Cloudy urine: causes, symptoms and treatment

Cloudy urine: causes, symptoms and treatment

What is cloudy urine?

Before finding out what cloudy urine is, let us first take note about what normal urine looks like. Normal urine has a straw yellow or pale yellow to dark yellow color and it is clear. The color of urine depends on the amount of water you drink. If you consume a lot of water, then your urine color will have pale yellow color as the urine will be diluted due to the high contents of water in it. On the other hand, the color of urine will be darker in color in those who consume very little water as the urine will be more concentrated. Whether urine is pale or dark yellow in color, this characteristic feature is a normal thing for all of us to have. However, if the urine loses this clear appearance, it is not normal and we refer to it as cloudy urine or foamy urine. Turbid urine is another name given for this same condition.

Cloudy urine is not always pathological. It can be a result of dehydration as well. So how will you know if the cloudy urine is something for you to worry about or not? Cloudy urine is only a problem if it tends to persist for a long period of time. If you notice cloudy or foamy urine in the absence of any other symptoms, and clears away quickly, then it is of little consequence.

Why is my urine cloudy and smell bad?

How is color of urine helpful?

color of urine meaning
Color of urine meaning Image credit: https://my.clevelandclinic.org/

Color of urine has always been a valuable tool that helps in diagnosis since the start of medicine. This is because it has helped to reveal a lot of important information regarding an individual’s health. Urine is what our body eliminates and this function of our body is very important as it helps to regulate the amount of water in the body and at the same time helps the body to get rid of various toxic and waste substances from our body. The color, smell and the amount of urine that one passes will give us valuable information whether or not something is wrong with the body. The ideal characteristics of the urine that says that it is healthy are a urine color of straw or pale yellow to dark amber color. If anything apart from this is noticed, it is an indication that there is something wrong.

What are the causes of cloudy urine?

First, answer this question: what is urine? Urine is a liquid that is made up of all the waste products and toxic products that are produced by our body by means of metabolism. This liquid is filtered from the blood through the kidneys, stored inside the bladder until you urinate to pass this liquid out of your body. Since urine is a collection of all the waste products in the body, it is considered as a good indicator of your health condition. Anything different from this indicates that there is a problem with your health. One of the common causes of cloudy urine is due to the presence of proteins in urine and proteins in urine indicate that there is something wrong with the kidney functions.

Cloudy urine is not always pathological. It can be a result of dehydration as well. So how will you know if the cloudy urine is something for you to worry about or not? Cloudy urine is only a problem if it tends to persist for a long period of time. If you notice cloudy or foamy urine in the absence of any other symptoms, and clears away quickly, then it is of little consequence.

cloudy urine with odor, no pain, in the morning with back pain, Child dehydration, pregnancy, STD
Cloudy Urine Causes Image credit: https://draxe.com

However, here are some common causes of cloudy or foamy urine:

Dehydration

As mentioned earlier, cloudy urine can be a sign of dehydration. If this is seen in the absence of other symptoms of dehydration, then it is not something to worry about, especially if this disappears rapidly. However, if it is associated with other symptoms of dehydration such as dry mucous membranes, increased skin turgor and increased thirst, then you should take this much seriously. To avoid this, drink plenty of fluids throughout the day.

Urinary tract infection

This is one of the most common causes of cloudy urine. During a urinary tract infection, there is increased number of pus cells and blood cells within the urinary tract in response to the inflammatory reaction that is occurring within the body and these pus cells and red blood cells will be passed out of the body along with the urine, thus making the urine cloudy in appearance.

Urinary tract infections can occur anywhere in the urinary tract and out of the common places; bladder is one place where such an infection can occur. This is known as cystitis. Cystitis usually is responsible for cloudy urine and this is commonly associated with a burning sensation of urination (known as dysuria).

Pregnancy

It has also been found that cloudy urine is commonly seen during pregnancy. This may be due to a urinary tract infection as urinary tract infections are one of the most common medical problems that pregnant women often experience. If you are pregnant and have noticed cloudy urine with or without other urinary tract symptoms, it is important that you seek medical attention quickly. This is really important because of the risks such as preterm deliveries and low birth weight of infants that are associated with bacterial infections during pregnancy.

Kidney stones

Kidney stones are another important symptom and affects up to 5% of the population. This can also cause cloudy urine because kidney stones too, just like urinary tract infections can cause pus in the urine. This gives urine a cloudy or foamy appearance. Kidney stones are an extremely painful condition. The reason for this is that due to the spiky surface of some kidney stones, they can damage the wall of the ureters as they pass down thus producing a sudden onset, severe colicky lower abdominal pain on the right or the left depending on the side where the stone is found. This pain is intermittent meaning that the pain comes and goes. You may be well in between the episodes. The tearing of the wall of the ureters can lead to infections which may result in the formation of pus that will be added to urine, thereby causing the urine to have its cloudy appearance.

Gonorrhea

Cloudy urine can also be symptoms of Gonorrhea infection. Gonorrhea is a sexually transmitted infection that can occur in both males and females. Gonorrhea is an infection of the genitals an may involve the rectum as well. This infection results in an increased discharge from the vagina in females and from the penis in males. When this discharge mixes with urine, it gives the urine a cloudy or a foamy appearance.

Chlamydia

This is another serious sexually transmitted disease that may not be detected in many. This also causes cloudy urine for the very same reason as explained with Gonorrhea.

Diabetes mellitus

Diabetes mellitus is a common cormobid condition which affects the kidneys in the long term, especially when it is poorly controlled. Therefore such conditions can cause cloudy urine.

