Brown, smelly pee: What's up with that?

Dear Alice, I frequently have dark brown smelly pee. I have no pain and no burning. What can I do for it to stop?

Dear Reader,

Believe it or not, your urine actually reveals quite a bit about your diet and health, so kudos to you for asking the question! While it’s hard to determine the cause of, and remedy for, your dark brown smelly pee, there are a number of factors which can potentially alter urine color and smell. Some causes may be benign, while others indicate more serious health conditions (more on those in a bit!). That being said, meeting with your health care provider can help to figure out the underlying cause and help you find ways to resolve it.

Before jumping into potential causes of atypical urine colors and odors, it’s helpful to first understand how it typically looks and smells. Urine consists of many components, including urea, ammonia, creatinine, and inorganic salts, which help expel waste from the body. Usually, it’s light-yellow to amber colored, clear, and sterile, with a relatively mild or unnoticeable smell. However, it’s possible for the following factors to cause variations in both urine color and odor:

  • Diet: Certain foods such as fava beans, aloe, rhubarb, blackberries, beets, and food coloring have been found to turn urine a pink or brown color. Similarly, certain foods such as asparagus may cause urine to have a distinct sulfur-smell.
  • Hydration: The less fluids a person drinks, the more concentrated their urine is, and the higher the likelihood that it smells like ammonia.
  • Medications: Antimalarial drugs, such as chloroquine and primaquine, as well as antibiotics such as metronidazole and nitrofurantoin, may make urine brown. Likewise, laxatives with cascara or senna, and methocarbamol (a muscle relaxant) may also cause urine to become brown.
  • Serious health conditions: Some conditions, such as liver cirrhosis, urinary tract infections (UTIs), acute viral hepatitis, blood from vaginal bleeding, hemolytic anemia, or a kidney or a urinary tract injury are possible causes of dark yellow or brown urine. Other conditions that may affect urine odor include bladder fistula, bladder infection, or ketonuria.

For a more comprehensive overview on factors related to unpleasant changes in urine scent, check out Why does my urine stink? in the Go Ask Alice! archives.

With all this in mind, you might decide to adjust your diet and ensure you’re well-hydrated in an attempt to remedy the smell and color of your urine. If a few days pass and you’re not seeing a change, talking with a health care provider may give you more clarity on the cause of its color and odor. In preparation for this visit, consider the following questions: Are you taking any medications which have been described to cause changes in your urine? Is your urine clear or cloudy? Have you been eating any new foods? How much water do you drink daily? How would you describe the smell of your urine (e.g., sweet-smelling, sulfur-like, etc.)? Though you may be worried or uncomfortable with this issue, you can rest assured that “urine” good hands with your provider and that there are likely helpful solutions for you!

Originally published Nov 17, 2017