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Date of last update: 8/13/2017.

Forum Name: Urology Topics

Question: Dark Urine: Not dehydrated. Peptic Ulcer?


 oguruma - Tue Jul 20, 2010 10:49 pm

Hello,

I am a 21 year old male, with no known history of any disorders that might pretain to this.

For the last 3 days my urine has been very dark. It is still yellow, but definitely darker than normal. It is about the same color as pine-sol, if that helps any. The first day that I noticed that it was dark yellow, I also had bad abdominal pain, and began to dry-heave, so I figured it was dehydration (I also had a 6-pack of beer the night before, and didn't drink anything else with it). I consumed a lot of water and sports drinks, and got some rest. I did not pass stool at all that day.

The next day, I drank a lot of water and sports drinks all day, and still had the abdominal pain (not nearly as bad as the first day). I counted my liquid intake and I drink 1/2 gallon of Gatorade, and 1 gallon of water, for a total of 1.5 gallons of fluid. I made the mistake of eating pizza that night, and had terrible abdominal pain/nasuea. I still had dark colored urine, and did not pass stool that day.

The next day I didn't have much pain at all (maybe a little bit), and I also made sure to drink plenty of liquid. I was urinating frequently like I normally would, but it was still dark, despite the fact I was keeping so well hydrated. I passed one small stool, but it was pale colored (lighter than normal, maybe closer to gray than brown) and had a vein of bright red blood running down it. It was not painful to pass. I generally pass stool every day atleast once, but I figured that my lack of bowel movements could be due to the fact that I was consuming less solid food because of my symptoms.

At this point, I am not sure what it could be. I figured it was not dehydration like I originally figured, since I am urinating frequently, and drinking lots of fluid. I have been rather stressed out lately, so that might have lead to an ulcer.

Any ideas? Thanks in advance for any input.
 Dr.M.jagesh kamath - Thu Jul 22, 2010 11:05 am

User avatar Hello,The nausea,dark urine,clay coloured stools,abdominal pain all point to one condition Hepatitis and probably infectious hepatitis known in common language Jaundice.
Infectious hepatitis is caused by a virus and hepatitis A is transmitted by the oral route by contaminated water or food.HepatitisB is by blood transfusions.
You must go to your family doctor and get investigated right away.Hepatitis A is self limiting.
There is nothing to worry but you must get investigated and treated.
Best wishes.
 Dr.M.Aroon kamath - Thu Jul 22, 2010 11:43 am

User avatar Hi,
Dr.Jagesh has clearly pointed out a very probable cause. However, i would like to take this opportunity offered by this particular query to add some general details concerning urine color as well as some of the often overlooked causes of "dark" colored urine.

The normal color of urine is due to certain pigments, chiefly urobilin as well as certain other pigments such as uroerythrin, as well as others, which may be present in very small amounts.

The color of urine may vary due to a host of factors.

Vitamins: High level of B complex vitamins, which are water soluble, can impart a dark yellow color. Ascorbic acid decreases urochrome excretion. In scurvy or subclinical vitamin c deficiency, urochrome excretion has been noted to increase.

Medications: some of the medications that can cause yellow-brown colored urine include sulfamethoxazole, quinine derivatives and nitrofurantoin.

Diseases such as hemolytic anemia, which is caused by the abnormal breakdown of red blood cells can cause a dark yellow to brown color in the urine. In the same way, hematuria and hemoglobinuria can give a red or dark yellow tinge to urine.


Dietary factors: asparagus is said to impart a dark yellow color to urine.
One early research study had shown that
- A low protein diet had been found to reduce the daily urochrome excretion markedly. A high protein diet was found to increase the excretion perceptibly. Gelatin or carrots when taken in the diet had no effect on the output.
- A new body, protochrome, the chemical reactions of which
are identical with those of urochrome, can be produced from
some of the proteins.
http://www.jbc.org/content/43/1/237.full.pdf

Some other studies had noted that diets containing the green parts carrots(containing green pigment) caused an increased excretion of urobilin (formerly urochrome) but the yellow parts(containing yellow pigment carotene) did not.
http://www.ncbi.nlm.nih.gov/pmc/article ... 35/?page=1

In practice, how then one may investigate an individual(such as you) who complains of voiding "dark" urine?

One sample protocol for testing for cause of a dark urine is as follows...

- First, a sample of urine should be centrifuged. After centrifugation, if the sediment is red or brown, and the supernatant is clear, it is hematuria.
- If the supernatant is red to brown, next step is to test with orthotolidine dye for presence of heme. If positive, it is either hemoglobinuria or myoglobinuria.
- These two may be differentiated by centrifuging a blood sample and looking at the plasma. if plasma is red, then it is hemoglobinuria and if clear, it is myoglobinuria.
- If orthotolidine test is negative, then one should investigate for porphyria or phenazopyridine( a bladder analgesic) ingestion or beeturia(due to excessive ingestion of beets).

I suggest that you should watch your diet very carefully and check your medical history(including herbal) and have your urine tested.

There is one other thing which i sort of remembered because you said that you "had a 6-pack of beer".

There are quite a few reports of individuals who developed acute renal insufficiency due to rhabdomyolysis and myoglobinuria in the context of a binge and heavy alcohol drinking. This is known as "acute alcoholic myopathy".
Best wishes!

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