Ever noticed how your urine may sometimes either look a little different in colour or smell a bit odd? The most common reason for urine to look darker or lighter than normal is the amount of water consumed daily. But changes in urine — not just in the colour or smell but also how much and how often you urinate — may indicate changes in physical health.
Almost every diagnostic check-up is incomplete without an analysis of urine, as it gives important indications about organ function and medical conditions. Urine, which is made by the kidneys and stored in the bladder until the body expels it through the urethra, is largely made up of water and waste products.
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“Urinalysis in the lab includes a routine analysis, urine chemistry to check for chemicals, sugar, protein, ketones, nitrite, bile salts and bile pigments including bilirubin (a pigment found in liver), and urine microscopy that tests the liquid for presence of pus cells, red blood cells, epithelial cells, microorganisms, casts, and crystals,” says Dr Nandini Govindarajan, consultant pathologist, Dr Kamakshi Memorial Hospital, Chennai. “This gives important insights into the health of patients and helps detect underlying conditions.”
The doctor cited an example: casts (tube-like substances released from the kidneys into urine when there are abnormalities in the organ) are an important indication of kidney disease, while crystals in urine may suggest that there are stones in the kidney or bladder.
Ingesting certain drugs and anaesthetics may change the colour of urine. “There may not be specific tests to detect all substance but in such cases, we ask for medical history of patients to determine if they are taking medications that change urine colour,” says Dr Nandini.
Urine colour and what is means
- Colourless and transparent: There’s not much to worry about urine that is colourless. Sometimes, it may mean over-hydration. Decrease water intake to ensure electrolytes in the body are not diluted.
- Clear and pale yellow: This is the normal colour of urine and indicates good health.
- Dark yellow: This is the colour of concentrated urine and could mean that a person is dehydrated or having liver issues. “Severe dehydration can cause acute kidney injury and even lead to renal failure,” says Dr Shyamala Gopi, consultant urologist and specialist in female urology and urodynamics, Apollo Hospital Chennai. “If detected on time, this can be reversed by increasing fluid intake. If the dehydration is caused by other underlying conditions, appropriate tests and remedial measures must be recommended. Dark-yellow urine along with clay-coloured stools could indicate jaundice or a problem in liver function.”
- Orange: Certain tuberculosis medications and medicines given for burning sensation while urinating can turn the urine orange. It could also mean liver problems.
- Dark brown: This may point to severe dehydration or an underlying liver condition.
- Red/pink: Ingesting beetroot or cough syrups with red dye can turn the urine red or pink. But a more serious cause could be blood present in urine — this can be confirmed through a microscopic examination of a urine sample to detect red blood cells. Blood in urine can be due to urinary tract infections (UTIs), prostate enlargement, kidney and bladder stones, tumour along the urinary passage, prostate or kidney tumours, and inflammation of the urinary passage.
- Cloudy or frothy: Too many pus cells or protein in the urine can make it look cloudy. Cloudy urine could point to a possible UTIs or diabetes. Urine that is cloudy and frothy could be an indication of renal problems.
- Milky white: Urine that is milky white may indicate certain metabolic disorders. “It could also be due to the presence of chyluria, a rare condition in which fluid from the lymph nodes leaks into the kidney and may be caused by an infection,” says Dr Nandini, a pathologist.
- Purple: This is a rare phenomenon describes as purple urine bag syndrome (PUBS). A study published in the Journal of Family Medicine and Primary Care says PUBS is a result of long-term use of urinary catheter in some patients and could also be connected to UTIs.
- Green or blue: Ingesting foods that have large amounts of dye in them or certain medications for pain or depression can cause the urine to turn blue or green.
“Apart from the colour, urine with a strong or pungent smell could indicate the presence of a UTI or high blood sugar, respectively,” says Dr Shyamala. “In some people, strenuous exercise can cause blood in urine, and should be evaluated for underlying muscle problems. Change in urine colour or smell can indicate a simple UTI that can go away with oral medications. But it could also point to undiagnosed diabetes or serious infections that involve the liver, kidney or bladder that must be evaluated by doing urine culture and imaging tests.”
The doctor says that such complications may need hospital admission and intravenous administration of antibiotic medications. “Any sudden changes in urine colour or smell — especially accompanied by burning sensation while urinating, fever, vomiting or back pain — should be reported to a general physician or urologist,” she adds.
When to consult a doctor
- Sudden onset of fever or lower back pain along with change in urine colour
- Urine is red in colour — indicating blood in urine
- Urine colour remains dark even after adequate hydration
- Dark-yellow urine for more than a week along with clay-coloured stools
- Vomiting and diarrhea along with change in urine colour.