Even the ancients understood that diseases could be recognized by smell. The famous Greek physician Hippocrates sensed diabetes from the smell of fruit in a patient’s mouth, and Chinese doctors sensed typhus from the smell of fresh bread. This is how many diseases associated with metabolic disorders manifest themselves, including through the smell of urine discharge.
Of course, bad breath isn't always dangerous, but if your urine smells strange for a long time, you should be concerned. When urine suddenly changes smell or color, this is a sign of serious illness. Learn how to recognize dangerous symptoms.
What does fresh urine from a healthy person smell like?
The content of the article
Fresh urine has a specific and unmistakable smell, but this can change depending on our health or the food we have eaten.
In a healthy person, urine is amber in color, relatively light and transparent. However, if it becomes slightly red, it may be a sign of serious kidney problems, bleeding diathesis, or a stone in the urinary tract.
The smell of ammonia necessarily indicates a dangerous concentration of ammonium phosphate in the urine, while diabetic acidosis manifests itself as the smell of acetone.
A dark, even brown color means increased levels of bilirubin, which is formed as a result of the death of red blood cells.
Bilirubin crystals in urine
However, not all odor changes are created equal.
Therapeutic measures
Diet therapy
The presence of a fishy odor in the urine requires immediate treatment. First of all, the doctor prescribes a special diet for the patient, which prohibits the consumption of the following list of foods:
- peas;
- beans;
- peanut;
- milk;
- chickpeas;
- liver;
- eggs;
- kidneys;
- meat;
- peanut;
- dark green vegetables;
- crayfish and other seafood;
- cabbage;
- soybeans
The smell of asparagus
Quite often on medical forums you can come across questions about the unnatural smell of urine after eating. If you feel this way too, then you belong to an elite group of people blessed with a harmless DNA mutation.
This feature has a genetic basis and is inherited in an autosomal dominant manner. It reflects the ability to metabolize vegetable precursor compounds. This connection was discovered in 1975 by American chemist R. White, who examined the urine of 115 people who had previously eaten asparagus.
The odor was found to be directly related to the presence of two to seven milligrams of sulfur-containing alkyl derivatives in the urine. These compounds are not naturally found in asparagus and are the result of the metabolism of precursor compounds in this vegetable. In this case, there is nothing to worry about because these compounds are harmless to our body and the smell disappears after a few days.
Smell of fish
While the properties of urine after eating asparagus were a natural consequence of metabolism, urine that has a fishy odor, although physically harmless, may be a more burdensome illness.
Trimethylaminuria (TMA), also known as fish odor syndrome, is a rare metabolic disorder in which the body lacks the FMO3 enzyme. This compound is involved in the conversion of trimethylamine, which is found, for example, in fish. When FMO3 is deficient or impaired, the body cannot break down TMA. Excess substance is excreted in the urine and then found in saliva.
Fish odor syndrome
Although the first diagnosed and medically documented case of this disease dates back to 1970, there are many references to this unpleasant disease in the literature. The Mahabharata, an ancient Hindu poem, describes a beautiful girl who exuded a fishy smell. Also in Shakespeare’s comedy “The Tempest,” one of the characters comments on Caliban’s illness: “What do we have here, a man or a fish? Alive or dead? It’s fish, it smells like fish!”
For unknown reasons, the disease is more common in women. Scientists suspect that female sex hormones such as progesterone and estrogen worsen symptoms.
Although there is no effective treatment for trimethylaminuria, patients are not doomed to social marginalization. By maintaining a healthy diet, avoiding legumes, certain fish, meats and foods containing nitrogen, carnitine and sulfur, you can reduce the amount of odor produced. In addition, antibiotics that reduce the concentration of bacteria in the digestive system and the use of acidic skin products with a pH of 6.5 will help.
Pathology of the genital area
A fishy smell of urine often occurs during inflammatory processes in the reproductive system. These could be genital tract infections or a violation of the quantitative composition of opportunistic microflora.
One of the reasons for the appearance of a fishy smell is a sexually transmitted disease during an exacerbation and in the presence of discharge from the urethra or vagina:
- chlamydia;
- gonorrhea;
- ureaplasma;
- trichomoniasis.
In men, changes in urine occur when there is a high content of anaerobic bacteria on the mucous membrane of the urethra. The presence of gardnerella leads to the development of inflammation of the glans penis (balanoposthitis), which makes the odor more pronounced. The appearance of an unpleasant stench also occurs with infectious urethritis.
One of the common factors in men that contributes to the appearance of a fishy stink during bladder emptying is prostatitis. With inflammation and enlargement of the gland, the patency of the urethra is blocked, the natural microflora is disrupted, and the number of leukocytes increases. This creates the conditions for a fishy smell to occur.
In women, unpleasant aroma of urine is caused by gynecological diseases: vaginitis and cervicitis. If the discharge is intense, it penetrates the urethra, causing inflammation there. Mixing with the mucus of the canal, leucorrhoea contributes to the development of an unpleasant stench.
