Smelly Urine - Causes, Diagnosis, and Management

What Is Urine?

The urinary system, or the body's drainage system, makes urine and eliminates it from the body. The cells present in the human body utilize various nutrients and produce waste products. These waste products are directly released into the bloodstream. When this blood reaches the urinary system, the kidneys filter it. It implies that the kidneys remove the valuable substances from the blood, send them back to the bloodstream, and form urine with the waste products and toxins. Next, the urine travels to the urinary bladder from the kidneys and is expelled from the body through the urethra (a tube-like structure that removes urine from the bladder to the exterior). A person might have problems related to urination if they have the following conditions:

• Urinary tract infections.

• Kidney failure.

• Enlargement of the prostate gland.

• Urinary incontinence (bladder control is lost).

• Overactive bladder.

• Urinary tract obstruction.

What Are the Causes of Smelly Urine?

Urine is a waste product produced by the body and is not a sweet-smelling substance. It has a distinct ammonia-like odor, especially when the person urinates for the first time in the morning or is dehydrated. However, smelly urine might be a sign of infectious diseases as well. If a person experiences smelly urine and other associated symptoms, they must immediately consult the doctor. One of the reasons for smelly urine is that urine contains more waste than water. The common causes of smelly urine are:

1. Concentrated Urine - Highly concentrated urine contains more ammonia and less water. As a result, the urine has a strong smell. The urine also becomes concentrated when a person remains dehydrated for prolonged periods. The other signs and symptoms of dehydration are listed below:

• Dry mouth.

• Lethargy.

• Weakness of the muscles.

• Headache.

• Dizziness.

2. Diet - Diet also plays a significant role in determining urine odor. People consuming asparagus-containing foods are more likely to experience abnormal urine odor. Sometimes, people having foods containing garlic experience changes in the urine smell. This is because garlic contains sulfur, so the patient must limit the consumption of these food items and notice the changes.

3. Medications and Herbal Supplements - The urine odor might change due to the following medications and herbal supplements:

• High doses of thiamine and choline (multivitamins).

• Antibiotics, including Sulfonamides.

• Anti-diabetic drugs (medications used to control diabetes).

• Chemotherapeutic drugs (medications used to treat cancer).

4. Medical Conditions - The following medical conditions might be associated with the change in urine odor:

a) Urinary Tract Infections - A urinary tract infection occurs due to the proliferation of harmful bacteria in the urine. The bacteria might grow and affect the other organs of the urinary tract. The first sign of urinary tract infections is the change in the urine odor. The patient might have the following symptoms with the change in the urine odor:

• Pneumaturia (gas in the bladder that exits while passing urine).

• Urinary frequency.

• A strong urge to urinate.

• Cloudy urine.

• Dark urine.

• Hematuria (blood in the urine).

• Fever.

b) Bacterial Vaginosis - As the name suggests, bacterial vaginosis is the bacterial inflammation of the vagina. People suffering from this condition have a distinct fishy urine odor that worsens after sex. Other symptoms are listed below:

• Pain.

• Burning sensation while passing urine.

• Itching.

• Whitish or grayish vaginal discharge.

c) Diabetes - People suffering from uncontrolled diabetes and taking antidiabetic medications are more likely to have changes in urine odor. The urine smell is very sweet if it contains too much sugar. Some of the other symptoms of diabetes are listed below:

• Intense thirst.

• Fatigue.

• Loss of weight.

• Itchiness in the genitals.

• Weight loss.

• Delayed wound healing.

• Vision problems.

• Hypertension (high blood pressure).

d) Organ Failure - Studies have reported that urine odor might also change if the organs involved in digestion and urination fail to work properly. People suffering from kidney failure are more likely to notice a change in urine odor.

e) Sexually Transmitted Infections - Sexually transmitted infections, including chlamydia, can cause abnormal vaginal discharge; the odor changes when this discharge flows with the urine.

5. Ovulation - Ovulation is the time when the ovaries release an egg in the female’s body. This egg fertilizes the sperm from the male genital tract and forms the future baby. Women are likely to experience hormonal changes at the time of ovulation. As a result, they might feel that their urine smells strong. However, ovulation itself does not change the urine smell.

6. Pregnancy - Some females might notice a change in the urine smell during pregnancy. This is because the body undergoes a lot of hormonal changes during pregnancy. If a female is suffering from urinary tract infections at the time of pregnancy, she is more likely to experience a change in the urine odor.

7. Liver Problems - People suffering from liver and kidney diseases are more likely to experience a change in the urine smell because these organs filter the waste products from the body. If the liver fails to function, the patient will likely experience smelly urine.

How Is Smelly Urine Diagnosed?

The doctor might recommend the patient undergo certain tests to diagnose the underlying causes of the change in the urine odor. Some of the tests are listed below:

1. Urinalysis - A sample of the patient’s urine will be taken and tested for bacteria and other abnormalities.

2. Cystoscopy - It is a procedure in which a thin tube-like instrument known as the cystoscope is inserted into the urethra to detect urologic abnormalities. It helps the doctor to look for urologic diseases.

3. Imaging Test - The doctor might perform an ultrasound or an X-ray if the urologic tests fail to detect the cause of changes in the urine odor.

How to Manage Smelly Urine?

Several home remedies are available to manage smelly urine, but the below-mentioned treatment measures can be followed to manage smelly urine:

• Antibiotics, including antifungals, can be used to manage smelly urine due to urinary tract infections.

• The doctor might prescribe an alternative medication if the patient has smelly urine due to some particular medication or supplements.

• The doctor might recommend lifestyle modifications and other treatment measures if the change in urine odor is due to diabetes.

What Home Remedies Help Prevent Smelly Urine?

The following home remedies help prevent smelly urine:

1. Avoids consuming foods that impart a strange odor to urine. Onion, asparagus, and garlic must be specifically avoided.

2. Drink a sufficient quantity of water daily because dehydration is one of the major causes of smelly urine. If a person stays hydrated, water dilutes the chemicals present in the urine.

3. The doctor might suggest alternative supplements if thiamine or choline are the major causes of changes in urine smell.

4. Using the restroom as soon as one feels the urge to pass urine.

5. Keeping one’s blood pressure and blood sugar levels under control.

Conclusion:

Smelly urine is a common symptom of many urologic problems. Usually, the urine does not have any pleasant smell, but changes in the smell must not be ignored. Several medical conditions, dietary changes, and daily habits influence urine odor. Though the patient might not have any symptoms due to a change in urine odor, the affected person must consult the doctor immediately. A urologist will help the patient diagnose the cause of smelly urine and further treatment will be recommended to improve the patient's living quality.