Urine Odor

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What is urine odor?

Healthy urine may have a mild smell but generally does not have a foul odor. In some cases, an unusual or strong urine odor may be due to benign conditions that are not harmful, such as eating certain foods or taking certain medications. When urine persistently smells bad or has a foul, strong or unusual odor, it may be caused by an underlying disease, disorder or condition.

Urine odor can be a symptom of a variety of conditions, including infection, inflammation, or other conditions of the urinary tract (kidneys, ureters, bladder and urethra). Urine odor can also be caused by diseases, such as diabetes and dehydration, which affect the urinary tract as well as other body systems. 

Urine odor can occur in all age groups and populations, and it may or may not occur with additional symptoms, such as a cloudy urine, bloody urine, and burning with urination.

In some cases, urine odor can be due to serious or life-threatening underlying diseases, such as pyelonephritis or liver failure. Seek prompt medical care if you have persistent urine odor. Timely diagnosis and treatment of the underlying cause reduces the risk of serious or life-threatening complications, such as kidney failure and shock.

Seek immediate medical care (call 911) if you have urine odor with severe abdominal or flank pain, grossly bloody urine, or an unexpected change in consciousness or alertness.

What other symptoms might occur with urine odor?

Urine odor may be accompanied by other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms can be due to problems in the urinary tract (kidneys, ureters, bladder and urethra), the reproductive system, the endocrine system, the cardiovascular system, and other organs and systems of the body.

Urinary tract symptoms that may occur with urine odor

Symptoms related to the urinary tract that can occur with urine odor include:

  • Abdominal or flank pain along your abdomen, side or back

  • Abnormal coloring of the urine, such as dark, tea-colored, bloody, or pink-tinged urine

  • Bladder spasms, pain or cramps, which are felt in the lower abdominal area

  • Cloudy or foamy urine

  • Dribbling urine or incontinence

  • Frequent urination or a decrease in urination

  • Painful urination or burning with urination

  • Urgent urination

Other symptoms that may occur with urine odor

Symptoms related to other organs or body systems that can occur with urine odor include:

Serious symptoms that might indicate a life-threatening condition:

In some cases, urine odor can occur with symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms:

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

  • Grossly bloody urine

  • Inability to urinate

  • Severe abdominal pain or flank pain along your abdomen, side, or lower back

What causes urine odor?

Urine odor may be described as foul, strong, musty, sweet, or as smelling like sulfur or ammonia. Urine odor may be caused by conditions that are not harmful (benign) or by mild to serious diseases and disorders.

Benign causes of urine odor

Urine odor may be caused by a variety of conditions that are not harmful or not caused by disease including:

  • Eating certain foods, such as garlic, onions, fish and asparagus. Asparagus can cause a sulfur-like smell of the urine. The unusual odor should go away after these foods have been digested.

  • Taking vitamins and certain medications can cause an unusual urine odor as a side effect.

Potentially harmful causes of urine odor

Urine odor may be caused by infection, inflammation, or other conditions of the urinary tract (kidneys, ureters, bladder and urethra) or the reproductive organs. Urine odor can also be caused by diseases that affect the urinary tract as well as other organs and body systems.

Causes of urine odor related to the urinary tract include:

Urine odor can be caused by other diseases and conditions including:

  • Dehydration, which can produce an ammonia-like urine odor

  • Liver failure, which can produce a musty urine odor

  • Maple syrup urine disease, which produces a sweet, caramel-like urine odor

  • Rectal fistula, an abnormal opening or connection between the rectum and other areas of the body

  • Untreated or poorly treated diabetes, which produces a sweet or sugary urine odor

What are the potential complications of urine odor?

Complications associated with urine odor vary depending on the underlying disease, disorder or condition. Complications of untreated or poorly controlled diseases, such as diabetes and liver failure, can be serious and even life threatening. Over time, underlying causes of urine odor can lead to serious complications including:

  • Diabetic coma

  • Electrolyte imbalance

  • Ketoacidosis

  • Septicemia (a blood infection)

  • Severe dehydration

  • Shock

  • Urosepsis (severe urinary tract infection that has spread and led to systemic inflammation called sepsis)

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 7
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Urine Odor. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/007298.htm.
  2. Urinary Tract Infection – Adults. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001549.