Cloudy Urine

1 What is cloudy urine?

Under normal health conditions, urine is clear and light yellow in color. When the urine doesn't have a clear appearance or looks discolored, it is known as cloudy, turbid, or foamy urine. In some cases, it may look cloudy due to multiple reasons. Some of these causes are harmless and resolve on their own. A simple case of dehydration could cause urine to have a cloudy appearance.

There are some causes that indicate an underlying condition which requires medical attention.

Cloudy urine may occur in people of all age groups, and may or may not be associated with other symptoms like foul odor or pain while urinating.

Cloudiness of urine may be due to the presence of mucus, pus, or blood in urine. Sediments of phosphates and urates also make urine cloudy.

Other components that can make urine cloudy are urinary clasts, proteins, blood cells, epithelial cells, and necrotic tissues.

There are some medical conditions which could lead to an excess of protein or crystalline substances to be discharged in the urine, which could cause the cloudy or foamy appearance of the urine. Any form of infection in the urinary tract (UTIs), which includes the bladder or urethra, could result in blood or pus to be discharged in the urine that could be responsible for cloudy urine. This could occur in both men and women.

Apart from this, there are several other causes of blood being passed in the urine which gives rise of the cloudy appearance of the urine. Women suffering from yeast infections or sexually transmitted infections could have vaginal discharge that gets into the urine while giving a urine sample, and this could give the urine a hazy or cloudy appearance.

The presence of pathogenic microorganisms in urine also makes urine hazy or cloudy. Symptoms of cloudy urine vary depending on the cause of the condition.

Some of the commonly associated symptoms of cloudy urine are:

  • Abdominal pain
  • Bladder spasm
  • Changes in color of urine
  • Foul smell of urine
  • Frequent urination
  • Pain while urination
  • Sudden urge to urinate
  • Stiffness in joints
  • High blood pressure
  • Dehydration
  • Fever
  • Increased hunger
  • Nausea and vomiting

Some of the symptoms that indicate a serious, underlying condition as the cause of cloudy urine are:

  • Persistent cloudy urine
  • High-grade fever
  • Abdominal pain
  • Flank pain
  • Blood in urine
  • Change in consciousness

Early diagnosis and treatment of the condition will help in controlling the serious and potentially life-threatening conditions.

Probable causes of cloudy urine

There are a number of factors that could cause the appearance of urine to be cloudy. If you notice your urine color to be cloudy, frothy, or milky, it may not be necessarily be a reason to panic.

Cloudy urine could just about be a sign of an underlying medical condition but may not be a cause of concern. It is important to remember that in medical terms, cloudy urine is considered to be a symptom and not really an illness in itself.

Here are some of main causes that could be behind the cloudy tinge of your urine. There could be causes beyond these for some people, but the broader ones have been covered here:

  • Food: There can be a change in the consistency and the color of the urine due to the food one eats. Although this is not the most common cause of cloudy urine, it certainly can have a noticeable impact.
  • Discharge: Discharge like sperm or vaginal discharge could in some cases mix with urine causing it to have a cloudy appearance.
  • Blood traces: Sometimes there could be small traces of blood found in the urine, which may not be seen as the usual appearance of blood in its natural form, but may show up as cloudy urine. This happens when blood traces are microscopic.
  • Urinary tract infection (UTI): A UTI or a urinary tract infection is one of the most common causes associated with cloudy urine. A urinary tract infection is easy to identify as it is most often accompanied with a burning sensation while urinating.
  • Bladder infections: These are infections that affect the urinary tract, sometimes known as cystitis. The presence of a bladder infection could result in the urine appearing cloudy for many people. Cystitis is characterized by an inflammation or a swelling in the bladder. This form of infection could also be associated with painful urination or difficulty in passing urine or the urge to frequently pass urine.
  • Kidney problems: Issues like kidney stones can often be a reason for cloudy urine. Kidney stones could result in pus to be excreted along with the urine which gives a foamy or cloudy appearance to the urine. In case you are suffering from kidney stones, the bigger symptom to watch out for would be the pain arising due to the stones rather than the cloudy urine. A kidney stone is known to have sharp and uneven edges that can cause tear around the ureter when big in size. It could also get stuck when passing urine thereby causing a blockage around the urinary tract. This tear in the ureter could also lead to infections which can cause the pus which eventually leads to cloudy urine.
  • Gonorrhea: This condition could also result in cloudy urine primarily because of the vaginal discharge that is a common occurrence in gonorrhea, and one of the main factors leading to cloudy urine. It is however not a cause of concern since gonorrhea is a very treatable sexually transmitted infection.

