IBS and Orange Poop: Causes, Red Flags, and What To Do in the UK
If you live with IBS and you suddenly notice your stool looks orange, it is understandable to worry. The reassuring truth is that most orange stools are short-lived and benign, most often linked to diet.
Sometimes, though, the colour change is a useful clue, especially if it appears alongside watery diarrhoea, urgency, abdominal pain, weight loss, or signs that bile is not flowing normally.
This guide explains why stool turns orange, how IBS and bile acids fit together, when to call your GP and practical steps you can take today.
We’ll explore the most likely dietary and medical reasons behind orange-coloured stools, explain how these can overlap with IBS, outline the symptoms to watch for, and clarify when it’s sensible to speak with your GP. If you’re unsure whether your symptoms fit IBS, see our guide to IBS quiz which walks through the assessments used to reach a diagnosis.
What causes Orange Stool?
Orange stool has three common explanations. First is dietary pigment from beta-carotene rich foods or artificial colourings. Second is medication or contrast agents from imaging. Third is bile acid diarrhoea, a common and under-recognised cause of watery diarrhoea that often overlaps with IBS-D.
The key red flag to know is that very pale or clay-coloured stools together with dark urine or jaundice can indicate reduced bile flow and require urgent medical assessment. Orange is usually diet related; chalky pale is different and needs prompt review.
Does IBS cause Orange Stool?
IBS doesn’t create an orange pigment. But it can change how fast things move through your gut and what you eat. Faster transit gives bile less time to turn stools brown, so they may look lighteryellow to orange.
What actually colours stool?
Typical brown stool is the end result of a journey involving bile produced in the liver, stored in the gallbladder, then released into the small intestine when you eat. Stool is brown mainly because of bile. Bile is a yellow-green fluid that helps you digest fat. Your liver makes it, your gallbladder stores it, and it’s released when you eat. As food moves through the gut, bile slowly turns brown. If things move too fast, or bile isn’t handled in the usual way, stools may look lighter — yellow or orange. IBS doesn’t make stool orange, but it can speed things up or change your diet, which makes these colour changes more likely.
Healthy stools usually range from light to dark brown because bile pigments are converted to a brown compound as food moves through the gut.
Normal variations you might see
• Tan to dark brown: all fine
• Green after fast transit or lots of greens: usually harmless
• Temporary colour from foods/dyes (beetroot red, blueberries dark, carrot/orange drinks)
When to get medical advice
• Pale or clay-coloured, especially with dark urine or yellow eyes/skin
• Black, tarry stools (unless clearly from iron or bismuth)
• Bright red blood or ongoing maroon colour
• Yellow, greasy, hard-to-flush stools with foul smell
• Any persistent colour change with pain, fever, weight loss, or diarrhoea lasting more than a week
If you’re unsure, note what you ate over the past 48–72 hours and check any new medicines or supplements, then speak with your GP if the colour doesn’t return to brown
Dietary reasons for orange stool-orange food!
The most frequent benign cause is dietary pigment. Beta-carotene and related carotenoids are abundant in carrots, pumpkin, sweet potato, squash, mango, and apricots. Concentrated juices, soups, smoothies, and vitamin formulations can deliver a large pigment load over a short period. Carotenoids are fat-soluble and can tint tissues and excretions when intake is high, a phenomenon well documented in case reports of carotenemia where the skin looks yellow-orange while the whites of the eyes remain normal. Although carotenemia concerns skin more than stool, it illustrates how strongly carotenoids can tint the body when intake is high. Artificial colourings in drinks and snacks can have similar visual effects for a day or two.
What to do first if you think diet is the reason
Look back over the last 48 to 72 hours. If you had a surge of high-carotene foods or vividly coloured products, pause them for a few days and observe. If colour normalises as intake settles, diet was likely the explanation. Keep your fluid intake adequate and make a short note in a food and symptom log so you can recognise the pattern if it recurs. If you are following a low-FODMAP approach, you can still moderate carotene without disrupting your plan.
Medications, supplements, and imaging contrast can cause orange poop
Some products are known to alter bodily colours temporarily. Rifampin and rifabutin can produce red-orange discolorations of body fluids. Phenazopyridine used for urinary discomfort can orange-tint urine and occasionally be associated with stool colour changes. Certain antacids and multivitamins contain dyes that may contribute. Contrast agents for scans may transiently change stool appearance in some people. If the timing fits a new product or recent imaging and the colour returns to normal after a few days, the change is usually of low concern. Always check the patient information leaflet and speak with your pharmacist or GP if unsure.