Cloudy urine alone is not useful to come to a diagnosis. Therefore it is important that you pay attention to other signs and symptoms that may be associated with cloudy urine to help you come to a diagnosis. For instance, if you are experiencing cloudy urine together with a burning sensation while passing urine, you may have a urinary tract infection. Urine may have a foul smell in case of a urinary tract infection. If you experience cloudy urine together with a severe, intermittent colicky abdominal pain, you could be having renal stones.

Don’t worry, cloudy urine does not always mean that you have a serious health condition behind. It can be normal as well, as mentioned previously. Cloudy urine may indicate a health condition only if you have been experiencing this symptoms for several days in a row. If you experience cloudy urine, first of all think about what you have done during the day that would have caused this. For instance, did you take any drugs, did you eat something different during the day or have you had sex and did you notice any additional symptoms associated with cloudy urine.

What are the risk factors of bladder infections?

Females have an increased risk of developing bladder infections than men. The reason for this is that women have shorter urethras, thus making it easier for the bacteria to reach the bladder. In addition, the female urethras are in close proximity to the anus, where many bacteria are found therefore there is a shorter distance for bacteria to travel.

Other risk factors include:

  • Elderly people
  • Immobility
  • Reduce fluid intake
  • Insertion of a urinary catheter
  • Blockage of the bladder outflow tract
  • Abnormalities of the urinary tract, which is caused by birth defects or injuries.
  • Urinary retention
  • Narrowing of the urethra
  • Enlarged prostate
  • Fecal incontinence
  • Pregnancy
  • Diabetes mellitus

What are the symptoms of bladder infection?

Signs and symptoms may not be the same in each and every person. It may also depend on the severity of the infection. Typically, the initial symptoms you may notice are changes in the urinary tract. As the condition worsens, pain may develop.

The following signs and symptoms can occur:

  • Dysuria – Burning sensation during urination.
  • Frequent urination
  • Urgent need to urinate
  • Urinary urge incontinence – Uncontrollable loss of urine. It is a common occurrence in elderly people.
  • Fever is rare but may occur
  • Lower abdominal pain
  • Nocturia – Frequent urination at night
  • Cloudy or blood stained urine
  • Strong foul smelling odor with urine
  • Back pain on either side – This is usually the kidney pain that you will feel. This indicates that the infection has spread to the kidneys.

Who is at risk of developing cloudy urine?

One of the common causes of cloudy urine is due to the presence of proteins in urine and proteins in urine indicate that there is something wrong with the kidney functions. Therefore if you have a high risk of developing kidney disease, then you are at risk of developing cloudy urine. You may be at a high risk of developing kidney disease if you have:

  • Diabetes mellitus
  • Family history of kidney disease
  • High blood pressure

How is the underlying cause for cloudy urine diagnosed?

The best way to diagnose the underlying cause for cloudy urine is by doing a urine analysis. Your health care provider will ask you to give a sample of your urine to do a urine full report. With a urine full report, any urinary tract infections can be diagnosed. It will also show if there are any proteins in the urine.

This test is done to test a sample of your urine for the presence of:

  • White blood cells
  • Red blood cells
  • Nitrites
  • Bacteria
  • Other chemicals

For this test, you have to provide a mid-stream or a clean catch sample of urine. This is to make sure that the urine sample is not contaminated with bacteria from the vagina or the tip of the penis.

If the urine full report indicates that there is a urinary tract infection, then your health care provider may ask you to do a urine culture to find out what the exact organism is and together with this, they will also order an antibiotic sensitivity test (ABST) to find out what antibiotics will help clear off the bacteria soon. The results of these investigations will help your doctor to plan your management effectively.

Another important test that your health care provider may ask you to do is the urine albumin to creatinine ratio. This test compares the level of albumin in urine to the level of creatinine in urine. Albumin is a protein and creatinine is a substance which is produced when muscles break down. This test will give a clue of how well your kidney is able to filter the blood. If this ratio is high (that is more than 30 mg/g) then it indicates that you may be having a kidney disease.

X ray of the kidneys, ureters and the bladder will help to diagnose any renal, ureteric or bladder stones.

How is cloudy urine treated?

There is no specific treatment for cloudy urine. Treatment depends on the underlying cause. Doctors do not treat cloudy urine alone, they treat the underlying cause. That way the cloudy urine will resolve on its own. If you feel that the cloudiness of your urine is due to your diet, then the solution is simple and quick. Stop eating those foods that may contribute to the cloudiness of the urine.

If the cloudy urine occurs as a result of bladder infections or a urinary tract infection, then antibiotics Is the mainstay of therapy. With proper treatment with antibiotics covering the causative organisms, the symptoms will clear up within a couple of weeks.

If the cloudy urine is due to kidney stones, then it is mainly conservative management where your health care provider will prescribe you pain killers for the pain and ask you to drink more water. They expect you to pass the stone on its own. If the stone fails to pass naturally, a urologist that is a doctor specialized in conditions related to the urinary tract will break them up with the help of an ultra sound treatment or shock wave so that you can pass the pieces.

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Thilini Gunawardane
About Thilini Gunawardane 28 Articles
I am a final year medical student and I'm currently doing my clinical rotations in a private hospital. A huge people-person, an open minded who spent several years in the field of Medicine. I am at my final year on Medicine and clinical rotations at a Hospital (Dr Neville Fernando Teaching Hospital (NFTH). My long term run is to be a consultant one day and serve everyone in need. This has always been in my bucket list and I myself as a go-getter, will make my promisses and prove it to my self. Every-day I wake up knowing how little I know and I work for it. I learn, I use all my sources I have. Working online, I have gained so much experience and learned many things that a person should have in a working environment, time/project management, satisfying the client, meeting deadlines on time.

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