Symptoms
A change in urine color is manifested by a deviation from the normal color of urine, which usually varies from pale yellow to amber. It may occur as a solitary sign or along with other symptoms. Urine is usually clear and not cloudy. It gets its color from urine pigments called urochromes. These are, among other things, breakdown products of hemoglobin.
Causes
The causes of a change in urine color are varied and can be harmless, physiologic, or pathologic. Foods:
- Foods, sweets, and beverages can affect urine color when ingredients in them are excreted by the kidneys. Example are beet (beet), berries (e.g. blackberries), carrots, rhubarb and food dyes such as indigocarmine.
Dilution:
- A large fluid intake or a large urine output (polyuria) dilutes the urine pigments and makes the urine appear lighter. On the other hand, dehydration makes the urine darker due to concentration.
Hematuria:
- Blood often enters the urine due to a urinary tract infection such as cystitis. However, in addition, many other causes are also possible.
Bilirubinuria:
- A beer-brown urine with accompanying symptoms such as loss of appetite, pale stools, jaundice and itching indicates diseases of the liver or bile ducts. A medical diagnosis is mandatory, because serious diseases such as pancreatic cancer may be underlying.
Pyuria:
- Pyuria is the excretion of pus in the urine. A common cause is infectious diseases.
Medications: countless medications – including commonly prescribed ones – can discolor urine. The following list shows a small selection. Because patients can not necessarily make the connection between the drug and discoloration, they should ideally be pointed out by a healthcare professional when the medication is dispensed:
- Amitriptyline (green)
- Beta-carotene (yellow)
- Chloroquine (reddish brown)
- Diagnostics, e.g. fluorescein (orange), methylene blue (green).
- Iron (reddish brown, black)
- Iron chelators (red)
- Indomethacin (green)
- Isoniazid (orange)
- Levodopa (red, black)
- Methyldopa (black)
- Metronidazole (red, black)
- Mitoxantrone (blue, green)
- Multivitamin preparations (green, yellow)
- Nitrofurantoin (yellow, brown)
- Phenolphthalein (pink)
- Propofol (blue-green)
- Rifampicin (red)
- Senna in laxatives (red-brown).
- Sulfasalazine (yellow-orange)
- Triamterene (blue)
Other causes (selection):
- Myoglobinuria, hemoglobinuria (hemolysis), chyluria, crystalluria, phosphaturia, cancer, fever, rhabdomyolysis, porphyria, burns.
Diagnosis
Urinary discoloration that cannot be attributed to a trivial trigger such as food must be evaluated by a physician to determine the causes and take appropriate action. Fresh urine should be used for evaluation because the color may change over time.
Treatment
Treatment depends on the cause.
