Fishy Smelling Urine

The urine of healthy people is usually clear and odorless. Fishy smelling urine can occur due to many different reasons and underlying conditions as discussed below.

Causes of fishy smelling urine

A few common causes of fishy smelling urine along with the symptoms and treatment options are as follows:

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  1. Urinary tract infections/UTI
  • Infection of any part of the urinary system, i.e., the bladder, kidneys, ureters, and urethra, by proliferation of bacteria or other pathogens can result in the occurrence of a urinary tract infection. The germs can gain entry into the urinary tract via direct contact with the urethra, often when passing urine, or from the bloodstream.
  • Bladder infection or cystitis and urethritis or urethral infection are the two most prevalent types of UTIs. As compared to men, women are more susceptible to developing UTIs due to the close proximity of the urethra to the anus and the vagina, both of which are home to varied pathogens.
  • People with UTI may experience burning sensations when urinating, painful urination, increased desire to pass urine, frequent urination, and/or fishy smelling urine. UTIs that affect the kidneys may also cause symptoms such as fever, chills, and night sweats.
  • Most cases of urinary tract infections are caused by bacteria. Hence, it is usually treated with antibiotic therapy which may last from two to 11 days.
  1. Kidney stones
  • Urine consists of many items such urea, minerals, etc. The kidneys perform the function of filtering urine. Increased amounts of calcium and oxalate in urine, due to varied reasons including kidney dysfunction, may lead to crystallized deposits formation in the kidneys. The crystals separate from pee and stay back in the kidneys. With the passage of time, the crystal deposits turn into kidney stones.
  • A few common symptoms of kidney stones include severe pain that keeps moving from the pelvis to the lower back area and vice versa; radiating pain in the flank area; significant urine color changes; and fishy smelling urine. Pain typically occurs due to trapping of the stones in the ureters after they move out of the kidneys.
  • Kidney stones may be treated via surgical or non-surgical means. Doctors will advise drinking plenty of water as it can sometimes cause the stones to become dislodged and get eliminated along with urine. Painkillers will be prescribed during this time. Surgery may be needed if non-invasive treatment options fail.
  1. Vaginitis
  • Vaginal infection by pathogens like bacteria, yeast, or fungus is known as vaginitis. These organisms are naturally found in the vagina. However, uncontrolled growth of the germs can eventually cause the infection.
  • Some common symptoms of vaginitis are painful urination, vaginal inflammation or swelling, uncomfortable sex, itching in and around the vagina, and foul pee smell which can sometimes be fishy smelling.
  • The type of infection determines the treatment. Vaginitis caused by bacterial overgrowth is remedied with antibiotic pills and creams, while yeast proliferation is stopped and controlled with topical antifungals. Doctors may prescribe oral antifungal drugs for treating severe yeast infections. Sugar helps fungal growth. Hence women need to avoid sugary foods till the infection has cleared out.
  1. Prostatitis
  • This condition is characterized by inflammation of the prostate gland, a walnut-shaped gland situated under the bladder in men. The gland is responsible for regulation and maintenance of sperm quality. The causes of prostatitis are not known in most instances; in some causes bacterial infection is the cause.
  • Associated signs and symptoms include fishy smelling urine, pain when passing urine, and discomfort and pain in the groin area. A serious type of prostatitis is acute bacterial prostatitis which is marked by mild to extreme fever, persistent urination, nausea, chills, and urge to urinate.
  • Bacterial infection caused prostatitis is treated with oral antibiotic therapy that lasts for about 30 days. Antibiotics injections may be required to treat severe cases.
  1. Liver problems
  • The presence of different liver diseases can cause liver dysfunction and elimination of fishy smelling urine. A healthy liver normally releases minor quantities of bilirubin into urine. However, liver abnormalities can cause the release of increased amounts of bilirubin into urine. This causes urine to not only emit a foul odor, but become dark amber in color. Such urine color and smell problems can be resolved by treating the underlying liver disease.
  1. Phenylketonuria
  • In this metabolic condition, the body is unable to process phenylalanine amino acid. This then causes higher levels of protein in blood and urine, which eventually results in urine that has a strong, mousy, or musty foul smell similar to rotten fish.
  1. Dehydration
  • Urine tends to become very concentrated due to insufficient intake of water and other fluids. The total volume of urine output is also significantly lower. Highly concentrated urine not only exhibits changes in color, but also emits a foul odor that smells like ammonia or rotten fish. Drink lots of water and other liquids to get rid of dehydration and fishy smelling urine.
  1. Pregnancy
  • Occurrence of UTIs during pregnancy is quite common. As stated above, urinary tract infections are marked by fishy smelling urine. It is also possible for urine to become smelly during pregnancy due to causes other than UTIs.
  1. Diabetes
  • Diabetic people suffer from high levels of blood glucose. The excess blood sugar is released into urine, leading to fishy sweet-smelling pee. Patients with untreated or mismanaged instances of diabetes marked by non-adherence to the diet restrictions are more prone to suffering from such urine abnormalities.
  1. Trimethylaminuria
  • It is a genetic condition with fishy smelling urine as one of the symptoms. If it is not hereditary, then it can also occur due to eating certain foods, liver issues, kidney disorders, and hormonal imbalances, etc. It is treated with medicines, diet modifications, and lifestyle changes.
  1. Medications
  • Use of ciprofloxacin, amoxicillin, and some other antibiotics can result in urine that smells like yeast or fish. Such odor changes may be evident even when low doses of antibiotics are consumed for a short while. Consuming multivitamin supplements also imparts fishy smell to urine.
  1. Caffeine
  • Drinking coffee or other caffeinated drinks in excess can also cause the urine to become smelly like fish. The diuretic nature of caffeine causes increased and frequent urination, leading to dehydration, concentrated urine, and foul smelling urine.
  1. Foods
  • Intake of asparagus and some other foods can cause fishy smelling urine due to the release of sulfur as a byproduct of asparagus breakdown. The strong and distinctive urine smell is imparted by this sulfur.


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