Yellow urine, also known as yellow urine, yellow-red urine, or red urine, refers to urine that is darker than normal, ranging from dark yellow, yellow-red, yellow-brown, or even like strong tea. Western medicine believes that yellow urine can be a normal physiological phenomenon, but it can also indicate conditions such as urinary tract infection, jaundice, and acute kidney injury. Traditional Chinese medicine, however, believes that yellow urine is often caused by heat or damp heat affecting the bladder, affecting organs including the heart, liver, gallbladder, stomach, small intestine, and bladder.
symptom
Classification
Traditional Chinese medicine divides yellow urine into six main types, namely, heart fire syndrome, gastrointestinal heat syndrome, liver and gallbladder damp-heat syndrome, cold and dampness stagnation syndrome, bladder damp-heat syndrome and yin deficiency and internal heat syndrome.
1. Syndrome of Blazing Heart Fire
Short, dark urine, painful and hot urination, fever and red face, restlessness and insomnia, frequent dreams at night, and even unconsciousness, coma and delirium. The tongue is red with prickles on the tip, the tongue coating is yellow or even burnt yellow, and the pulse is rapid.
2. Gastrointestinal heat syndrome
Short yellow urine, thirst, bad breath, constipation, abdominal distension that refuses to be relieved by pressure, red tongue with a dry yellow coating, and a slippery and rapid pulse or a deep and rapid pulse.
3. Liver and gallbladder damp-heat syndrome
Urine may be short and yellow or reddish yellow, even the color of strong tea; there may be a bitter taste in the mouth, loss of appetite, nausea and vomiting, and pain in the ribs, often accompanied by yellowing of the body and eyes, fever, or alternating chills and fever. The tongue may be red with a greasy yellow coating, and the pulse may be rapid and wiry.
4. Cold-dampness stagnation syndrome
The urine is yellow and red like tea, but the amount is not insufficient. The complexion is dark, the body and eyes are yellow, the patient is tired and exhausted, has poor appetite and abdominal distension, is cold and afraid of cold, and has loose stools. The tongue is pale with a white greasy coating and the pulse is weak and slow.
5. Bladder damp-heat syndrome
Short, yellow or red urine, often accompanied by frequent, urgent, and painful urination, or urinary retention, lower abdominal pain or distension, bitter taste in the mouth and dry throat, thirst without desire to drink. Red tongue with yellow coating, slippery and rapid pulse.
6. Yin deficiency and internal heat syndrome
Short, yellow urine with a burning sensation, dizziness, tinnitus, dry throat, afternoon hot flashes, restless feeling, soreness in the waist and knees, nocturnal emission, and spermatorrhea. Red tongue with little coating, and a thready pulse.
Typical manifestations
Yellow urine is primarily manifested by a significantly darker, yellower urine color, which may persist or occur intermittently. Patients may also experience urinary system symptoms such as frequent urination, urgency, and pain, or systemic symptoms such as jaundice of the sclera, skin, and fatigue, depending on the cause and severity of the condition.
complication
Yellow urine generally does not cause obvious complications.
reason
Overview
Yellow urine can be caused by a variety of factors, primarily categorized by Western and Traditional Chinese Medicine (TCM) explanations. Western medicine explanations include insufficient water intake, dietary factors, medication use, urinary tract infections, jaundice, and acute kidney injury. Traditional Chinese Medicine explanations include emotional imbalance, improper diet, exogenous damp-heat, and excessive heat in the internal organs.
Cause of symptoms
1. Western medicine reasons
(1) Insufficient water intake: Drinking too little water causes the body to be dehydrated, which increases renal tubular reabsorption and concentrates urine, resulting in decreased urine volume and yellow urine.
(2) Dietary factors: When a large amount of foods rich in vitamin B2, such as carrots and pumpkins, are consumed , the body will excrete excess vitamin B2 through urine , making the yellow color of the urine darker.
(3) The use of certain drugs, such as berberine, riboflavin, furazolidone, metronidazole, etc., may cause yellow urine because the drug components reach the kidneys through blood circulation and enter the urine after filtration.
(4) Urinary tract infection: When pathogens invade the urethra, they cause inflammation of the urethral mucosa. This affects normal urination function, causing urine to become concentrated, resulting in yellow urine. Urinary tract infections can be divided into upper urinary tract infection and lower urinary tract infection according to the site of infection. The former mainly causes pyelonephritis and ureteritis, while the latter mainly causes cystitis and urethritis.
