Bacterial Infection: Causes, Symptoms, Treatment & Prevention
What Causes Urine To Smell Like Fish And How Is This Treated?
If your urine has a fishy odor, it's often related to diet or water intake, which is temporary and easily remedied. But, sometimes, it may signal an underlying condition that needs treatment.
Urine is made up of water and a small concentration of waste products. Urine typically has a subtle odor of its own, but this can change or fluctuate for a number of reasons. In some cases, your urine may even take on a fishy smell.
Keep reading to find out what may be behind your symptoms and what you can do to find relief.
In many cases, a fishy-smelling pee is simply indicative of what you eat or drink. Your urine contains some of the chemical compounds found in food you've recently consumed. These compounds will carry some of the food's scent into your urine.
With that in mind, it's unsurprising that eating fish can cause your urine to have a fishy smell. Other foods that can cause this include eggs, dairy, and some meat. This may be due to the fact that these foods contain choline, a substance associated with fishy body odor in general.
Other foods that can cause this include asparagus, which contains a substance called asparagusic acid that triggers the release ofsulfur into the urine. Brussels sprouts or cabbage may cause a similar effect.
Dehydration can also cause or aggravate the fishy smell in your urine. When you're dehydrated, there's less water to dilute the concentrations of chemicals. This will give your urine a stronger smell.
Since caffeine can also be a cause of fishy-smelling urine. It's also a diuretic that can worsen dehydration, so it may be a good idea to limit it.
What you can do
You can avoid foods known to cause fishy-smelling urine, but this can be difficult. Instead, make sure you drink plenty of water—especially when drinking caffeine—to help dilute the scent and stay hydrated.
That said, there can be medical causes of fishy pee.
A UTI can cause bacteria from the infection to contaminate the urine, resulting in a distinct fishy smell. UTIs are more common in females assigned at birth (FAABs) than males assigned at birth (MAABs).
What you can do
If your symptoms haven't disappeared within 24 hours, see your doctor. They'll prescribe antibiotics to help eradicate the infection before it spreads to the kidneys.
Bacterial vaginosis occurs when there is too much "bad" bacteria in the vagina, disrupting the balance of "good" and "bad" bacteria. This can cause a grayish, fishy-smelling vaginal discharge that may be noticeable when urinating.
What you can do
Sometimes bacterial vaginosis will go away on its own. If your symptoms persist for a week or more, see your doctor. Your doctor can treat it with antibiotics, though it may return after treatment is over.
Trimethylaminuria is a rare metabolic disorder that occurs when the body is unable to break down certain compounds properly. This includes fishy-smelling trimethylamine.
Trimethylamine is produced in the intestines after consuming certain types of food that are high in protein. With trimethylaminuria, trimethylamine is released into the urine instead of being broken down.
What you can do
Trimethylaminuria is inherited, and there is no cure. However, foods that contain choline can worsen the odor, so you can reduce your symptoms by avoiding these.
Prostatitis is an acute inflammation of the prostate gland in men. It's caused by a bacterial infection. It can progress quickly. The bacteria in the urine can cause it to smell like fish.
What you can do
If you suspect prostatitis, see your doctor. Your doctor will prescribe you antibiotics to treat the infection.
While you're waiting for the antibiotics to work, your doctor may prescribe you alpha blockers. These relax the bladder neck and reduce painful urination. Anti-inflammatory drugs —including over-the-counter options like ibuprofen (Advil) — can also be effective.
Kidney stones moving into or from the kidneys can cause an infection somewhere in the urinary tract. This infection will affect the urine and can cause urine that smells like fish. It may also cause blood in the urine or cloudy urine.
What you can do
Some kidney stones will pass on their own, but if you're experiencing severe pain, you should see your doctor.
Your doctor can prescribe pain medication to make your symptoms more bearable. They can also prescribe an alpha blocker to relax the bladder and make it easier for the stone to pass.
If the stone is larger and at risk of becoming stuck in the urinary tract, your doctor may perform surgery to remove it.
Although liver problems usually don't cause urine that smells like fish, it's possible.
This is especially true of liver failure. This occurs when the liver isn't functioning properly and is unable to process toxins as it should. These toxins are then released in the urine, causing a strong smell.
If liver problems are causing fish-smelling urine, you're likely to notice other symptoms, too. This includes jaundice and more difficulty urinating.
What you can do
Your individual treatment plan will depend on the diagnosis. Some liver problems will be treated with lifestyle changes, including a modified diet and potentially losing weight. Others may require treatment, including dialysis or surgery.
Cystitis is bladder inflammation caused by a bacterial infection, such as a UTI. The bacteria can result in a strong fish smell in the urine.
