Does your pee smell fishy or like overripe fruit? It could point to health issues
Petai, coffee, and certain supplements and medicines may be responsible for your urine’s unusual odour as well. We ask the experts when you should be sniffing around for signs of diabetes, UTI and more.
Depending on how you look at them, bathroom breaks can be welcomed reprieves or inconvenient disruptions to your busy schedule. But regardless, toilet trips are necessary to release the pressure on your bladder.
Most people would feel the urge to pass urine when there’s around a cup or 200ml of urine in the bladder. On average, you produce around 1,500ml of pee a day, depending on how much water you drink. And all that liquid needs to be released about four to six times a day on average.
Urine is mostly water and is produced by the kidneys filtering waste (known as urea) from your blood. It is this waste that creates funky smells in the toilet bowl after you’re done tinkling – the catch is, it shouldn’t be that funky.
“In most cases, a healthy person's urine should not have a strong smell," said Dr Priyanka Khatri, a consultant nephrologist at Alexandra Hospital.
But if you haven’t been drinking enough water, your urine will have a high urea content and a strong ammonia odour, added Dr Chong Kian Tai, a urologist from Farrer Park Hospital.
In most cases, a healthy person's urine should not have a strong smell.
Drinking alcohol or caffeinated drinks such as coffee or tea can also lead to "concentrated or smelly urine", said Dr Khatri. Such beverages are diuretics, which means they make you pass lots of urine. And when you don't adequately replace the lost water, your urine gets concentrated.
"Also, a minor percentage of alcohol can be excreted in urine," said Dr Khatri, adding that if you drink a lot, you are going to expect an alcohol-like smell in your pee. Similarly for coffee, its polyphenols can make your urine smell like, well, coffee, she said, if you drink a lot of the beverage.
Certain food can also “perfume” your pee, such as petai (also known as stink beans), asparagus, curry, garlic and onion. "Some vegetables like onion and garlic break down into compounds like methyl mercaptans or sulphur-containing chemicals. If such foods are ingested in large quantities, these compounds can be released in the urine and cause a pungent, sulphur-like smell," said Dr Khatri.
According to Dr Chong, taking too much Vitamin B6 supplements is another cause of the smell. Similarly, some medicines for diabetes and antibiotics (especially a group called sulfonamides) can also add a pong to your urine, noted Medical News Today.
Dr Chong also pointed out that using a douche or scented feminine hygiene products "may expose your private parts to harmful chemicals". "Sometimes, this can cause infections, changes in the normal bacteria levels, and strong odours when urinating," he said.
SHOULD YOU BE ALARMED IF YOU SMELL SOMETHING?
If your urine smells foul but you feel fine otherwise, consider drinking up to two to three litres of water a day to neutralise the odour, advised Dr Khatri.
Too much water to chug? "A healthy person can drink that amount of water with no issues, but patients with underlying heart and kidney disease should follow their doctor's advice on how much water to drink in one day."
But "if you have fever, abdomen pain or discomfort when passing urine, please see a doctor immediately to treat possible urinary tract infections", advised Dr Chong.
Here’s a look at some scenarios where a smelly urine could indicate health issues:
URINARY TRACT INFECTION
Smells like: Something fishy
What it could be: The peculiar smell could point to a urinary tract infection or UTI (which can happen to both men and women), especially if the infection is caused by the bacteria, Aerococcus urinae, according to Medical News Today.
There may or may not be other symptoms, including a burning sensation during urination, cloudy or bloody urine, the need to pee urgently or frequently, lower abdominal or back pain, or a mild fever.
Smells like: Something fishy
What it could be: How do you tell whether the odour is caused by a vaginal infection or UTI? Both issues can make your nether region feel like it is burning when you’re urinating, noted Healthline, but a vaginal infection also hurts during sex.
The fishy odour also worsens after sex, according to Medical News Today. Other symptoms include itchiness in the vagina or vulva, or a thick and milky discharge.
Smells like: Sweet, overripe fruits
What it could be: At least you can skip the air freshener? Erm, no. The smell is not good news as it can signal diabetes. This is because the body is trying to get rid of the excess blood sugar and is dumping it in your urine, which creates the sweet smell, according to Healthline.
Watch out for other signs, including frequent urination especially at night, intense thirst, fatigue, slow wound healing, blurred vision or high blood pressure.
Smells like: Old socks or rotting wood
What it could be: Phenylketonuria or PKU results in the decreased metabolism of the amino acid phenylalanine, which is behind the smell in the urine. This rare condition can cause a serious health issue as the build-up of the amino acid, which comes from eating protein and aspartame (yes, the artificial sweetener), can lead to neurological problems.
In fact, individuals born with this genetic condition will also notice the mouldy, musty odour on their breath and skin, according to Mayo Clinic. Other symptoms include decreased skin pigmentation, intellectual disabilities, or slow-developing social skills.
MAPLE SYRUP URINE DISEASE
Smells like: Maple syrup
What it could be: Yes, you read right. If your infant produces urine that reminds you of maple syrup, take him to the doctor pronto as the lack of treatment can lead to brain damage and death, according to Healthline.
The sweet urine smell is triggered by the body’s inability to break down the amino acids leucine, isoleucine, and valine. Like phenylketonuria, this rare disease can lead to brain issues if the amino acids' levels are not controlled.
Smells like: Rotten eggs and garlic
What it could be: The condition is nicknamed “breath of the dead” for the way the patient's breath smells – and not just the urine. The odour is a sign that the liver isn't able to filter out toxins and as a result, sulphur substances have made their way into the bloodstream, lungs and kidneys.
This severe form of liver damage often leads to portal hypertension, which refers to the increased pressure in the portal vein that carries blood from the digestive organs to the liver. As a result, blood can't flow easily through the liver and gets backed up in the veins surrounding the organ, according to Healthline.