Some of the other causes that could result in cloudy urine include:

  • Other sexually transmitted diseases
  • Urinary tract infection (UTI)
  • Kidney problems
  • Dehydration
  • Diabetes
  • Sickle cell anemia
  • Leukemia
  • Lymphoma
  • Certain autoimmune conditions
  • Inflammation of prostate gland
  • Prostate gland infection
  • Cardiovascular diseases

Why is my urine cloudy?

Cloudy urine may be associated with a foul odour when diabetes is uncontrolled or when the person moves to a low-carb diet. This is caused by the presence of high levels of ketone in urine.

The smell of ammonia in cloudy urine is caused by dehydration. In some cases, UTI may also be associated with cloudy urine with a foul odour. The cause of cloudy urine in men and women may be different.

In men, enlarged prostate, prostate infection, and prostate cancer may result in cloudiness. In women, cloudy urine may be caused by yeast infections, sexually transmitted diseases, or endometriosis. Certain medications are also known to change clear urine into cloudy.

Detecting the cause

Visual inspection of the urine sample is the best way to detect cloudiness. Physical examination by your doctor includes temperature, blood pressure, and abdominal examination. A kidney function test is used to detect abnormalities in the kidney.

Urine analysis is another diagnostic test for identifying the cause of cloudiness in urine. Radiological investigations are suggested in some special cases like prostate problems, where ultrasound scan may be of use. Ultrasound images are used in identifying kidney diseases too. In children, cystogram is suggested in certain cases for confirmation of the diagnosis.

Treatment depends on the underlying cause of the symptom. Drinking plenty of water helps to control dehydration, one of the causes of cloudiness in urine. Antibiotics are suggested for UTI, one of the most common causes of cloudy urine. Speak with your doctor thoroughly to understand all treatment options available to you.

2 Causes of cloudy urine

In a well-hydrated person, urine remains clear and slightly yellowish in color. There may or may not be an odor, mostly depending on the food consumed. Coffee, garlic, and beer are known to cause a strong-smelling urine.

Cloudy urine can be categorized into: 

  • Cloudy, but white urine
  • Cloudy and colored
  • Cloudy with strong odor
  • Cloudy with back pain

The causes of the different categories of cloudiness may differ as indicated below.

Cloudy or hazy urine may be caused by increased excretion of phosphate in urine. This may be due to large amounts of milk or milk products in the diet. Phosphate supplements, vitamin D intoxication, and hyperparathyroidism may also result in cloudiness, but without foam.

Another cause of cloudiness is increased secretion of oxalic acid, which may be due to certain food materials like spinach, nuts, tea, rhubarb, or animal fat. Other causes include low intake of calcium, deficiency of vitamin B6, and genetic disorders like primary hyperoxaluria.

Intestinal diseases like Crohn’s disease, chronic pancreatitis, intestinal bypass surgery, and cystic fibrosis are also implicated in the development of cloudy urine. Large amounts of leukocytes in urine may lead to hazy urine. This may result from tuberculosis, strep infections, the presence of kidney toxins, sepsis, and Kawasaki disease.

Cloudy and frothy, or foamy, urine may be caused by proteinuria, a condition characterized by increased secretion of proteins in urine. Emotional stress, strenuous physical exercise, and exposure to cold or heat may also cause hazy urine with foam.

Other causes of this category of cloudy urine include heart failure, kidney diseases, and increased production of protein. Kidney diseases like glomerulonephritis and interstitial nephritis are characterized by increased excretion of fat and protein in the urine, causing cloudiness and frothiness.

A number of diseases are characterized by increased production of urine including: 

Amber or dark yellow colored urine may be produced by dehydration or by foods rich in beta-carotene, vitamin B2, vitamin C, and artificial colors. Liver diseases like cirrhosis or hepatitis, gallbladder disease, and pancreatitis affect the flow of bile resulting in dark, foaming urine and other symptoms.

Dark-colored urine is produced by increased excretion of uric acid in urine. Having foods rich in purines like organ meats, meat extracts, gravies, beer, whiskey, asparagus, and cauliflower may result in increased excretion of uric acid.

Gout is a disease characterized by increased uric acid excretion in urine.

Gonorrhea and certain medications are also implicated in the formation of dark-colored urine. Beta carotene, chlorpromazine, ethoxazene, methyldopa, and phenacetin are some examples of medications that result in cloudy and dark-colored urine.

Pink or red-colored urine results from the presence of blood in urine. Strenuous exercise like a marathon, UTI, kidney stones, low platelet count, abnormalities in clotting of blood, hemochromatosis, hemochromatosis, and chemotherapy treatment of lymphoma and leukemia, all have hematuria as one of the symptoms.