Bile acid diarrhoea and orange or yellow stool
Bile acid diarrhoea, also called bile acid malabsorption, happens when an excess of bile acids reaches the colon. Bile acids are detergents. In the colon they draw water into the bowel, increase motility, and can cause watery diarrhoea, urgency, post-meal worsening, bloating, and a lighter yellow-to-orange colour because bile has not been fully modified into brown pigments. The British Society of Gastroenterology guideline on chronic diarrhoea highlights bile acid diarrhoea as common and treatable, and recommends specific testing where symptoms suggest it. NICE Diagnostics Guidance DG44 reviews SeHCAT scanning for suspected bile acid diarrhoea and describes when it can guide management decisions.
What cause Bile acid malabsorption?
Bile acid malabsorption (bile acid diarrhoea) happens either because the liver makes too many bile acids despite a normal-looking ileum or because the ileum can’t re-absorb them properly due to disease or damage (Crohn’s affecting the terminal ileum, surgical resection, radiation, severe infection, short bowel).It can also follow other conditions that increase bile reaching the colon or speed gut transit, such as after gallbladder removal, untreated coeliac disease, s SIBO or post-infectious states, and pancreatic or biliary problems.
How common is bile acid diarrhoea in people diagnosed with IBS-D?
Multiple studies and reviews indicate a significant overlap between bile acid diarrhoea and IBS-D. A widely cited systematic review reported that in excess of one quarter of IBS-D patients have evidence of bile acid diarrhoea depending on the test used and thresholds applied. Other cohorts and meta-analyses span roughly 10 to 50 percent.
The practical implication is straightforward. If you have IBS-D with frequent watery stools, urgency, nocturnal symptoms, bile acids are worth investigating.
Treating a bile-acid component can change outcomes meaningfully because the mechanism is different from general antidiarrhoeal therapy.
Two diagnostic tests are commonly discussed. The first is the SeHCAT retention scan, which involves two brief scans about a week apart after swallowing a radiolabelled bile-acid analogue.
The second approach is fasting serum biomarkers such as 7α-hydroxy-4-cholesten-3-one, often abbreviated as C4, which reflect hepatic bile acid synthesis. Elevated C4 can support the diagnosis when SeHCAT is not available.
Your GP can refer to gastroenterology for assessment and to discuss the most appropriate route locally. Alongside these tests, clinicians usually consider basic blood work to exclude mimics and coexisting issues, for example coeliac serology, liver function tests, full blood count, inflammation markers, and thyroid profile when indicated.
Treatment options when bile acids are the driver
When SeHCAT or C4 suggests bile acid diarrhoea, or when clinical suspicion is high and testing is unavailable, management typically combines diet strategies with bile acid sequestrants prescribed by a clinician. Cholestyramine and colesevelam are the most commonly used binders in the UK. They act by binding bile acids in the intestinal lumen so they cannot stimulate water secretion and rapid transit in the colon. Response often correlates with the severity of SeHCAT abnormality, with lower retention values predicting better response, though individual results vary. A lower fat dietary pattern, sensible distribution of fat across meals, and the addition of soluble fibre where tolerated can complement medication. People on long-term binders may need monitoring of fat-soluble vitamins and attention to drug timing because sequestrants can interfere with absorption of other medicines if taken at the same time.
Where IBS fits in and where it does not
IBS is a functional gastrointestinal disorder defined by symptom clusters such as abdominal pain related to defecation and altered stool form and frequency.
IBS itself does not generate orange pigment.
The colour difference you see is typically a proxy for either diet or transit speed.
On IBS-D flare days, transit is often faster which can leave less time for pigments to be converted to brown. That said, persistent watery orange or yellow stools warrant consideration of bile acid diarrhoea because it is a biological mechanism with specific tests and treatments. It is also common to find both factors in play.
Someone may have IBS-D and a coexisting bile-acid component. In that scenario, targeting bile acids often reduces stool frequency and urgency, while IBS strategies such as a low-FODMAP programme, stress modulation, and judicious use of antispasmodics can refine symptom control.
When to seek medical advice
There are three simple pathways to keep clear in your mind.
First, if you have pale or clay-coloured stools, especially together with dark urine or yellowing of the eyes or skin, contact your GP or NHS 111 urgently because this pattern suggests impaired bile flow rather than dietary pigment.
Second, if orange stool persists beyond a week, recurs frequently without obvious dietary triggers, or appears with persistent diarrhoea, unintentional weight loss, fever, or ongoing abdominal pain, book a GP appointment.
Third, if you have IBS-D symptoms with watery stools, urgency, or nocturnal episodes, ask about assessing for bile acid diarrhoea through SeHCAT or serum C4 in line with UK guidance.