(5) Jaundice: Increased bilirubin levels in the blood can cause jaundice, resulting in yellow skin and urine. These include hemolytic diseases that cause excessive bilirubin production (such as thalassemia, hereditary spherocytosis, etc.), liver dysfunction leading to abnormal bilirubin metabolism (such as viral hepatitis, cirrhosis, etc.), and bile duct obstruction leading to abnormal bilirubin excretion (such as gallstones, cholecystitis, etc.).
(6) Acute kidney injury: Acute kidney tissue damage and renal dysfunction caused by factors such as violent injury can lead to decreased urine volume and darker urine color.
(7) Others: such as prostatitis, epididymitis, orchitis, hookworm disease, etc., may also cause yellow urine.
2. Traditional Chinese Medicine reasons
Yellow urine can be seen in many diseases, such as jaundice, diarrhea, ascites, edema, and stranguria.
(1) Syndrome of blazing heart fire: Emotional disorders and excessive consumption of spicy, dry, and hot foods can lead to blazing heart fire or the invasion of damp-heat evil into the pericardium. The heart fire transfers heat downward to the small intestine, causing the small intestine to malfunction in secretion, thereby causing yellow urine.
(2) Gastrointestinal heat syndrome: External pathogens enter the body and turn into heat, or a person is addicted to spicy and greasy food, causing heat toxins to accumulate in the stomach and intestines and affect the bladder, which can cause yellow urine.
(3) Damp-heat syndrome in the liver and gallbladder: Damp-heat invades the liver and gallbladder, or damp-heat in the spleen and stomach migrates to the liver and gallbladder over a long period of time, resulting in poor liver and gallbladder secretion, internal obstruction of damp-heat, and migration to the bladder, which can cause yellow urine.
(4) Cold-dampness stagnation syndrome: Internal accumulation of cold-dampness can lead to damage to spleen yang, stagnation of qi, and obstruction of dampness, which can flow down to the bladder and cause yellow urine.
(5) Damp-heat syndrome in the bladder: Damp-heat invades the body or the patient is addicted to spicy, hot, fatty and sweet foods, which can cause damp-heat to accumulate inside the body and turn into heat, which can cause yellow urine.
(6) Yin deficiency and internal heat syndrome: Yin deficiency, long-term illness, irregular sexual intercourse or excessive intake of warm and dry foods can damage Yin. Yin deficiency can cause internal heat, which can lead to yellow urine.
Common diseases
Pyelonephritis, ureteritis, cystitis, urethritis, thalassemia, hereditary spherocytosis, viral hepatitis, cirrhosis, gallstones, cholecystitis, acute kidney injury, prostatitis, epididymitis, orchitis, hookworm disease, jaundice, diarrhea, bloating, edema, and stranguria
Seeking medical treatment
Outpatient indications
1. Yellow urine symptoms persist for a long time;
2. Accompanied by yellowing of the skin and sclera;
3. Accompanied by frequent urination, urgency, pain, and difficulty urinating;
4. Other severe, persistent or progressive symptoms and signs occur.
If the above situation occurs, you should go to the hospital for treatment in time.
Treatment department
1. If you suspect that it is caused by a urinary system disease, you can go to the nephrology department or urology department for treatment.
2. If you suspect that it is caused by jaundice, you can go to the gastroenterology department for treatment.
3. If the patient wants to take traditional Chinese medicine treatment, he should go to the Department of Traditional Chinese Medicine for treatment.
Medical preparation
1. Make an appointment in advance and bring your ID card, medical insurance card, medical card, etc.
2. The doctor may conduct a detailed physical examination. It is best to wear loose and easy-to-put-on-and-off clothing.
3. A routine urine test may be required. Avoid strenuous exercise and sexual activity before the test. Women should avoid the menstrual period to prevent it from affecting the test results.
4. Liver function tests may be required, and it is recommended to visit the doctor on an empty stomach.
5. If you have had medical treatment recently, please bring relevant medical records, examination reports, laboratory test results, etc.
6. If you have used certain medications to relieve symptoms recently, you can bring the medicine box.
7. Family members can be arranged to accompany the patient to seek medical treatment.
8. Patients can prepare a list of questions they want to ask in advance.
What questions might a doctor ask a patient?