What you can do
Your doctor will likely prescribe you antibiotics to get rid of the infection before it spreads to the kidneys. You can use a heating pad to relieve discomfort. Drinking plenty of water can help flush the infection from your system.
Phenylketonuria is an uncommon inherited disorder. It raises the number of phenylalanine in the blood. This can cause a buildup of the substance in the body and a high concentration of phenylalanine in the urine, which can cause a fishy odor. It usually affects infants.
What you can do
Phenylketonuria can't be cured, but treatment can be highly effective at managing symptoms. It's essential to follow a diet low in phenylalanine.
This means avoiding foods containing the substance, such as:
Trichomoniasis is a sexually transmitted infection (STI) caused by a protozoan parasite. In some cases, the infection causes vaginal discharge that has a strong fish-like odor. This discharge may be clear, white, yellow, or greenish.
What you can do
If you suspect trichomoniasis, see your doctor. They'll prescribe oral antibiotics to clear the infection. To prevent reinfection, wait 7 to 10 days after both you and your partner have finished treatment to resume sexual activity.
If your urine has started to smell like fish and there isn't an obvious reason why — like diet or dehydration — make an appointment to see your doctor within the next couple of days. You can book an appointment with a urologist in your area using our Healthline FindCare tool.
You should see your doctor as soon as possible if you're experiencing:
You should seek emergency medical attention if you're experiencing:
In these cases, you may have a kidney stone or an infection that is spreading to your kidneys.
What does unhealthy urine smell like?
Your pee can have different smells, and a fish odor isn't the only type that might indicate an underlying problem. In fact, what your urine smells like can often be subjective, and people will describe the odor differently. Other options include an ammonia smell or a sweet smell.
What does diabetic urine smell like?
Certain conditions have a distinct urine smell associated with them. One such condition is diabetes, which may cause urine to smell sweet.
Why does my discharge smell like fish?
A fishy smell in your urine is often caused by your diet or dehydration and can be easily fixed by avoiding certain foods and drinking more water.
But it could also be a sign of a more serious medical issue that requires treatment, such as infection or kidney problems.
New York Reports A Record 15 Cases Of A Rare Disease Linked To Rat Urine In 2021, As Vermin Complaints Flood In
Rats have been terrorizing New Yorkers even more than usual this year, teaming up in clan warfare during the food-scarce days of strict Covid lockdowns and harassing sidewalk diners once the city began opening up.
And this year, more New Yorkers have been falling seriously ill from a rare but potentially fatal bacterial disease called leptospirosis, which is spread through exposure to rats, and specifically through contact with rat urine or contaminated water.
Last month, the city's health department reported 14 cases of leptospirosis – an unusually high number since just New York has documented a total of 57 cases in the 15 years since 2006 – and alerted healthcare providers to be on the lookout for symptoms. Of the first 14 cases, 13 people were hospitalized with acute renal and hepatic failure, and one person died as a result of an infection, the alert said.
Last week, there was a 15th case. That person appears to have recovered, the health department told Insider.
Brooklyn Borough President Eric Adams, the Democratic nominee to be the next mayor of New York, holds a bag of rat poison in 2019. Angela Weiss/AFP via Getty ImagesThe disease is treatable with antibiotics and some people won't experience any symptoms, though one in ten cases progress to severe complications, according to the Centers for Disease Control. Every year, there are roughly 150 cases of nationwide, according to the CDC, with most cases occurring in Puerto Rico and Hawaii.
The last time leptospirosis made news in New York was in 2017, when a cluster in the Bronx landed three people in the emergency room – sparking a wave of media coverage and criticism of the city's rat mitigation efforts. A 46-year-old man who worked in a meat processing facility had been hospitalized for muscle pain and shortness of breath after cutting his hand at work. He eventually developed the first documented case of testicular swelling associated with leptospirosis.
The two others lived or worked on the same block where the first man worked. Of the three, two recovered and one person died, the city said at the time.
A few months later, New York issued a veterinary medical alert when dogs started falling ill, some of which were believed to have slurped contaminated water in standing puddles while taking walks during the unusually warm winter.
There are about 16 cases of canine leptospirosis a year in New York, according to a surveillance report. Canine cases do not predict where human cases will occur, and while canine to human transmission is possible, no case has ever been documented in New York.
Climate change, homelessnessThe 15 cases of leptospirosis reported this year came from all over the city. The city's health department says it can't say for certain what's behind the higher number of cases.
Climate change is a likely driver, since warm, moist environments contribute to higher rates of leptospirosis. "Changes in climate that allow bacteria to persist could contribute to an increase in human cases," a health department spokesperson told Insider this week.
