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Bad-smelling urine / smelly urine - causes, symptoms and home remedies

Bad-smelling urine / smelly urine - causes, symptoms and home remedies


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Bad-smelling urine is usually a clear indication of a health impairment. Because normally, fresh urine smells neutral and has a clear, slightly yellow color. If there is an unpleasant smell, it is in many cases a urinary tract infection or a metabolic disorder such as diabetes. In rare cases there can be an inherited disorder of the amino acid metabolism, which is colloquially referred to as "maple syrup disease".

A change in smell can also be caused by certain foods, e.g. Asparagus, garlic or coffee are produced, as well as from medication or after excessive alcohol consumption. In order to rule out a serious illness, a doctor should always be consulted as a precaution in the case of malodorous urine. If, for example, cystitis is not treated early during pregnancy, this can have serious consequences such as cause premature labor.

Definition

Urine (also called "urine") is a liquid excretion product that is formed in the kidneys and then excreted in the urinary tract (kidney pelvis, ureter, bladder and urethra). The emptying of the urinary bladder (“micturition” or “urination”) primarily serves to regulate the fluid and electrolyte balance, and the body is “cleaned” of metabolic breakdown products (e.g. urea, uric acid), drug residues and other toxic substances by these are flushed out with the urine.

Depending on the fluid intake, the kidneys produce about 1.5 to two liters of urine per day, with about 200 to 400 milliliters being normally released with each micturition. The urine consists of 95 percent water, the rest consists of electrolytes and urea, and in various proportions, among other things, vitamins, organic acids (e.g. citric and oxalic acid), creatinine and uric acid.

Urine texture: what smell and color reveal

Normally, the urine has a clear, slightly yellow color, which is caused by metabolic products (urochromes) such as porphyrins or bilirubin. Depending on the occurrence of urochromes or substances ingested with food, the urine may also have a completely different color. Examples here are intense yellow (hypotonic urine), red-brownish, black or green. It can also appear white or colorless or transparent (e.g. in diabetes). Fresh urine naturally smells neutral. The typical pungent, pungent ammonia-like odor only arises after a long time due to the bacterial decomposition.

Urine is generally considered an important indicator of various diseases. Accordingly, the urine test (urine analysis) is one of the oldest medical methods by which, among other things, kidney and urinary tract diseases, diabetes or liver diseases can be detected. In addition to visual abnormalities such as blood in the urine or a cloudiness, the color and smell of the urine play an important role in the diagnosis. For example, dark urine for a sick liver or strong-smelling urine may indicate a metabolic disorder.

Causes of malodorous urine

Normally the urine smells normal when urinating. Only when the urea is converted into ammonia by bacteria after a while does the severe, typically pungent, stinking stench develop. Accordingly, this is usually an indication of poor cleanliness and hygiene, as is known, for example, from toilets at motorway service areas or bathrooms that have not been cleaned for a long time.

In other cases, the urine already has a strange, unpleasant smell when urinating, for example after eating certain foods (such as asparagus) and in diseases such as diabetes mellitus or a bacterial infection. In newborns, a noticeable smell of the urine can indicate a congenital disorder of the fat metabolism or amino acid metabolism. Accordingly, any deviations should be observed and immediately examined by a doctor in order to avoid health risks.

Smelly urine of asparagus

Often there is a temporary change in the smell of urine after consuming certain medications (such as penicillin) or food. Accordingly, this is normally harmless and does not require medical treatment.

The “classics” include above all onions, garlic, coffee and asparagus. In the latter, the unpleasant, pungent, sometimes cabbage-like odor arises, for example, from an enzyme that breaks down the aspartic acid contained in the asparagus into sulfur-containing substances. However, this does not affect everyone equally. A study from 1987 showed that only 43 percent of the test subjects had the corresponding enzyme and were therefore affected by stinking urine after eating asparagus.

