Cloudy Pee Could Be Related To What You Eat, Doctors Say

Photo credit: Witthaya Prasongsin - Getty Images
Photo credit: Witthaya Prasongsin - Getty Images

You’d be lying if you said you never checked the toilet after you went to the bathroom. And there’s nothing wrong with that—taking a peek every once in a while is actually a good thing (and encouraged!).

It’s thought that pee should always be clear, but there are several totally NBD reasons why your pee might look a little hazy, says Hajar Ayoub, MD, a urologist with UT Health and UT Physicians. Most of the time it looks exactly how it should—clear, pale, and yellow—but sometimes, our urine appears cloudy or even opaque.

Murky pee is not always a cause for concern, says Andrew Bernstein, MD, a urologist with New Jersey Urology. “The vast majority of urine changes that are asymptomatic are actually nothing to worry about,” he says. That means if you don't have headaches, pain while peeing, abnormal swelling in your abdomen, or blurred vision, then your urine change is probably nothing to worry about.

FYI: Urine consists of water, salts, and bodily waste, and the combination of all three affects the basicity, or acidity, of your urine. The more alkaline your pee is, the cloudier it gets. One super common (and harmless) cause is a diet high in fruits and vegetables, says Dr. Bernstein. If that’s what you eat a lot of every day, your pee will take on a foggy appearance and that’s okay.

But if your pee appears milky or has a strong odor and it doesn't return to normal in a few days, you should check in with your doc.

Not sure if you need to worry about your pee looking off? These are the potential reasons this may be happening and what you can do.

Meet the experts: Hajar Ayoub, MD, is an associate professor of surgery at UT Health Houston McGovern Medical School. She has authored several papers and chapters on bladder dysfunction and complications of pelvic reconstructive surgery.

Andrew Bernstein, MD, is chief of the department of robotic surgery at Overlook Hospital in Summit, New Jersey, and chief of the urology department at Short Hills Surgery Center in Millburn, New Jersey. He has written numerous peer-reviewed articles and textbook chapters, and has spoken on a variety of urologic topics, including bladder cancer, urinary incontinence, and robotic prostate surgery.

1. You're not drinking enough water.

Dehydration is a common culprit for cloudy pee, says Dr. Ayoub. After all, studies show that 75 percent of Americans are chronically dehydrated. But drinking more Diet Coke or iced coffee isn't necessarily going to help you out. You need good old fashioned H20, she says.

That's because any kind of caffeinated beverage can make dehydration worse. “When we don’t consume enough water, urine becomes more concentrated and crystallized,” says Dr. Ayoub. “This will cause irritation in the bladder and can lead to cloudy urine.” Other signs of dehydration include headache, dizziness, fatigue, and dry mouth.

It’s recommended that the average adult drink about 70 ounces a day (barring any fluid restrictions for medical reasons, such as heart and kidney diseases), she says.

2. You have a urinary tract infection.

Yes, every woman's favorite thing—a UTI—can definitely cause your pee to look a bit cloudy. That's because UTIs happen when bacteria infects any part of the urinary system (your kidneys, bladder, and urethra), but UTIs typically only infect your bladder or urethra. They can be caused by dehydration, constipation, or just not emptying your bladder all the way, says Dr. Ayoub.

That bacteria is what makes your pee look opaque: "Urine will sediment, stagnate, and become a milieu for bacteria," explains Dr. Ayoub. A UTI can be treated with a round of antibiotics, and it’s definitely a "the sooner, the better" type of situation.

3. You have something called vaginitis.

Vaginitis is basically inflammation of the vagina, and it can also bring about murky urine along with abnormal vaginal discharge and an unpleasant odor, plus itching, and possibly even pain during sex, says Dr. Ayoub.

Vaginitis can also develop as a result of an allergic reaction to certain irritants and chemicals in personal care products like soaps or perfumed feminine products. If you think you might have vaginitis, see a doc—they'll likely prescribe you an antibiotic or antifungal medication and things should clear up in a week or two

4. You have a sexually transmitted infection.

Sexually transmitted infections (STIs) like gonorrhea and chlamydia, cause cloudy urine, says Dr. Ayoub—especially in the early stages of the infection. "These infections often result in discharge which taints the urine,” she says.

