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Can pale stools equate to high bilirubin levels in the bloodstream?

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General & Family Physician
Practicing since : 2001
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Would pale stools equate to high bilirubin (sp) levels in the bloodstream? (specifically if related to pancreatic cancer)? I have an appt with dr next week but am worried sick. I have been having pale stools on and off for the past few months. My bilirubin levels are normal.
Posted Wed, 27 Mar 2013 in General Health
Answered by Dr. Michelle Gibson James 18 minutes later
Hi, thanks for using healthcare magic

It is understandable to be concerned.

Bilirubin or bile is the pigment that contributes to the colour of stool. Normally it is formed from the breakdown of red blood cells and travels to the liver where it is altered and some of it enters the intestine. The altered pigment that remains in the intestine enters into the stool and gives it the brown colour, some also enters the urine by absorption in the blood stream and is also responsible for its colour.

Pale stools implies a decrease in this pigment reaching the intestine and may indicate that there is a blockage along some aspect of the pathway eg in the liver or as it passes out the liver to the intestines or in the gallbladder and pancreas which is also part of the normal pathway.
In this case some of the liver enzymes in the liver function tests may , in some persons , be increased because ALT (one of liver function tests) may look at the passage ways.

Any disease of the pancreas would normally cause an increase in other blood tests, particularly amylase. It would normally be associated with jaundice and an increase in bilirubin, so the fact that it is normal is good and makes the diagnosis of pancreatic cancer less likely.This cancer is also associated with pain, decreased appetite and weight loss.

Your doctor will likely suggest liver function tests and imaging of the abdomen with a CT scan to determine the exact cause of your symptoms.

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by
Follow-up: Can pale stools equate to high bilirubin levels in the bloodstream? 1 hour later
Thanks so much for your answer! I have a 3 cm focal nodular on my liver that they have been monitoring for about 2 years now. It has remained stable. I had an MRI of the abdomen last May and it came back as normal "pancreas is unremarkable." Would the MRI have picked up pancreatic cancer? I've read mixed messages as to whether the MRI/CAT scan can detect the smaller tumors. thank you so much for your feedback
Answered by Dr. Michelle Gibson James 6 hours later

The MRI is one of the most accurate imaging test and would have picked up any lesion that has been present at the time. Unremarkable means that there was no evidence of any lesions on the pancreas when it was seen.
The nodule in the liver may be causing intermittent blockage of the ducts and may be causing the on and off pale stools that you are having.

Please feel free to ask any other questions
Above answer was peer-reviewed by
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