The smell of urine in women, reminiscent of rotten fish, is produced when the natural flora of vaginal dysbiosis (bacterial vaginosis) is disturbed, when opportunistic microorganisms such as gardnarella and atopobium (anaerobic bacillus) predominate. Bacteria change the pH of an acidic environment to alkaline, resulting in a fishy odor. Predisposing factors include frequent change of sexual partners, decreased local and general immunity, non-compliance with the rules of personal (intimate) hygiene.
The smell of maple syrup
Another metabolic disorder that causes foul-smelling urine is something called maple syrup disease (MUSD). As in the case of asparagus and trimethylaminuria, the cause of its occurrence is also a genetically determined disorder in the metabolism of amino acids (leucine, isoleucine, valine) with autosomal recessive inheritance.
In MSUD, inhibition of biochemical reactions at the level of branched-chain alpha-keto acid dehydrogenesis causes the accumulation of both alpha-keto acids and leucine, isoleucine and valine in the blood, cerebrospinal fluid and urine, which in turn causes symptoms of the disease.
The patient's urine smells like maple syrup or burnt sugar. The effectiveness of treatment varies depending on the depth of the metabolic defect and the time of initiation of therapy. Untreated babies usually die at the end of the first year of life, so postnatal testing is critical as soon as the mother or doctor notices the smell. Starting treatment in the first week of life reduces the consequences of the disease.
Postnatal examination of the child
Treatment methods
Why urine smells in men: possible causes and treatment
The type of treatment is determined by the reason why the man and his sweat smells like fish. In most cases, the use of medication is sufficient. Surgery is rarely required.
Drugs
The drugs are necessary if there is an infection or inflammation with a fishy odor in men. Types of prescribed medications:
- antibiotics – destroy pathogenic microorganisms;
- antifungal - used for thrush;
- non-steroidal anti-inflammatory drugs – relieve pain, reduce inflammation;
- ointments with an antibacterial effect - relieve itching and burning;
- antiseptics – disinfect the skin of the genital organs;
- probiotics – used after antibiotics to normalize microflora;
- creams and ointments that accelerate regeneration are prescribed for the presence of microcracks on the penis.
A complex of drugs works most effectively. All medications can be used by a man only after undergoing tests and consulting a specialist.
Operation
Surgical intervention if a man smells fishy is extremely rare. It is necessary only for phimosis, which is a consequence of the lack of treatment for balanoposthitis.
Another likely option that requires surgery is abnormalities in the structure of the genital organs, which impede personal hygiene and cause the accumulation of dirt in the folds of the skin. This condition is detected and corrected in childhood.
Folk remedies
Alternative medicine recipes can be used if a man and his sweat smell of fish. As an independent method of treatment, they are effective in the following cases:
- excessive sweating;
- hygiene after intimacy to prevent STI infection;
- endocrine diseases.
In the presence of other conditions and pathologies in which a man smells like fish, folk remedies are used as an auxiliary therapeutic method. They can be used in conjunction with medications. The most effective recipes:
- Sitz baths. The base is a decoction of oak bark, chamomile, and a solution of soda. Perform once a day for 15-20 minutes for 10 days.
- Washing. Decoctions of calendula, yarrow, plantain, soda solution. Rinse the penis and scrotum 3-5 times a day after washing with baby soap or a special intimate hygiene product.
- Compresses. Soak a gauze swab with aloe juice, plantain juice or a decoction of a plant with an antibacterial effect. Apply to the affected area for 15-20 minutes.
Frequent use of these remedies for the smell of fish and sweat in men is prohibited due to the high risk of drying out the mucous membranes. This will provoke a burning sensation on the head of the penis or intensify its manifestation.
Prevention - when to go to the urologist?
When you smell unusual urine odor, don't panic. In most cases, this is the aforementioned result of a special diet or a lower tolerance to foods containing, for example, high concentrations of sulfur. However, if you want to be sure that everything is fine with us, you should take a urine test. This is one of the main diagnostic tests, which, despite its simplicity, answers many questions related to the functioning of the urinary system, mainly the kidneys.
Through examination, the physician can quickly determine whether the morphotic components of the sediment include, for example, leukocytes or erythrocytes. This test detects dangerous bacteria, fungi and mucus with great confidence.
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Diagnostics
Whatever the causes of the smell, it indicates the presence of a disease that needs to be treated. When the urine smells like fish, the attending physician first questions the patient about the presence of chronic and hereditary diseases and conducts a thorough personal examination. The next stage of diagnosis is a series of instrumental and laboratory studies, which include:
- General tests (urine, blood);
- Bacterial culture of urine;
- Biochemical blood test;
- Analysis for the detection of trimethylamine and its oxide form in urine;
- Smears of the mucous membranes of the urethra and vagina;
- PCR (polymerase chain reaction) technique.
- Ultrasound of the kidneys, bladder, ureters, urinary tract;
- X-ray of the pelvic organs;
- Cystography.
Based on the collected medical history and interpretation of test results, the doctor prescribes a conservative treatment regimen. As a rule, the prognosis for cure is favorable. The main thing is timely seeking qualified help and consistent implementation of all medical instructions.