1. When did you first experience yellow urine? Was it constant or intermittent?
2. What color is your urine? Is it dark yellow, yellow-red, yellow-brown, or like strong tea?
3. In addition to yellow urine, are there any other discomfort symptoms, such as frequent urination, urgency, and pain when urinating?
4. What’s your typical diet like? Do you enjoy spicy or greasy foods? Have you recently been eating a lot of foods rich in vitamin B2, such as carrots and pumpkin?
5. How much water have you been drinking recently?
6. Have you ever been diagnosed with urethritis, cystitis, hepatitis, or other diseases? Have you received treatment?
7. Have you taken any medication recently?
8. What is your usual emotional state?
9. What is your living environment like? Is it humid?
10. Do you have any other illnesses?
11. Have you received treatment at other medical institutions? How was the treatment? What was the effect?
What questions can patients ask their doctor?
1. Why does my urine become yellow?
2. What tests do I need to do?
3. How should I be treated? Do I need to be hospitalized?
4. Is it curable? How long does treatment take?
5. I have other diseases. Will this affect my treatment?
6. How should I take care of myself?
7. Do I need follow-up examinations? How often?
examine
Scheduled inspection
The doctor will first perform a physical examination on the patient to gain a preliminary understanding of the lesion. He may then recommend blood tests, urine tests, liver function tests, kidney function tests, abdominal ultrasound, CT, liver puncture biopsy and other tests to determine the cause of the disease.
Physical examination
1. Visual examination
The doctor will mainly observe the patient’s complexion, sclera color, tongue quality and changes in tongue coating.
2. Palpation
The doctor will not only check whether the patient has any abdominal masses, tenderness in the lower back and back, and the tightness of the abdominal wall, but will also check the size and texture of the liver, and whether there is any pain in the kidney area.
3. Medical consultation
The doctor will mainly ask the patient about the specific color of urine, accompanying symptoms, diet, emotional state, medical history, etc.
4. Palpation
The doctor will help determine the syndrome by feeling the changes in the pulse.
Laboratory tests
1. Blood routine test
This test can understand the levels of red blood cells, white blood cells, hemoglobin and other indicators, and then help determine whether the patient has infection, anemia and other conditions.
2. Urinalysis
A high white blood cell count is helpful in diagnosing urinary tract infections. Elevated urobilinogen levels can aid in the diagnosis of icteric disorders. Other abnormalities, such as proteinuria, can also help assess renal function.
3. Liver function test
This test can help determine whether there is liver disease, providing clues to the cause of yellow urine. Hepatitis patients often have significantly elevated levels of ALT (alanine aminotransferase) and AST (aspartate aminotransferase).
4. Renal function test
This test can help determine whether there is kidney damage, providing clues to the cause of yellow urine. Patients with acute kidney injury may see elevated serum urea and creatinine levels.
Imaging examinations
1. Abdominal ultrasound
If it is suspected that yellow urine is caused by jaundice due to liver or bile duct diseases, abdominal ultrasound can be performed to understand the size and shape of the liver, whether there are space-occupying lesions in the liver, the size of the gallbladder, and whether there are stones or dilation in the bile duct.
2. CT examination
It is very helpful for liver and gallbladder diseases and for identifying the causes of yellow urine. It is also valuable for the diagnosis of bile duct dilatation, bile duct stones and gallbladder cancer.
Pathological examination
For patients with liver space-occupying lesions, liver puncture biopsy can be performed when the nature of the lesion needs to be identified.
diagnosis
Diagnostic principles
Generally, a diagnosis can be made based on a medical history consultation and the patient’s symptoms of yellow urine, frequent urination, urgency, and pain during urination, combined with a physical examination, blood test, urine test, liver function test, kidney function test, abdominal ultrasound, CT scan, liver biopsy, and other tests. During the diagnosis process, Western medicine doctors typically need to differentiate between several common diseases that cause yellow urine, such as urinary tract infection, viral hepatitis, and acute kidney injury; while Traditional Chinese Medicine doctors typically need to identify several common syndromes associated with yellow urine.
Differential diagnosis
1. Western medicine differential diagnosis
(1) Urinary tract infection: In addition to yellow urine, there may be other symptoms such as frequent urination, urgency, and pain during urination. Urinalysis can reveal the presence of bacteria and elevated white blood cell count.
