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Urinary Disorders

Ammonia Smell in Urine

09/14/2009

Question:

Hi I am reasonable old female and I have been having problems with a strong ammonia smell in my urine. I drink about 2 1/2 to 3 liters of water in a 13 hr period so I don`t feel like it would be dehydration because my urine is clear and not dark but still smells strongly or ammonia and not just in the morning every time I urinate. It started happening 2 weeks ago. I have been to the doctor over an over and not really coming out with results. I have had reoccurring UTIs and bladder infections since I was a child. I do believe I have had and passed stones though they could never find them on an ultrasound or ct scan and the doctors weren`t to worried when my left kidney was "slightly" enlarged. I only believe I had stones and passed them because it felt like a little piece of glass travelled down on the inside when I urinated. I was very painful, but I was okay after. I have done the 24 creatinine urine test where you urinate in a container. Results came up empty and so did blood tests. I am simply tired of going to the doctor and complaining of a burning pain near the kidney area in my back and the ammonia smelling urine and only coming up with the answer of oh, you have a UTI or bladder infection. If that`s the case why do I keep getting them? and why every 3 to 4 months does this seem to happen? I don`t change my diet, have STDs, or anything. I also have had a total hysterectomy, but feel there is no relation. Hopefully you can help?

Answer:

There are several reasons for having malodorous urine. Number one reason is dehydration and lack of adequate water intake. Although you claim to drink water but if you check your intake and output by a log book you can tell for sure if your intake had been enough. You should have at least two liters of urine output daily. Another reason is infection. The reason is most organism such a E Coli turn the urine to alkaline and hence, malodorous urine. Infections very common in sexually active women. Hygiene and low dose antibiotics after intercourse will help. Lastly, in some individuals the kidney is not capable to acidify urine. This condition not only causes bad smell in urine but also promotes infection and certain stone formation. Sometimes acidification of urine can be achieved by Vitamin C or other urine acidifiers.

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Response by:

Ahmad  Hamidinia, MD Ahmad Hamidinia, MD
Formerly, Professor of Clinical Surgery
College of Medicine
University of Cincinnati