Practical food guidance while symptoms are active
Begin with a short lookback over the last three days. If you consumed a lot of high-carotene foods or brightly coloured products, reduce them for 48 to 72 hours and watch for normalisation. Keep hydrated, and if stool is loose consider adding soluble fibre such as oats or a small dose of psyllium husk if it fits your current diet plan. Review any new medications or supplements and note timing. If you recently had an imaging scan with contrast, mention this to your clinician. If watery or orange stool persists despite the above, move promptly to a discussion with your GP about bile acids. For many people, that conversation and a simple test are the pivot from months of guesswork to a focused plan.
If diarrhoea is present, smaller and more frequent meals with moderated fat may ease urgency while you investigate. Fat distribution matters because bile secretion rises with fatty meals. Soluble fibre can help absorb water, thicken stool, and slow transit in some people. If you have not undertaken a structured low-FODMAP programme, consider doing so so you gain symptom control without long-term over-restriction. As symptoms settle, reintroduce foods methodically. For those ultimately diagnosed with bile acid diarrhoea, the goal is not an excessively low-fat diet indefinitely but a pragmatic pattern that works alongside medication, preserves nutrition
Differentiating look-alikes
A few visual patterns are worth knowing. Pale or clay stools with dark urine and jaundice are a bile flow red flag and require urgent review. Black tarry stool can indicate upper gastrointestinal bleeding unless you are clearly taking iron or bismuth, so err on the side of caution. Bright red blood may reflect haemorrhoids or fissures but also colonic sources and warrants assessment. If the palms and soles of your skin look orange while the whites of your eyes remain normal, think of carotenemia from high carotene intake, which is usually benign and resolves with dietary change.
How Nutrition and Vitality can help alongside your GP
If your GP has ruled out any medical conditions such as bile acid malabsorption and your symptoms persists private tests such as breath testing for SIBO or targeted stool analysis may be worth considering as well as strategies to reduce transit time. For IBS a low-FODMAP trial and reintroduction as well as stress modulation tactics may be of great benefot.
If would like to organise a consultation with an IBS specialist please visit our sister company ibs-solutions.co.uk
Summary
Orange poop may be caused by:
1. A brief viral illness or dietary upset can speed transit and lighten colour without other concerning features.
Try and hydrate, keep meals simple, and observe for short-term improvement.
2. Diet high in beta-carotene or colourings
Carrots, sweet potato, pumpkin, squash, mango, apricots, turmeric-heavy dishes, and brightly coloured drinks or supplements can tint stool for a day or two.
Reduce these foods and colourings for 48 to 72 hours and monitor for normalisation.
3.Faster transit on IBS-D days
When stool moves quickly, bile pigments have less time to turn brown, so it can look yellow to orange.
What to do next: Book a consultation at our sister clinic ibs-solutions.co.uk
4.Bile acid diarrhoea (bile acid malabsorption)
Excess bile acids reaching the colon draw water in and speed motility, causing watery diarrhoea, urgency, post-meal worsening, bloating, and lighter yellow-to-orange stools. Discuss tetsing with your GP
5.Fat-heavy meals or gallbladder changes
Very fatty meals or previous gallbladder removal can increase bile entering the bowel and lighten stool colour.
Try to distribute fat more evenly across meals; consider tailored advice from a nutritionist
6. Medications and supplements
Examples include rifampin or rifabutin, phenazopyridine, multivitamins with strong dyes, some antacids, and high-dose beta-carotene supplements.
What to do next: check the patient leaflet or speak to a pharmacist or GP
7. Recent imaging contrast or bowel preparation
Contrast agents and some bowel preps can temporarily change stool appearance.
What to do next: this typically resolves within a few days without specific treatment.
Frequently asked questions
Can IBS itself cause orange stool?
IBS does not produce orange pigment. Faster transit in IBS-D can leave stools lighter or more yellow-orange on flare days. If watery colour changes persist, assess for bile acid diarrhoea because it is common in IBS-D and treatable.
How long should I wait before I seek help?
If diet is the cause, colour usually normalises within a few days after reducing high carotene foods or colourings. Persistent change, ongoing diarrhoea, weight loss, fever, or pain should prompt GP review.
What tests check for bile acid diarrhoea?
The SeHCAT scan with two quick appointments about a week apart is widely used in UK hospitals and uses a very low radiation dose. Fasting serum C4 is an alternative where available. Your GP can refer to gastroenterology to discuss the most appropriate choice locally.
If bile acid diarrhoea is confirmed, what treatments help?
