Mycoplasma Genitalium: Symptoms, Diagnosis, and Treatment
Urinary Tract Infection
A urinary tract infection (UTI) is a bacterial infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a simple cystitis (a bladder infection) and when it affect the upper urinary tract it is known as pyelonephritis (a kidney infection). Symptoms from a lower urinary tract include painful urination and either frequent urination or urge to urinate (or both), while those of pyelonephritis include fever and flank pain in addition to the symptoms of a lower UTI. In the elderly and the very young, symptoms may be vague. The main causal agent of both types is Escherichia coli, however other bacteria, viruses or fungus may rarely be the cause.
Urinary tract infections occur more commonly in women than men, with half of women having at least one infection at some point in their lives. Recurrences are common. Risk factors include female anatomy, sexual intercourse and family history. Pyelonephritis, if it occurs, usually follows a bladder infection but may also result from a blood borne infection. Diagnosis in young healthy women can be based on symptoms alone. In those with vague symptoms, diagnosis can be difficult because bacteria may be present without there being an infection. In complicated cases or if treatment has failed, a urine culture may be useful. In those with frequent infections, low dose antibiotics may be taken as a preventative measure.
In uncomplicated cases, urinary tract infections are easily treated with a short course of antibiotics, although resistance to many of the antibiotics used to treat this condition is increasing. In complicated cases, longer course or intravenous antibiotics may be needed, and if symptoms have not improved in two or three days, further diagnostic testing is needed. In women, urinary tract infections are the most common form of bacterial infection with 10% developing urinary tract infections yearly.
What Causes Smelly Urine?
Smelly urine or urine that has an unusual odor may be a sign of diabetes, an infection, eating asparagus, or using certain medications, among other causes. Treatment can depend on the underlying cause.
Urine often has a slight ammonia smell, especially first thing in the morning or when a person is dehydrated.
Smelly urine can also be a sign of an infection, however, so if the smell does not go away on its own, or if additional symptoms develop, see a doctor.
In this article, we explore what causes smelly urine and offer strategies to reduce the smell.
Smelly urine does not always stem from a health condition. Dehydration, some vitamins, and some medications can give urine an unpleasant odor.
Common causes of smelly urine include:
Concentrated urineWhen urine is highly concentrated, it contains more ammonia and less water. This can cause it to have a strong smell.
Urine tends to be more concentrated when a person is dehydrated. This is often the case first thing in the morning or when a person does not drink enough water throughout the day.
Symptoms of severe dehydration include:
If any symptom of dehydration does not go away after the person has drunk plenty of water, they should see a doctor. The underlying issue may be a kidney infection.
FoodsMetabolites are any substances that form during digestion. As the body excretes them in urine, some can cause the urine to smell.
When asparagus, for example, is broken down during digestion, its metabolites give urine a foul smell.
Medication and supplementsSome medications and supplements that can lead to a change in the odor of urine include:
Some health issues that lead to smelly urine require short courses of treatment, while others require more lasting attention.
Urinary tract infectionA urinary tract infection (UTI) happens when harmful bacteria proliferate in the urethra, bladder, or kidneys.
Most people have symptoms beyond smelly urine, including:
Infections with certain bacteria, notably Aerococcus urinae, may cause very bad-smelling urine, with or without other symptoms.
A UTI usually clears up with antibiotics. If a person does not receive treatment, the infection can spread, so see a doctor as soon as possible.
Bacterial vaginosisThe vaginal infection bacterial vaginosis causes a distinct fishy odor that may be worse after sex. Other symptoms include:
Learn about treating bacterial vaginosis at home here.
DiabetesDiabetes medications may change the smell of urine, and so too can the disease — especially if blood sugar levels go uncontrolled.
Some people notice a very sweet smell. This happens when there is too much sugar in the urine.
Other symptoms of diabetes include:
When organs involved in digestion or urination are not working properly, it can affect the way urine smells.
According to one 2012 study, some people with kidney failure, for example, notice a bad body odor or foul-smelling urine. Another 2012 study found that liver disease can change the way urine smells.