(2) Viral hepatitis: In addition to yellow urine, there may be symptoms such as yellowing of the skin and sclera, anorexia, fatigue, fever, chills, abdominal pain, nausea, etc. The diagnosis can be confirmed by combining whether the patient has unclean food, unclean drinking water, liver function tests, pathogen serology tests, etc.
(3) Acute kidney injury: In addition to yellow urine, there may be symptoms such as decreased urine volume, fatigue, lack of appetite, nausea, and vomiting. The diagnosis can be confirmed through renal function tests.
2. Differential diagnosis of traditional Chinese medicine
(1) Heart fire syndrome and gastrointestinal heat syndrome: Both are internal heat syndromes. However, the former may be accompanied by irritability, redness or even pricking of the tongue tip, and a hot and astringent feeling during urination; the latter may be accompanied by bad breath, toothache, constipation, abdominal distension and pain that refuses to be pressed.
(2) Liver-Gallbladder Damp-Heat Syndrome and Cold-Damp Stagnation Syndrome: Both syndromes are caused by liver-gallbladder pathogens, resulting in dark yellow urine and yellowing of the body and eyes. However, the former is a Yang syndrome, accompanied by dry mouth, bitter taste in the mouth, pain in the ribs, alternating chills and fever, with an acute onset and a short course; the latter is a Yin syndrome, accompanied by symptoms such as dull complexion, fatigue, poor appetite, and abdominal distension, with a slow onset and a long course.
(3) Bladder damp-heat syndrome and Yin deficiency internal heat syndrome: Both are lower jiao lesions. However, the former may be accompanied by symptoms such as frequent urination, urgency, pain during urination, and lower abdominal pain; the latter has short yellow urine with only a mild burning sensation, accompanied by tinnitus, fever in the five hearts, and soreness of the waist and knees.
treat
Expected treatment
Physiological yellow urine caused by insufficient water intake, use of certain medications, etc. generally does not require special treatment; for yellow urine that persists for a long time or is accompanied by other discomfort symptoms, you should seek medical attention in time to determine the cause, and then take targeted treatment to improve the discomfort symptoms as soon as possible.
Treatment of the cause
1. Urinary tract infection
Patients should ensure adequate rest and fluid intake, and follow their doctor’s instructions to take antibiotics that are sensitive to the pathogenic bacteria in sufficient doses and for an adequate course of treatment. Commonly used drugs include fosfomycin, nitrofurantoin, norfloxacin, ofloxacin (such as ofloxacin), and cefuroxime. If a urinary tract infection is caused by an organic lesion such as urinary tract malformation, urinary tract stones, tumors, prostatic hyperplasia, or phimosis, surgical treatment is required to remove the cause after the infection is controlled.
2. Viral hepatitis
Patients should pay attention to proper rest and ensure a balanced and nutritious diet. At the same time, they need to take appropriate measures under the guidance of a doctor according to the type of disease and the actual pathological condition. For example, those with abnormal liver function can use reduced glutathione, compound glycyrrhizin, bicyclol, vitamin E and other drugs for treatment; those with intrahepatic cholestasis can use ursodeoxycholic acid, adenosine methionine and other drugs for treatment; patients with chronic hepatitis B often need to use antiviral drugs (such as tenofovir, entecavir, telbivudine, etc.) and interferon (such as ordinary interferon α and polyethylene glycol interferon) for treatment; patients with severe hepatitis may need artificial liver or liver transplantation.
3. Acute kidney injury
The treatment of this disease is based on the principles of early identification and correction of reversible causes, maintenance of water, electrolyte and acid-base balance, promotion of renal function recovery, appropriate nutritional support, active prevention and treatment of complications, and timely renal replacement therapy. Common measures include discontinuation of all nephrotoxic drugs as much as possible, intravenous nutritional supplements, use of drugs such as glucocorticoids as prescribed by doctors, peritoneal dialysis, etc.
Symptomatic treatment
1. Drink more water
For yellow urine caused by concentrated urine due to drinking too little water, the symptoms can be improved by drinking more water to increase urine volume.
2. Stop taking suspicious food or medicine
Yellow urine caused by excessive intake of foods or drugs containing vitamin B2 can be relieved by adjusting the diet and stopping the relevant drugs.
Drug treatment
See causal treatment and Traditional Chinese Medicine treatment for details.