But cloudy urine can show up in more chronic stages of the infections too: “In the chronic setting, they also cause scar tissue in the urethra which prevents the bladder from emptying and therefore results in cloudy urine,” says Dr. Ayoub.

The tricky thing is if you're not paying close attention to your urine and discharge, you might miss an STI—aside from a change in appearance or amount of discharge, many STIs are asymptomatic, she points out. Check with your doctor if you notice abnormal discharge, experience any itching or pain along with cloudy urine, and ask for an STI test.

5. You have a kidney stone—or multiple kidney stones.

Kidney stones are literally good for nothing–and those sharp, spiky, painful-to-pass suckers could be the reason for the fog in your pee.

“When moving, the stones might cause tiny scratches that result in blood in urine, which then shows up as cloudiness," says Dr. Ayoub. If the stones contain bacteria, they might bring on a UTI too, which again results in cloudy urine. “Also, if the stones break up, some pieces will make urine look cloudy as well,” she says.

There's literally nothing fun about kidney stones, so check in with your doctor ASAP if you experience any symptoms.

6. Your urine might actually have blood in it.

So, yeah, blood is red—but if it shows up microscopically in your urine, it could make your pee look more cloudy than pinkish. “Causes of blood in urine include UTIs, kidney and bladder stones, enlarged prostate, and—rarely—urinary tract tumors," says Dr. Ayoub. It’s important to note that not every case of cloudy pee involves blood, she says, but you should get your urine tested and see a urologist to be sure.

7. You have chronic kidney disease.

Just so you know, this one is highly unlikely in an otherwise healthy person, but chronic kidney disease (CKD) is still a possibility with cloudy urine.

CKD is a progressive decline in the kidneys’ ability to perform one of its main functions: filtering metabolic waste products from the blood. “This can lead to the excretion of protein, which makes the urine look cloudy,” says Dr. Ayoub.

Other symptoms include nausea, fatigue, difficulty breathing, muscle cramps, and yellowing of the skin. The kidney damage is usually permanent, but controlling your blood pressure and glucose levels can help ease progression, per the National Institute of Diabetes and Digestive and Kidney Diseases.

8. You have diabetes.

Diabetes is a chronic disease that develops when your blood glucose (or blood sugar) is too high. Insulin, a hormone produced by the pancreas, helps regulate that sugar and use it as energy. But when your body doesn’t make enough insulin or doesn’t use it properly, the sugar stays put in the blood instead of going to other cells.

There are two main types of diabetes: Type 1 occurs when the body isn’t producing insulin, and type 2 (the more common of the two) occurs when the body isn’t responding to insulin properly. Both types can result in cloudy urine, according to Dr. Ayoub, “as they can cause sugar to appear in the urine when the blood sugar levels are elevated.” If you've had cloudy urine for a while—along with other common diabetes symptoms like urinating often and feeling extremely thirsty—check in with your doctor.

9. You have bacteriuria.

Bacteriuria occurs when bacteria has colonized in your urine and can be caused by not peeing after sex, wiping from back to front after a bowel movement, or a recent surgery in your urinary tract. It sounds like a UTI, but it really isn’t and it’s often asymptomatic, says Dr. Bernstein. It affects more woman than men, and is more likely if you are sexually active, pregnant, or have diabetes.

Bacteriuria usually clear up on its own. In fact, it often goes untreated unless you are pregnant, in which case a doctor will usually prescribe antibiotics. If you have recurring bacteriuria, Dr. Bernstein says practicing proper hygiene (i.e., wiping from front to back, bathing regularly, and wearing fresh underwear) can help prevent it from coming back.

10. You have a fistula.

A fistula is rare in an otherwise healthy person, but they are a little more serious. “It’s when there is a connection between two body parts that are not supposed to be connected,” says Dr. Bernstein. Fistulas are usually the result of a surgery or infection, and can be caused by cancer, previous cancer treatment (like radiation), prolonged childbirth, or a complication from bladder surgery. For example, your bladder can connect to the colon, rectum, or vagina, causing an infection and leading to cloudy urine.

Other symptoms include urine leakage, pain when using the bathroom, and passing stool or wind through the vagina, says Dr. Bernstein. Because fistulas are more complicated and concerning, they are almost always treated with surgery to remove the abnormal connection between organs, he adds.

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