Urinary tract infections (UTIs) are common bacterial infections that can affect any part of the urinary system, including the kidneys, ureters, bladder, or urethra. One of the most common symptoms of a UTI is changes in the color and smell of urine. Here’s an overview of what you can expect your pee to look like if you have a UTI.
Cloudy or murky urine
Normally, pee should be a pale yellow to gold color and appear relatively transparent. Cloudy or murky pee is one of the classic signs of a UTI. The cloudiness is caused by pus mixing into the urine. Pus contains dead white blood cells, tissue debris, and bacteria. This cloudiness occurs because your body sends white blood cells to fight the infection, and those dead white cells become pus.
Dark or brown urine
UTIs can sometimes cause pee to turn a dark or brown color. This symptom often results from blood mixing into the urine. The medical term for blood in urine is hematuria. Blood may get into the urine because the inflammation from the UTI causes minor damage and bleeding in the urinary tract. This symptom calls for prompt medical attention because it can signify a more serious type of infection.
Bright or neon yellow pee
Infections increase the concentration and change the composition of your pee. Dehydration from infection can make pee more concentrated. Your kidneys will also excrete more bilirubin into concentrated urine, giving it a bright or neon yellow appearance.
Strong or foul odor
UTIs often cause pee to have a stronger, more unpleasant smell. This odor results from the bacteria as well as chemical changes to your urine. Some describe the smell as similar to ammonia. The urine may also smell bad or unusual due to the presence of blood or pus.
Burning or stinging
A UTI can make peeing feel painful or uncomfortable. You may feel a burning or stinging sensation when you urinate. This symptom occurs because the inflamed urethra becomes irritated when urine passes through it. Passing frequent, small amounts of urine is also common with a UTI.
Foamy or bubbly urine
Pee that looks foamy or soapy may indicate protein or white blood cells in the urine. Both can signal an infection. The frothy look results from the mixture of protein, white blood cells, and air bubbles.
Urine containing visible sediments
UTIs can cause visible blobs, strings, or particles in pee. These sediments are typically formed by mucus, blood clots, tissue, or bacteria. The presence of visible sediments always warrants medical evaluation to determine the underlying cause.
What causes these UTI pee changes?
The most common cause of UTI pee changes is infection with bacteria that have gotten into the urinary tract. The leading culprit is Escherichia coli (E. coli), accounting for about 90% of UTIs. Certain strains of E. coli have traits that enable them to cling to and invade the lining of the urethra or bladder, causing inflammation and infection.
Less often, UTIs may be caused by other bacteria like Klebsiella, Proteus mirabilis, Staphylococcus saprophyticus, or Enterococcus faecalis. There are also non-infectious conditions that can mimic a UTI by altering pee color and smell, such as:
- Dehydration – Concentrates urine color
- Medications – Certain antibiotics, laxatives, chemotherapy drugs
- Foods – Beets, blackberries, rhubarb
- Vitamins – High-dose B-complex, riboflavin
- Diseases – Kidney stones, diabetes, liver problems
However, most cases of significantly abnormal-looking pee are due to UTIs. The bacteria multiply in the urinary tract, causing inflammation and shedding of tissue, white blood cells, and sometimes blood into the pee.
What do the different pee colors mean?
Here is a summary of what the various pee colors may signify with a UTI:
| Pee Color | What It Typically Means |
|---|---|
| Clear or transparent yellow | Normal pee |
| Cloudy or murky | Pus in urine from UTI |
| Dark yellow | Concentrated urine from dehydration |
| Bright or neon yellow | Concentrated urine with more bilirubin from UTI |
| Brown or pink | Blood in urine (hematuria) from UTI |
| Red or pink | Blood in urine from UTI |
| Orange | Concentrated urine plus bilirubin, medications, or foods |
| Blue or green | Rare side effect of medications |
Cloudy or foul-smelling urine with a UTI often means pus or bacteria are present. Brown, pink, or red urine indicates blood mixing with pee. While these colors always warrant evaluation, they don’t necessarily confirm a severe kidney infection. Mild bleeding from the urethra or bladder can produce these colors.
