdominal pain, fever, or blood in the stool, it would be prudent to consult your pediatrician for further evaluation. They may recommend a follow-up visit to assess your child's overall health and ensure that there are no underlying issues affecting digestion or absorption.

In summary, green stool in your child following gastroenteritis is likely a normal response to the recent illness and dietary changes. As long as your child is otherwise healthy, eating well, and not exhibiting any alarming symptoms, there is usually no cause for concern. However, maintaining open communication with your healthcare provider is essential, especially if you have ongoing worries about your child's health or stool characteristics.

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