Holy moly! This is a Very serious problem. The presence of white (clay) colored stool is a good indicator of liver trouble. My daughter had the same symptoms when her liver was very sick.
This is a link to info on diagnosing the problem. It is called hyperbilirubenaemia or cholestatic jaundice. The should check to make sure the bile ducts are working well with no sludge in the galblatter and check liver enzymes and liver function. I am not aware of any common reason for clay colored stools in combination with pain. BUT< there are alot of things I am not aware of so don't get too excited...
In the meantime, milk thistle is a good liver helper. It works well for us.
Cholestasis is a failure of bile flow, and its cause may lie anywhere between the liver cell (hepatocyte) and the duodenum. Cholestasis may be due to failure of the hepatocytes to generate bile flow (certain rare inherited defects such as Dubin-Johnson syndrome where the main problem appears to be impaired transport of bilirubin across the cell membrane), obstruction to bile flow in the intrahepatic bile ducts (a rare condition of unknown cause called primary biliary cirrhosis), or obstruction to bile flow in the extrahepatic bile ducts (stones, tumours especially of the pancreas, strictures). The last one is the most important cause of cholestatic jaundice. Hyperbilirubinaemia is conjugated in type since conjugation of bilirubin proceeds undisturbed but the bile returns into the blood.
Clinical features: < BACK TO TOP >
There is jaundice of various intensity, static or fluctuating, reflecting the mechanism and severity of cholestasis.
Stools are pale or clay-coloured due to deficiency of pigments (bilirubin is not delivered into the gut).
There is dark urine from the renal excretion of conjugated bilirubin.
Generalised pruritus (itch), probably due to skin deposition of bile salts is commonly reported; sometimes scratch marks are visible.
White-yellowish hard lipid deposits in the skin over joints and tendons (xanthomas) and around the eyes (xanthelasmas) develop due to protracted elevation of serum cholesterol (bile cholesterol is returned to blood).
There can be weight loss due to marked malabsorption (bile salts are required for fat digestion and indirectly for absorption of lipid soluble vitamins).
Bleeding tendency (easy bruising) is sometimes noted due to vitamin K deficiency (vitamin K is a lipid soluble vitamin).
Dystrophy of the bones due to vitamin D deficiency (vitamin D is also a lipid soluble vitamin) can also be a problem.
Investigations in individual patients are determined by the clinical findings. It is usual to find elevated levels of conjugated bilirubin in blood together with raised alkaline phosphatase.
Where there is no obvious cause for cholestasis, initial efforts are directed to identifying a large biliary duct obstruction, and ultrasound should be carried out initially.
ERCP (endoscopic retrograde cholangiopancreatography) is the best investigation if the biliary tract is dilated, as demonstrated on ultrasound.
Liver biopsy is performed when there is strong evidence of liver damage such as in biliary cirrhosis or inherited abnormalities of bilirubin transport into intrahepatic bile ducts.
This depends on the underlying cause of the cholestasis.
HTH, please make sure that she finds a diagnosis. I do hope that it is not something harmful to her. I hope that info helps!