When to see a doctor
It’s important to get evaluated if you notice any unusual changes in your pee, especially if you also have UTI symptoms like:
- Burning with urination
- Increased frequency or urgency to pee
- Pressure or cramping in the pelvis or lower back
- Strong-smelling pee
- Fevers, chills, or fatigue
A simple UTI may clear up with a short course of antibiotics. More complicated infections involving the kidneys require urgent treatment. Leaving a kidney infection untreated can lead to permanent kidney damage or sepsis.
See your doctor right away if you have any of these more serious signs:
- Blood or pus in urine
- High fever (over 101°F)
- Back or side pain
- Nausea or vomiting
- Confusion or agitation
Certain people have a higher risk of complications from UTIs based on their age, gender, or medical history. Young children, pregnant women, men, and the elderly require prompt evaluation for suspected UTIs.
How are UTIs diagnosed?
Doctors can often make a presumptive UTI diagnosis based on symptoms and a visual assessment of urine color changes. However, they’ll recommend urine testing to confirm the diagnosis and guide treatment.
Common urine tests for diagnosing UTIs include:
- Dipstick test: Checks for signs of infection like nitrites, leukocytes, and blood.
- Microscopy: Fresh pee is examined under a microscope to look for bacteria and white blood cells.
- Urine culture: The urine sample is incubated to allow any bacteria present to multiply. This shows what germs are causing the infection.
- Urinalysis: Checks urine color and chemical composition for clues about the cause of abnormalities.
Doctors may also order blood tests to assess complications like kidney problems. Imaging tests like ultrasounds, CT scans, or MRIs can provide views inside the urinary tract to check for any anatomical issues.
Treatments for UTIs causing abnormal pee
Treatment focuses on eliminating the infection with antibiotics and addressing any symptoms. Options may include:
- Oral antibiotics: Antibiotics taken by mouth for 3-7 days usually cure simple bladder infections. Amoxicillin, nitrofurantoin, cephalexin, and trimethoprim-sulfamethoxazole are common choices.
- IV antibiotics: Severe kidney infections or cases not improving with oral medicines may need intravenous antibiotics given in the hospital.
- Pain relievers: Ibuprofen, naproxen, or acetaminophen can help relieve any pain or discomfort.
- Phenazopyridine: This medication turns urine orange but can help ease UTI pain and urgency.
- Drink more fluids: Staying hydrated dilutes urine and speeds healing.
Your doctor will tailor the treatment based on your symptoms, urine test results showing the germ causing the infection, and any medication allergies you may have.
Lifestyle remedies and prevention
You can reduce your chances of getting another UTI by practicing these daily prevention tips:
- Urinate as soon as you feel the urge.
- Wipe from front to back after using the toilet.
- Urinate shortly after sex.
- Stay hydrated.
- Avoid potentially irritating feminine products.
- Wear breathable cotton underwear.
- Take showers instead of baths.
Cranberry juice and supplements are also thought to help prevent UTIs by keeping bacteria from adhering to the urinary tract. Talk to your doctor about other suitable options for UTI prevention, especially if you get frequent infections.
When to call your doctor again
Be sure to call your doctor if:
- Symptoms don’t start improving within 2 days of starting antibiotics.
- You finish treatment but symptoms still aren’t fully resolved.
- You develop a fever, nausea, or worsening pain.
- Abnormal urine doesn’t return to a more normal color.
Relapsing or recurrent UTIs may require longer courses of antibiotics, different medications, or further evaluation to identify any underlying causes that may need correction.
The bottom line
Changes in pee color, smell, and consistency provide clues that you may have a UTI brewing. Cloudy, bloody, or foul-smelling pee due to a UTI requires prompt medical attention. Doctors can run urine tests to diagnose the infection and get you started on appropriate antibiotics. With treatment, your pee should soon return to its typical pale yellow hue and be free of any sediments, blood, or pus.