Heat stroke and exposure to cold are also implicated in cloudy and pink-colored urine. Muscle damage due to different causes, porphyria, certain drugs, urinary catheter, and acute poisoning with ethanol also causes the color change in cloudy urine. Black urine is a symptom of alkaptonuria, a metabolic disease, and melanoma. 

High levels of ketone in blood result in cloudy urine with a strong odor. People on a low-carb diet or uncontrolled diabetes often have this symptom. Dehydration, autoimmune diseases, and UTI are other causes of cloudy urine with a strong odor.

Kidney stones may cause cloudy urine associated with lower back pain. In men, prostate conditions like enlarged prostate, prostatitis, and prostate cancer lead to cloudy urine. In women, yeast infections, endometriosis, and sexually transmitted diseases are causes of cloudy urine.

Cloudy Urine

3 Diagnosing and treating cloudy urine

Medical history and physical examination provide important clues regarding the probable cause of cloudiness in urine. During the physical examination, body temperature and blood pressure are assessed.

Abdominal extermination reveals bladder tenderness or other abnormalities in the abdominal region. In women, the vaginal examination is also suggested. Kidney function tests are recommended when the suspected cause is kidney abnormalities.

Urine analysis is the major test used in confirming the diagnosis of the urinary cause of the symptom. Chlamydia and gonorrhea infections are tested in the first pass urine. Specific urine culture is recommended if tuberculosis is implicated in the development of cloudy urine.

Intravenous pyelogram, an ultrasound scan of kidney and other organs in the abdominal region, and micturating cystogram are the radiological investigations used in confirmatory diagnosis. In men, the prostate scan is suggested for prostate problems.

Early diagnosis and treatment may prevent many serious conditions that lead to cloudy urine. Treatment method suggested depends on the underlying cause of cloudiness. Antibiotics are the treatment of choice for UTI and bladder infections.

Kidney stones may be treated with medications or broken down with ultrasound treatment or shock wave. During pregnancy, proteinuria is often a sign of high blood pressure. Bed rest and medications are recommended to reduce pressure during this period.

Surgery or medications are suggested to control interstitial cystitis. If food is the culprit in the cause of cloudy urine, cutting the item from the diet helps to prevent cloudiness. Dehydration can be controlled by having plenty of water.

The fogginess of urine caused by increased intake of phosphates or purines can also be controlled by keeping oneself well hydrated. This will help to clear cloudiness in the urine. Persistent cloudiness in urine should be brought to the attention of a doctor, so as to avoid major risks.

Cloudy urine is associated with a number of complications that depend on the underlying cause of the condition. Some of the complications, as in uncontrolled diseases, are potentially life-threatening.

Diagnosis and treatment of the underlying cause decrease the chance of complications. Diabetic coma, eclampsia, electrolyte imbalance, ketoacidosis, seizures, severe dehydration, shock, and septicemia are the complications associated with the underlying conditions that cause cloudy urine.

4 Can cloudy urine be associated with pain?

When one experiences severe pain along discolored or cloudy urine, it could be a strong indication of a UTI or kidney stones.

However, both pains are different from each other. While UTI pain primarily occurs while urinating, kidney stone pain is far beyond that in most cases.

In the case of pain arising due to a UTI, relief comes almost immediately after the person finishes on the toilet. When one suffers from kidney stones, pain can be agonizing and worsens when the kidney stones pass through the urethra while passing urine, and rubbing its uneven edges around the urethra. Unlike in a UTI, in this case the pain could also continue after one stops urinating. The cloudy appearance of urine in case of kidney stones can also have visible traces of blood.

Usually, the smell of cloudy urine is stronger due to a UTI rather than kidney stones.

When cloudy urine comes with symptoms like foul odor and pain, then it could very well be a strong indicator of a UTI.

5 Is cloudy urine different for men and women?

For men:

In case of men, one of the most common reasons why cloudy urine occurs is due to ejaculate secretion getting mixed with the urine.

This is not the same as semen getting mixed with the urine, as in this case the semen is in the urinary tract and is excreted from the body when one passes urine.

Semen mixed in the urine gives it a cloudy and milky appearance. However, it is not too common.

For women:

Cloudy urine in women is usually common during pregnancy. This is due to the amount of hormonal and physical changes during this time. Some of these changes cumulatively can cause cloudy urine, which is neither a cause of concern nor uncommon.

During pregnancy, a number of women experience an increase in vaginal discharge which could get mixed with the urine and cause it to have a cloudy appearance.

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