One thing is certain: the genes are crucial that not every asparagus can smell in the urine. Because the ability to break down aspartic acid is inherited. If both parents “smell it” strictly after they have eaten the “royal vegetables”, the children are also affected in any case, with only one parent the chance drops to 50 percent.

Bad-smelling urine caused by inflammation

The bad smell often arises in the course of a urinary tract infection, which means inflammation of the urinary tract, which is usually caused by bacteria. A distinction is made between two forms: The lower urinary tract infection is a urethral infection or a bladder infection (cystitis). In the case of an upper infection, on the other hand, there is an inflammation of the kidney (pyelonephritis).

In most cases there is an infection with the naturally occurring intestinal bacterium Escherichia coli (E. coli, coli bacteria), which enters the urinary tract via the urethra and causes inflammation there. Fungi or viruses are less often responsible, and it can also be a so-called haematogenic infection, in which the pathogen is spread further via the blood.

Overall, women are far more likely to develop a urinary tract infection because they have a much shorter urethra. In addition, the urethral opening is closer to the anus than in men, which makes intestinal bacteria easier to get into the urethra. Accordingly, there are various causes in women, such as wiping after defecation or drying after bathing or showering from the anus towards the vagina or unprotected vaginal intercourse directly after anal or oral sex.

Other risk factors include coated condoms, a diaphragm and improper intimate hygiene, since the protective vaginal mucosa is quickly attacked by intimate sprays or disinfectant lotions and pathogens can therefore penetrate more easily and cause an infection.

Women with a very active sex life are generally more prone to cystitis because the walls of the vagina, urethra and bladder are close together and are mechanically severely irritated by frequent sexual contact. As a result, the immune system is weakened, which in turn causes the pathogens to enter the urinary tract correspondingly faster ("honeymoon cystitis").

Malformation of the urinary tract, bladder or kidney stones, tumors or a permanent bladder catheter can favor an infection. Furthermore, people with a weakened immune system or diabetes mellitus are at greater risk, as are older men who suffer from an enlarged prostate (prostate hyperplasia).

Complaints of urinary tract infection

Depending on how serious the infection is and which structures are affected, very different symptoms can occur in individual cases. In some cases, women experience no further restrictions apart from an uncomfortable feeling when urinating.

Typical first signs are an unusually frequent urge to urinate, problems with urination (severe burning, cramp-like pain), unpleasant smelling urine, a weakened urine stream and pain in the lower abdomen. The frequent urination is so pronounced in some cases that those affected are literally surprised by the urge to urinate and wetting occurs if a toilet is not reached in time.

Other signs include clouding or dark urine, blood in the urine is also possible with a urinary tract infection. If the kidney is inflamed, the infection is usually particularly severe, in addition to fever, chills, massive abdominal or flank pain, nausea and vomiting, and a general feeling of "flu".

Men with concomitant prostate inflammation may experience blood in their sperm, sexual listlessness, erectile dysfunction and ejaculation disorders.

Smelly urine during pregnancy

Urine can smell bad during pregnancy, because during this time there is a significantly increased risk of a urinary tract infection. The background is that the muscles of the ureter are relaxed due to the hormonal change, which slows the flow of urine from the kidneys to the bladder and germs can rise more easily than usual.

Danger: If such an infection occurs during pregnancy, special care should be taken. If treatment is not timely, the kidneys can be affected quickly, which in turn can lead to premature birth or miscarriage in an emergency.

Cause diabetes mellitus

Another typical cause of unpleasant smelling urine is the chronic metabolic disease diabetes mellitus, which is one of the most widespread diseases worldwide. Various symptoms are subsumed under the term “diabetes”, which as a common feature have a permanently elevated blood sugar level.

A general distinction is made between type I and type II diabetes in so-called diabetes. In addition, there is the special form of “gestational diabetes” (gestational diabetes), which develops in about 5% of the expectant mothers from around the 20th week of pregnancy, but usually disappears after birth.