Bile acid sequestrants such as cholestyramine or colesevelam and an individualised nutrition plan are standard. Response is often better when SeHCAT retention is low, though personal results vary. Clinicians monitor vitamins and drug timing when binders are used long term.
Could supplements be the reason for orange stool?
Yes. High doses of beta-carotene supplements and some multivitamins can tint stool and sometimes skin. If you are taking a high dose, pause and observe. If in doubt, speak to your pharmacist or GP.
If none of the above are the causes what can I do?
Consider booking a consultation with an IBS specialist who can help you with diet and private testing such as SIBO TESTS
References
- Arasaradnam RP, Brown S, Forbes A, et al. Guidelines for the investigation of chronic diarrhoea in adults. Gut. 2018. PubMed PMID: 29437875.
- National Institute for Health and Care Excellence. Diagnostics guidance DG44: SeHCAT for investigating bile acid diarrhoea. NICE, UK.
- Slattery SA, Niaz O, Aziz Q, Ford AC, Farmer AD. Systematic review with meta-analysis: the prevalence of bile acid malabsorption in functional diarrhoea and IBS-D. Aliment Pharmacol Ther. 2015. PubMed PMID: 26201435.
- Vijayvargiya P, Camilleri M, Shin A, Saenger A. Methods for diagnosis of bile acid malabsorption in clinical practice. Clin Gastroenterol Hepatol. 2013; updates reviewed in 2017–2020. PubMed PMIDs include 23466772 and 28801116.
- Walters JRF, Pattni SS. Managing bile acid diarrhoea. Therap Adv Gastroenterol. 2010; and subsequent reviews on FGF19 and hepatic bile acid synthesis feedback. PubMed PMIDs include 21180616.
- Bannaga AS, Kelman L, O’Connor M, et al. How commonly is bile acid diarrhoea misdiagnosed as IBS-D. Neurogastroenterol Motil. 2020. PubMed PMID: 32189431.
- Camilleri M. Bile acid diarrhea: prevalence, pathogenesis, and therapy. Gut Liver. 2015; and Mayo Clinic Proceedings 2021 overview. PubMed PMIDs include 26243882 and 33516063.
- Walters JRF, Tasleem AM, Omer OS, Brydon WG, Dew T, le Roux CW. A new mechanism for bile acid diarrhoea: defective feedback inhibition of bile acid biosynthesis. Clin Gastroenterol Hepatol. 2009. PubMed PMID: 19577011.
- BouSaba J, Eckert D, Brenner DM. Bile acid malabsorption in IBS-D. Curr Gastroenterol Rep. 2021. PubMed PMID: 33950328.
- Ricketts JR, Rothe MJ, Grant-Kels JM. Carotenemia: a review of current literature. Pediatr Dermatol. 1999; with subsequent adult case reports of diet-related pigment changes. PubMed PMID: 10571804.
- Rock CL, Swendseid ME. Plasma beta-carotene response to supplementation is affected by dietary fat. Findings help explain carotenoid handling and pigmentation. Am J Clin Nutr. 1992. PubMed PMID: 1609757.
- British Society of Gastroenterology. Chronic diarrhoea guideline commentary on SeHCAT and serum C4 for suspected bile acid diarrhoea. Gut. 2018.
- NHS patient resources and UK hospital leaflets on SeHCAT testing and bile acid sequestrants, for example Guys and St Thomas’ and York and Scarborough Teaching Hospitals.
- Drug labelling and clinical pharmacology references for colour changes associated with rifampin class antibiotics and phenazopyridine; see respective UK product characteristics and PubMed pharmacology reviews.
Author – Victoria Tyler BSc Hons MBANT
Victoria Tyler owns and runs two busy clinics : Nutrition and Vitality and the IBS and Gut Disorder Clinic.
Nutrition and Vitality, along with the IBS and Gut Disorder Clinic, were founded with the goal of helping patients alleviate IBS symptoms by uncovering and addressing the root causes of their digestive issues.
As a Registered Nutritional Therapist, Victoria holds a BSc (Hons) in Nutritional Therapy and has trained with the Institute of Functional Medicine. She is also accredited by BANT and CNHC.
Before transitioning into health, Victoria earned a degree in Economics and an MBA, working with corporations including Canon and Vodafone. However, her own health challenges led her to pursue a career in Nutritional Therapy.
With a passion for learning, Victoria is committed to staying at the forefront of Functional Medicine. She helps patients manage IBS and other digestive disorders, including SIBO, Candida, and IBD, by identifying and addressing their root causes.
Victoria strongly believes that every symptom has an underlying cause, and there is always a solution to every health condition. To learn more, or to see patient reviews, visit Victoria’s profile on Google.
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