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Urine - abnormal color

Discoloration of urine

 

The usual color of urine is straw-yellow. Abnormally colored urine may be cloudy, dark, or blood-colored.

Causes

 

Abnormal urine color may be caused by infection, disease, medicines, or food you eat.

Cloudy or milky urine is a sign of a urinary tract infection, which may also cause a bad smell. Milky urine may also be caused by bacteria, crystals, fat, white or red blood cells, or mucus in the urine.

Dark brown but clear urine is a sign of a liver disorder such as acute viral hepatitis or cirrhosis, which causes excess bilirubin in the urine.

Pink, red, or lighter brown urine can be caused by:

  • Beets, blackberries, or certain food colorings
  • Hemolytic anemia
  • Injury to the kidneys or urinary tract
  • Medicine
  • Porphyria
  • Urinary tract disorders that cause bleeding
  • Blood from vaginal bleeding 

Dark yellow or orange urine can be caused by:

  • B complex vitamins or carotene
  • Medicines such as phenazopyridine (used to treat urinary tract infections), rifampin, and warfarin
  • Recent laxative use

Green or blue urine is due to:

  • Artificial colors in foods or drugs
  • Bilirubin
  • Medicines, including methylene blue
  • Urinary tract infections

 

When to Contact a Medical Professional

 

See your health care provider if you have:

  • Abnormal urine color that cannot be explained and does not go away
  • Blood in your urine, even once
  • Clear, dark-brown urine
  • Pink, red, or smoky-brown urine that is not due to a food or drug

 

What to Expect at Your Office Visit

 

The provider will perform a physical exam. This may include a rectal or pelvic exam. The provider will ask you questions about your symptoms such as:

  • When did you first notice a change in urine color and how long have you had the problem?
  • What color is your urine and does the color change during the day? Do you see blood in the urine?
  • Are there things that make the problem worse?
  • What types of foods have you been eating and what medicines do you take?
  • Have you had urinary or kidney problems in the past?
  • Are you having any other symptoms (such as pain, fever, or increase in thirst)?

Tests that may be done include:

  • Blood tests, including liver function tests
  • Ultrasound of kidneys and bladder
  • Urinalysis
  • Urine culture for infection

 

 

References

Gerber GS, Brendler CB. Evaluation of the urologic patient: history, physical examination, and the urinalysis. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, eds. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 3.

Landry DW, Bazari H. Approach to the patient with renal disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 114.

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        Review Date: 8/31/2015

        Reviewed By: Jennifer Sobol, DO, urologist at the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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