Children and adolescents are particularly affected by type I diabetes. The cause here is usually severe damage to the pancreas, which means that the vital hormone insulin can no longer be produced sufficiently. Accordingly, the necessary insulin must be administered by injection in these cases, which - like food intake - must be carried out according to a precise schedule in order to constantly supply the body with sufficient energy.

Type I diabetes affects only about 5% of all cases. The most common form is the type II variant, which accounts for over 90 percent of diabetes diseases in Germany. In contrast to juvenile (adolescent) diabetes, this primarily affects older people (“adult diabetes”), but more and more children also suffer from type 2 diabetes.

Type II arises on the one hand from a reduced response of the body cells to insulin (insulin resistance). Hereditary predisposition, disturbed insulin release and disturbed production of certain intestinal hormones are also possible. In addition, type II mostly occurs in combination with high blood pressure, overweight (especially on the abdomen) and fat metabolism disorders. These physical changes are summarized under the name "metabolic syndrome" (also "prosperity syndrome").

In diabetes, the symptoms depend on the stage in which the disease is, with initially only minor or sometimes no symptoms at all in both forms. Typical examples include intense thirst, headache, dizziness, fatigue, frequent urination and foul-smelling urine. Nausea and vomiting, cravings for sweets, severe itching or visual disturbances such as fibrillation can also occur.

Type II in particular often runs for a long time without clear symptoms, so that it is recognized only late. In many cases, this can result in long-term health consequences such as poorly healing wounds and swollen feet ("diabetic foot"), diseases of the retina ("diabetic retinopathy"), nerve damage or even a heart attack.

In type I, on the other hand, the symptoms appear much earlier in most cases, with weight loss, discomfort, intense thirst and increased urination occurring. It is also possible that a so-called “diabetic coma” (coma diabeticum) occurs with loss of consciousness due to extremely high blood sugar levels.

Maple Syrup Disease

In very rare cases, the so-called "maple syrup disease" can be the trigger for unpleasant urine. This is also known as "branched chain disease" or "leucinosis". It is a congenital, non-gender-related (autosomal) and recessive inheritance disorder in the amino acid metabolism, which means that the protein components (amino acids) leucine, isoleucine and valine can no longer be broken down accordingly. As a result, these amino acids and some breakdown products accumulate in all organs and body fluids. One of the breakdown products is reminiscent of maple syrup or Maggi seasoning.

The most common form of the disease occurs in the first few days of life and is mainly manifested by vomiting, poor drinking, lethargy, an unpleasantly sweet and spicy urine smell, stiffening of the neck and breathing problems that can lead to loss of consciousness and seizures. Accordingly, early detection and treatment of the disease is particularly important. If left untreated, the maple syrup disease can lead to severe overacidification of the body (ketoacidosis) with cardiovascular failure or respiratory arrest and may thus be fatal.

In addition to the "classic" variant, the symptoms of the so-called intermediate form of leucinosis only appear in infancy. Recurring vomiting, growth disorders, a delay in psychomotor development and various disorders of movement coordination (ataxia) are typical here.

The "intermittent" form only occurs between the ages of 12 and 24 months. In this case, those affected are often initially completely unremarkable and have no physical, mental or neurological deficits. However, this changes in the case of unusual metabolic stresses (fever, vaccinations, operations, etc.), through which the patient develops symptoms such as ataxia, impaired consciousness, coma or ketoacidosis, which can be fatal if left untreated.

Treatment for malodorous urine due to urinary tract infection

If a urinary tract infection is the cause, the therapy depends on how and how it came about. If there is a bacterial infection without other risk factors ("uncomplicated urinary tract infection"), an antibiotic is usually sufficient. If very severe pain occurs, the doctor can prescribe pain relieving or antispasmodic medication in parallel. Warmth (e.g. hot water bottle, grain pillow) is often very beneficial. It is important to drink enough liquid (at least two to three liters a day) to flush the urinary tract accordingly and to empty the bladder regularly despite the symptoms.