The spokesperson said that none of the leptospirosis cases had been traced to the widespread flooding in September from Hurricane Ida. Similarly, no infections had been linked to Hurricane Sandy in 2012.
Housing insecurity also puts people at greater risk of coming in close contact with rats and contaminated water. Three of the people infected this year were experiencing homelessness, and all of the local infections recorded in the health department's database since the year 2000 involved a person who was experiencing poverty.
A health department notice about rat control is seen on a street in Brooklyn on June 16, 2017. Robert Nickelsberg/Getty ImagesDr. Robert Glatter, a physician at Lenox Hill Hospital in New York, said leptospirosis frequently goes undiagnosed because it affects vulnerable populations who often can't access healthcare.
"The main issue for practicing physicians in big cities is to know about the disease, and then consider it in patients presenting with certain risk factors such as poverty or homelessness," he said in an email.
A task for SisyphusBrown rats, sometimes known as Norwegian rats, have been a fixture of New York City since they began arriving on boats from Western Europe in the 1700s. In 2014, statistician Jonathan Auerbach estimated that there were about 2 million rats in New York, which is about a quarter the size of the city's human population.
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There's no reliable headcount of New York City rats and how many of them carry the disease. Dr. Ian Lipkin, a Columbia University epidemiologist who co-authored a 2014 study on pathogens, including the bacteria that cause leptospirosis, in New York rats, said that the best thing the city can do is invest in rodent control.
The city spends millions of dollars a year getting rid of rats. There's even a regular "Rat Academy," which is aimed at turning community members into soldiers in the war on rats. (It will be held virtually this year, starting Oct. 21, and you can register here.)
But as Joseph Lhota, who was known as the city's "rat czar" in the 1990s, put it once: "Anybody who's in charge of eradicating rats in New York knows exactly what Sisyphus felt like."
A poster of New York Mayor Bill de Blasio is seen on a street where trash bags have been left out for collection during the Covid19 pandemic in June 2020. Noam Galai/Getty ImagesJust a few months after the 2017 outbreak in the Bronx, New York Mayor Bill de Blasio demanded "more rat corpses" and announced a $32 million anti-rat plan on top of the city's regular sanitation budget. This included $8.8 million for new trash compactors and another $16.3 million to put down concrete "rat pads" over the dirt, basement floors at the city's public housing units with the worst rat issues.
But then came Covid. While it appears that the widespread closures of restaurants and bars in March of 2020 helped to depress the number of rats scampering through the city, New York's vermin population appears to have more than recovered, says Dr. Robert Corrigan, a New York urban rodentologist who has guided several mayors on their anti-rat initiatives.
Rat complaints to New York's 311 hotline dipped down during 2020, the first year of the pandemic, and have increased by 20% so far in 2021, for a total of almost 20,000 complaints.
That coincided with a $45.6 million sanitation department budget cut, which reduced trash pick up around the city, including a 25 percent reduction in the areas identified by de Blasio's plan for rat mitigation.
Last week, a resident from Mariana Bracetti Plaza in the East Village – one of the developments included in de Blasio's anti-rat plan – posted a video to Instagram that went viral. In it, rats were plundering the pile of trash outside her window so voraciously that it woke her up.
A spokesperson for the New York Housing Authority said that inspectors had responded to the infestation and that no recent leptospirosis infections had been reported at its properties.
Richard Reynolds holds two dead rats hunted by his Jadterrier. Angela Weiss/AFP via Getty Images A Batman for New York's rat-averseRichard Reynolds knows all too well the problem of rats repeatedly returning to a pile of garbage.
Reynolds leads a double-life: By day, he's an American Kennel Club certified dog show judge. By night, he runs a volunteer group of rat-hunting dog-owners, becoming a version of Batman responding to calls from desperate city residents. He gets complaints from public housing projects "constantly," often to the same trash cans.
Most Friday nights, for over thirty years, he makes the trip into New York from his home in New Jersey to lead rat-hunting trips with his terriers.
The resulting spectacle is not for the squeamish, as fresh blood streams from the dogs' mouths and maggot-infested rat carcasses are dragged out into the open.
Reynolds says he's never had a dog get sick as long as he's been hunting rats.
"You can tell when you see a pile of dead rats if they look sick and dehydrated, they probably have lepto," Reynolds said. "Our dogs walk right past those rats."
Richard Reynolds with other members of the volunteer R.A.T.S. Squad in lower Manhattan. Angela Weiss/AFP via Getty ImagesLike others, Reynolds is well aware that ridding New York City of rats is an uphill battle.
"If you have two rats today, you'll have 24,000 rats a year from now if there's enough trash for them to eat," he said.
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