Mrs. Phelps brought in her 12-month-old Tommy for a routine well check. During the history taking she mentioned a “by-the-way” concern. It seemed that occasionally Tommy had passed bright green bowel movements. Mrs. Phelps’ mother-in-law offered that in her experience this meant an infection of the bowel.
Tommy seemed to be doing well, otherwise. He showed no signs of infection. But grandma had had the experience—and we certainly wanted the doctor’s opinion.
It is obvious that the color of body fluids can cause parents grave concern. Blood-tinged body fluid is always a sign of a potentially significant problem, mandating consultation with a physician. But green, in the eyes of most laymen, warrants almost as much concern as red.
In some cases green does herald a significant problem. For example, green-stained vomitus may indicate bowel obstruction. But in reference to green bowel movements, this is not a sign of a life-threatening illness, though it may be alarming to parents.
The color of a bowel movement is based on two factors: the pigment in the food eaten and the bile that is produced by the liver and infused into the bowel by the gall bladder. Bile is emerald green, but is changed chemically to a brown color through the various processes of the intestinal tract. It takes time, however, for the chemical process to change the bile from green to brown. Therefore, any condition that speeds up the transit of the waste material through the intestinal tract will cause a green bowel movement.
At times this is associated with disease processes, such as intestinal viral or bacterial infections. But certain food substances and chemicals also augment bowel motility and, in turn, decrease the transit time. Thus, a green bowel movement can be produced without the presence of infection. Intermittent green stools in a child without fever or any other symptoms are of no significant importance.