If it is a complicated or chronic infection, longer antibiotic therapy may also be necessary in some cases. If there are other risk factors such as diabetes, an enlarged prostate or a bladder stone, these must be eliminated if possible (for example, by an operation) to prevent a chronic infection.

If the urinary tract infection occurs during pregnancy, treatment must be carried out as soon as possible. If not treated, the risk of kidney inflammation (pyelonephritis) increases, which in turn can lead to premature labor and, in the worst case, to premature birth or miscarriage. Accordingly, a doctor should be consulted immediately if symptoms such as a burning or stinging when urinating, a persistent urge to urinate or malodorous urine. Only certain antibiotics such as e.g. Pivmecillinam in question to ensure that the health of the unborn child is not compromised.

Treatment for diabetes

Therapy for diabetes mellitus depends on the form of the disease. In general, the treatment goals should be agreed individually between patient and doctor in the respective case and regularly checked. Since there is an absolute insulin deficiency in type 1 diabetes, those affected have to inject the vital hormone all their lives. Here, on the one hand, normal insulin and, on the other hand, so-called “insulin analogues” are available, in which some amino acids are exchanged.

The treatment options for a Type II are more complex. Since this type is often based on overweight or obesity (obesity) in connection with a lack of exercise, a change in diet and regular physical activity are of fundamental importance in order to achieve the central goal of weight loss. If these measures do not improve, blood sugar-lowering drugs or later insulin are used.

It is particularly important that those affected make themselves aware that the success of the therapy is largely determined by their own actions. Diabetes is not curable, but extensive diabetic training can help to significantly improve the quality of life and life expectancy of patients by providing tips and information on appropriate nutrition, diet, exercise and medication. Accordingly, the individually tailored therapy measures should be firmly and permanently integrated into everyday life and implemented responsibly. Furthermore, blood sugar and blood fat values ​​as well as blood pressure must be continuously monitored by the treating doctor.

Therapy maple syrup disease

In acute therapy for leucinosis, the focus is on lowering the concentrations of the damaging amino acids, and the formation of toxic breakdown products must be avoided. In order to achieve this, the protein intake through the food is usually stopped for a maximum of two days, in parallel with the administration of high-energy substances such as glucose. In most cases, artificial nutrition (via infusion) and sometimes blood washing (dialysis) are necessary to reduce the amino acid leucine and its toxic breakdown products.

Since the three protein components leucine, isoleucine and valine cannot be broken down properly in maple syrup urine disease (English), but are vital at the same time, they have to be supplied to the body in sufficient quantities despite illness. The long-term or long-term treatment therefore consists in a low-protein diet and the targeted and supplementary intake of special leucine, isoleucine and valine-free amino acid mixtures, which are enriched with trace elements, vitamins and salts.

For the patient, the necessary diet means doing without particularly high-protein foods such as milk or milk products (curd cheese, cheese, yoghurt etc.), meat, eggs and nuts. Instead, the menu should consist mainly of fruit, vegetables, potatoes, rice and reduced-protein baked goods, pasta, etc.

Naturopathy for unpleasant smelling urine

If the urine smells unpleasant, drug therapy is not always necessary. Instead, naturopathy can often offer an effective alternative or support to alleviate the symptoms. Stinking urine often indicates a dehydrated state of the body, and larger amounts of garlic, fish, onions, asparagus, alcohol and eggs can also be responsible for the unusually bad smell. Accordingly, it often helps to drink as much water as possible (at least two to three liters a day) to clean the urinary tract and supply the body with sufficient fluids.

If there is a urinary tract infection, in addition to water and unsweetened tea, special bladder and kidney teas with extracts of medicinal plants such as nettle, birch or juniper are particularly suitable, which stimulate urine production. An infusion of bearberry leaves (Arctostaphylos uva-ursi) has a disinfecting and antibacterial effect. Cranberry juice from health food stores or pharmacies can be helpful, as it can reduce the number of bacteria in the bladder area and prevent new bacteria from becoming lodged.

