Urine and the health of your urinary tract system

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In the previous article, we talked about stool and the potential health implications of your digestive system. In this article, we will look at what urine can tell you about the health of your urinary tract system.

Urine test also known as urinalysis. It is common in medical examination to identify the presence or elevation of abnormal substances such as protein, glucose, blood, bacteria, drugs, and many more. The results of urine tests can sometimes be affected by your diet, when you are dehydrated, after taking medicines, after strenuous exercise, and many other factors.

How is urine related to your health?

Your urinary system consists of kidneys, ureters, bladder and urethra. When blood circulates from all over your body and enters the kidneys, excess waste and water are being filtered out. The waste usually made up of water, urea, chloride, sodium, potassium, creatinine and other dissolved ions, and various inorganic and organic compounds.

The waste is then flowed to your bladder through ureters and is stored there until you urinate. The function of urinary system is to eliminate waste from your body, regulate your blood volume and blood pressure, regulate the levels of electrolytes and metabolites, and blood pH.

When there is an abnormality in the respective organs or functions, it will reflect on your urine colour, turbidity (cloudiness), pH, smell, etc. In most cases, issues with urinary tract can be treated. Unattended condition for example infection on urinary tract can cause sepsis, multisystem organ failure, and even death.

Urine of a healthy individual

Normally, urine of a healthy individual range from pale yellow to deep amber colour depending on the concentration of a pigment called urochrome (or urobilin), an organic waste product generated from the breakdown of old red blood cells.

Under normal condition, the urine smell is quite mild and rarely noticeable. Its cloudiness indicates whether you are well-hydrated or otherwise. The pH value of a normal urine ranges from 4.5 to 8.

For most people, daily urination of 6 to 7 times is considered normal, this also depends on how much water you drink and whether you take any diuretic substances (e.g., coffee, tea, certain medications).

Colour

Urine varies in colours for several reasons. It can be caused by foods, medications, water content, minerals, and also potential health risks (Figure 1).

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Smell

The smell of your urine can give you a clue of the potential health problems:

Strong ammonia-like smell: Dehydration
Sweet fruity smell: Diabetes or severe liver diseases
Foul smell: Urinary tract infection (UTI), bladder fistula caused by ulcerative colitis or Crohn’s disease, kidney stones.

Certain medications can also cause foul-smelling urine, for example:

Vitamin D
B vitamins
Sulfonamide (antibiotics)
Certain medications for diabetes
Certain medications for rheumatoid arthritis
Chemotherapy

Turbidity / Cloudiness

A cloudy urine is usually because of dehydration or high-alkaline diet. However, there are also other medical conditions that can cause cloudiness in urine. For example:

Excessive presence of white blood cells because of infection, such as:
- Urinary tract infections (UTI)
- Sexually transmitted infections (STIs)
- Sexually transmitted diseases (STDs)
- Prostate problems, vaginal infection (vaginitis).
Leakage of lymphatic fluid into kidneys (chyluria).
High content of minerals in urine, a potential risk for kidney stones.
For a person with diabetes, a cloudy urine can mean damage of the kidneys.

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Frequency

Frequent urination is a common problem as you age where your bladder gradually loses its holding capacity. Often, an overactive bladder can also be caused by over-consumption of diuretic foods and drinks such as alcohol, coffee, tea, watermelon, hawthorn, and many more. People with heart failure, liver failure, hypertension, oedema, kidney disorder, etc. usually need to take water pills to get rid of water and salt from their body. Other medical conditions that may lead to frequent urination are such as:

Urinary tract infection (UTI)
Infection that reduce the bladder’s capacity to hold urine
Diabetes
Prostate problems

Presence of blood in urine

Urine with blood is also known as haematuria. Sometimes, the blood appears as tiny clot, sometimes it diffuses in the urine and turns urine to pink, red, or brown. It is also common that the blood is visible only through microscope.

Presence of blood in urine indicates that you may have underlying medical conditions, for example:

Bladder or kidney stones
Kidney diseases
Kidney scarring
Enlarged prostate
Urinary tract infections (UTI)
Bladder or kidney cancer

In rare occasion, strenuous exercise can also lead to haematuria. Doctors are still investigating the causes. Preliminary findings link this to trauma to the bladder, severe dehydration, or the lysis of red blood cells due to sustained aerobic exercise.

Pain when passing urine

Painful or burning sensation during urination is commonly caused by urinary tract infection (UTI), which happens when there is an infection of bacteria in the bladder, urethra, or kidneys.

Some other potential causes may also include:

Irritation or inflammation of the genitals
Irritation or inflammation of the urethra
Sexually transmitted infections, such as gonorrhea or chlamydia
Kidney stones
Prostate disease or prostate cancer

Foamy or bubbly urine

Passing urine with lots of bubble every now and then is quite normal, especially when you are exerting force during urination or having full bladder. Sometimes, it is also caused by exercise, dehydration, stress, fever, or cold temperatures.

However, consistently foamy urine indicates the presence of protein in your urine (proteinuria or albuminuria). Healthy kidneys remove waste and keep proteins in your blood. While damaged kidneys unable to efficiently separate the proteins and cause protein leakage into the urine. Therefore, high level of protein in urine is a sign of kidney disease. This is commonly seen in people with diabetes and hypertension.

Common tests for urinalysis

When your doctor orders an urinalysis, he or she may look out for the presence of sugar and ketones, pH, concentration of urine, white blood cells, presence of blood, etc. The examinations usually include the following:

Visual assessment of the color and cloudiness of the urine.
Examination of the chemical substances using a urine dipstick.
Microscopy examination to look for white and red blood cells, abnormal cells, skin cells, crystals, bacteria, yeast, or other pathogens.
For infection cases, a bacteria culture may be performed.

Conclusion

It is important that you keep an eye on your urine colours, smell, turbidity, bubble, frequency, blood, etc. If there is a persistent change over a few days or pain sensation during urination, do not hesitate to seek immediate medical attention. Unattended condition for example urinary tract infection can cause sepsis, multisystem organ failure, and death.