The symptoms of organ failure vary, depending on the area involved and the cause. Liver failure also tends to cause yellowing of the skin or eyes, while kidney failure may also cause pain during urination.
Some people find that asparagus gives their urine a strong, foul odor that may last from a few hours to a few days.
Some people may not be able to detect the odor. Research from 2016 suggests that about 60% of people have one of several genetic variants that either decreases their ability to smell asparagus in urine or eliminates it entirely.
Some people notice a change in the smell of their urine during pregnancy. Various hormonal changes involved may change the smell of urine — or the person's sensitivity to smells.
Many people report a stronger sense of smell during pregnancy, though very little research has looked into this phenomenon.
It is worth noting that pregnant people with UTIs may not have any more noticeable symptoms — a change in the odor of urine may be the only warning.
Prompt treatment of UTIs decreases the risk of serious complications for both the person and their baby.
The following tips may help:
Also, having an overall healthy lifestyle and reducing or eliminating alcohol intake can protect the liver and may help get rid of the smell.
The doctor will ask about certain lifestyle factors, recent health changes, and when the bad smell began. They may do a urine culture to check for bacteria and other signs of infection.
When the diet is responsible for the smell, the doctor may be able to diagnose the problem based on symptoms alone.
In some cases, the doctor may order imaging scans of the urinary tract or kidneys. A person may also need blood work to check for other health conditions.
A bad smell in the urine often goes away on its own, especially when dehydration or something in the diet causes it.
A person does not need to see a doctor if they can identify a harmless cause of their smelly urine, such as asparagus.
Other causes need medical treatment. While a UTI is relatively harmless, it can progress and cause serious health issues, including kidney infections. With early treatment, a person should feel better in a few days.
Because some people with UTIs have no symptoms, see a doctor if the bad smell lasts longer than a few days. This is especially important for people who are pregnant.
Other health issues that can cause this odor require ongoing treatment. For example, a person with diabetes may need to switch medications or make certain lifestyle changes.
If a person who has any chronic condition finds that the smell of their urine changes significantly, it may be a good idea to flag it with a doctor.
Foul-smelling urine can be alarming, but it may be short-lived, and drinking more water may help the smell fade faster.
However, if there is not a clear cause — such as asparagus, supplements, or dehydration — it is a good idea to consult a healthcare provider.
Why Does My Urine Smell Like Fish?
A fishy smell in urine can result from dietary factors, an infection, and other health issues.
If fishy-smelling urine is the only symptom, a person may want to wait for a couple of days to see if it clears up. If other symptoms are present and include pain in the lower back or difficulty urinating, a person should contact their doctor.
It can also be a sign of trimethylaminuria which can have genetic causes.
In this article, we look at the causes, symptoms, and treatments for urine that smells like fish.
A fishy smell is uncommon in urine. Many of the causes are not serious, but it can sometimes indicate a severe condition, such as damage to the kidneys or liver.
In many cases, the culprit responsible for the smell of fish is a chemical called trimethylamine oxide. When a fish dies and bacteria begin to decompose the tissue, this chemical is released and converted to trimethylamine (TMA), which causes the fishy odor.
A fishy smell in urine may be caused by the presence of bacteria, TMA, or an interaction between them.
According to a study from 2013, most healthy people produce chemicals that break down TMA, which stops them from smelling like fish, even when they have eaten fish recently or have a lot of bacteria in their systems.
If a person suspects that any of the following causes are responsible for the fishy smell, it is usually safe to wait a few days and see if the smell clears up without treatment.
Pregnancy
Pregnancy can make the urine more concentrated. This can lead to a stronger smell, and it may make a fishy smell more noticeable. See a doctor if the smell does not disappear in a day or two.
Dehydration during pregnancy can make the urine look darker or smell worse. A person who is pregnant and noticing these symptoms should ensure that they are drinking enough water.
Vitamins and supplements
Some of these can make the urine smell fishy, especially supplements of calcium, vitamin B6, and vitamin D. The odor may be more noticeable when a person is dehydrated. If an individual stops taking these supplements and their urine still smells fishy, they should contact a doctor.