Related drugs
Fosfomycin, nitrofurantoin, norfloxacin, ofloxacin (such as ofloxacin), cefuroxime, reduced glutathione, compound glycyrrhizin, bicyclol, vitamin E, ursodeoxycholic acid, adenosine methionine, tenofovir, entecavir, telbivudine, conventional interferon α, pegylated interferon
Surgical treatment
If patients with yellow urine have organic lesions or non-surgical treatment cannot solve the problem, surgical treatment should be considered.
Traditional Chinese Medicine treatment
1. Syndrome differentiation and medication
(1) Heart fire syndrome: Treatment should be to clear the heart and purge fire, and the main prescription is Dao Chi San. If the patient is not conscious, then it is necessary to clear away heat and open the orifices, and take An Gong Niu Huang Wan with Qing Gong Tang. Commonly used Chinese medicines include raw Rehmannia root, Akebia root, musk, realgar, Coptis root, Scutellaria baicalensis, Gardenia jasminoides, and Curcuma zedoaria.
(2) Gastrointestinal heat syndrome: For patients with heat evil in the stomach, the treatment should be to clear the stomach and purge fire. The main prescription is Qingwei San, and commonly used Chinese medicines include raw Rehmannia root, Chinese angelica root, peony bark, Coptis chinensis, Cimicifuga heracleifolia, etc. For patients with heat evil in the intestines, the treatment should be to purge heat and attack the lower part. The main prescription is Dachengqi Decoction or Xiaochengqi Decoction, and commonly used Chinese medicines include Rhubarb, Magnolia bark, Citrus aurantium, etc.
(3) Liver-gallbladder damp-heat syndrome: Treatment should focus on clearing the liver and gallbladder, purging heat and dampness. The main prescription is Longdan Xiegan Decoction. Commonly used Chinese herbs include Gentiana scabra, Scutellaria baicalensis, Gardenia jasminoides, Alisma orientalis, and Akebia chinensis.
(4) Cold-dampness stagnation syndrome: Treatment should be aimed at warming the middle and strengthening the spleen, dispelling cold and transforming dampness. The main prescription is Yinchen Shufu Decoction. Commonly used Chinese herbs include Yinchen, Baizhu, Fuzi, dried ginger, cinnamon, etc.
(5) Bladder damp-heat syndrome: Treatment should focus on clearing damp-heat and promoting urination. The main prescription is Bazheng Powder. Commonly used Chinese herbs include Plantago seed, Dianthus radix, Polygonum multiflorum, Talc, Gardenia jasminoides, etc.
(6) Yin deficiency and internal heat syndrome: Treatment should be to nourish Yin and reduce fire. The main prescription is Zhibai Dihuang Wan. Commonly used Chinese herbs include Zhimu, Huangbai, Rehmannia root, Cornus officinalis, and Paeonia suffruticosa root.
2. Acupuncture therapy
(1) Main acupoints: Bladder Shu, Zhongji, Yinlingquan, and Xingjian.
(2) Acupoint combination: For the syndrome of blazing heart fire, Shenmen and Neiguan should be added; for the syndrome of excess heat in the gastrointestinal tract, Neiting and Quchi should be added; for the syndrome of damp-heat in the liver and gallbladder, Taichong and Zulinqi should be added; for the syndrome of cold-damp stagnation, Mingmen and Yinlingquan should be added; for the syndrome of damp-heat in the bladder, Weizhong and Kunlun should be added; for the syndrome of internal heat due to yin deficiency, Taixi and Sanyinjiao should be added.
It should be noted that patients who need Chinese medicine treatment should first go to a regular Chinese medicine hospital for treatment, and then be prescribed Chinese medicine by a professional Chinese medicine doctor after diagnosis. When purchasing medicine, you should pay attention to identifying the supplier of medicinal materials. It is recommended to choose large pharmaceutical companies such as China Resources Sanjiu. Such companies can strictly follow national standards, control the quality of medicinal materials from the source, and ensure the quality and efficacy of the Chinese medicine sold.
Treatment cycle
The treatment cycle is affected by factors such as the severity of the disease, treatment plan, treatment timing, age and physical condition, and may vary from person to person.
Estimated treatment costs
There may be significant individual differences in treatment costs, and the specific costs are related to the selected hospital, treatment plan, medical insurance policy, etc.