Homeopathy for an uncomplicated urinary tract infection

Is it an "uncomplicated infection" without further risk factors such as a bladder stone or prostate disease, homeopathy can help. Depending on what complaints exist, very different means are used here. Belladonna, for example, has proven itself when there is a strong urge to urinate when lying or standing and urinating frequently. Cantharis vesicatoria ("Spanish fly") and Apis mellifica are suitable if there are strong burning and / or stinging pains when urinating in parallel with the constant urge to urinate.

Field horsetail (Equisteum arvense) can help with a rather dull pain and large amounts of light urine without a feeling of relief. In the event of severe complaints at the end of voiding and chronic infections of the urinary tract, experts recommend Sarsaparilla.

Important: Which remedy is the right one in each individual case, as well as the individual dosage and duration of intake, should always be discussed in advance with a naturopath, pharmacist or naturopathic doctor.

Proven home remedies for smelly urine

A number of other home remedies for cystitis are available for the natural treatment of a urinary tract infection. A simple hot water bottle is often very beneficial, which is placed on the stomach, between the legs or on the lower back, depending on the painful area, and thus directly helps to relieve the cramps in the abdomen and bladder.

An envelope with the so-called Swedish bitter (Swedish herbs) has a relaxing effect on the muscles of the bladder and can therefore have a positive effect on the healing process.

Swedish herbal envelope for cystitis

You need:

  • Ready mixed Swedish herbs from the pharmacy or a mixture you have prepared yourself
  • Fatty ointment (e.g. marigold ointment)
  • Cotton or kitchen paper
  • a piece of plastic film (cling film, piece of trash bags, etc.)
  • a thicker cotton cloth

In order to prevent skin irritation, the region around the pubic bone is first creamed with the ointment. Then the kitchen paper or cotton wool is soaked with the herbs and placed on the affected area. To protect clothing and bedding, a piece of plastic film can be placed over it if necessary. This also ensures that the moisture stays in the cotton for longer. Finally, the whole thing is covered with a warm cloth and the envelope is left on the painful area for about 2-4 hours. If this is removed again, the skin should be powdered for calming.

Important: If irritation does occur, it usually helps if you pause for a while and shorten the circulation time the next time.

Medicinal plants that can be used effectively in the case of a urinary tract infection include birch leaves, bearberry leaves, goldenrod cabbage and squirrel root. A tea made from these herbs helps to rinse out pathogens, has an anticonvulsant and anti-inflammatory effect.

Recipe for kidney and bladder tea
  • 30 g bearberry leaves
  • 15 g birch leaves
  • 15 g goldenrod herb
  • 15 g of hawk root
  • 250 ml water

Bring the water to a boil. Mix the herbs, put two teaspoons in a cup and brew with the boiling water. Let the infusion steep for 10 minutes, strain and drink in small sips.

In the area of ​​hydrotherapy, an increasing hip bath is considered a helpful procedure for malodorous urine due to cystitis. Schüssler salts are also well suited for the treatment of an acute urinary tract infection. Here, among other things, the salts No. 3 (Ferrum phosphoricum) and No. 9 (sodium phosphoricum) are used. (No)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Social Science Nina Reese, Barbara Schindewolf-Lensch

Swell:

  • Günther H. Jacobi: Practice of men's health: prevention, conventional medical facts, holistic approach, Thieme, 2003
  • Norbert Enders: Proven Use of Homeopathic Medicines: Volume 1: Diagnoses and Symptoms, Karl F. Haug, 2012
  • Richard Hautmann, Jürgen E. Gschwend: Urology, Springer, 2014
  • Josefine Neuendorf: The urine sediment: microscopy, preanalytics, evaluation and diagnosis, 2015
  • Hans-Ulrich Comberg: General medicine: 39 tables, Thieme, 2004
  • Rudolf Hänsel, Otto Sticher: Pharmacognosy - Phytopharmacy, Springer, 2006


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