Diet
Certain foods, including asparagus and fish, can make the urine smell. If foods are responsible, the smell should go away after a few hours.
Fishy-smelling urine may be the first indication of a mild or severe health problem. Some people may have no other symptoms or several. In either case, a person should contact a doctor if they cannot identify the cause of a fishy odor.
The following causes often require medical attention:
Urinary tract infections (UTIs)
A UTI occurs when too much harmful bacteria grow in the urinary tract. This can make the urine smell. In some people, a UTI causes no symptoms. When symptoms are present, they often include:
Most UTIs can be treated with antibiotics. If left untreated, a UTI may spread to the kidneys.
Anyone who suspects that they have a UTI should see a doctor.
Bacterial vaginosis (BV)
This bacterial infection in the vagina causes fishy, foul-smelling discharge. While it does not affect the urine, a person may notice the odor while using the bathroom.
The smell and other symptoms may get worse immediately after sex. Women with BV may believe that they have a yeast infection, but the smell is a distinguishing factor. Some other symptoms include:
BV is common in sexually active women. Some sexually transmitted infections may also cause an unusual odor, and it is important to see a doctor for testing.
Fish odor syndrome
Trimethylaminuria, better known as fish odor syndrome, is a rare disorder that causes a person's bodily emissions to smell like fish. The odor can arise from the saliva, sweat, or urine. A person develops this condition when they are not able to break down TMA.
In many cases, the disorder is passed genetically and causes no other symptoms. Less often, a person who has a diet very high in TMA and unusual bacteria in the gut can develop the syndrome.
A person emitting a fishy odor that persists, in spite of good hygiene, should see a doctor. Dietary changes, antibiotics, and nutritional supplements may help.
Kidney problems
The kidneys filter the urine, which helps to remove toxins from the body. When the urine smells, it may indicate that the kidneys are not functioning correctly, often due to infections or kidney stones.
Symptoms of a kidney infection may include:
Kidney infections may require hospitalization, though some can be managed at home with antibiotics. Anyone with symptoms of a kidney infection should see a doctor right away.
Kidney stones are mineral deposits that collect in the kidneys. They can be as small as a grain of rice or grow to resemble pebbles and small rocks.
Passing a kidney stone can be painful. Sometimes they become stuck. A person who is first experiencing symptoms, or who notices bleeding when trying to pass a kidney stone, should see a doctor. Drinking plenty of water can help the stone to pass more quickly.
Prostatitis
Prostatitis describes swelling and inflammation of the prostate, and it is often the result of an infection. People with prostatitis may notice changes in urination, including a fishy smell.
Symptoms of prostatitis are similar to those of a UTI. People with prostatitis may also experience:
Treatment depends on the cause of the inflammation. A doctor may prescribe medication, such as antibiotics and pain relievers, or they may recommend surgery. Warm sitz baths can help with managing the pain at home.
Liver failure
Like the kidneys, the liver helps the body to filter out toxins. When the liver is not functioning correctly, it releases more of a substance called bilirubin into the blood. This can pass into the urine, making it smell bad.
Symptoms of liver failure include:
Some people are more susceptible to liver failure than others. Anyone with one or more of the following conditions should contact a doctor immediately if they suspect that their liver is failing:
Treatment will depend on the extent of the liver failure, but it may include medication, hospitalization, or a liver transplant.
Fishy-smelling urine is not often a medical emergency. However, people who experience pain, a fever, or signs of kidney or liver problems should call a doctor or visit the emergency room.
When no other symptoms are present, the smell may disappear without treatment in a few days. If this does not happen, a person should consult a doctor.
It is easy to overlook urine as an indicator of health, but it can provide important information about how well the body is functioning.
While fishy-smelling urine may be alarming, the causes are usually minor. A doctor can provide a diagnosis and recommend the quickest path to recovery.
A fishy smell in the urine will often go away without treatment in a few days. If the smell does not improve, seek medical attention. Serious conditions can occasionally be responsible for this odor, and prompt treatment can be vital.
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