The common reaction to unusual or different appearing urine is panic. Foamy urine is not all that uncommon and can result from a variety of reasons and conditions. This article will explain the issue in clear detail and erase the panic from your mind.
Foamy urine can be a result of several simple things. Forceful urination generates bubbles in the urine giving it that foamy appearance. Urine that is foamy in appearance consistently despite the force applied can signify protein in the urine or a more serious problem with the kidneys. Before prematurely jumping to conclusions, read on to learn everything you need to know about foamy urine.
Determining if foamy urine is due to a chemical in the toilet or toilet cleaner is straightforward. Simply urinate in a clean sterilized container and see if the foam and bubble still appear. If not it was due to chemicals in the toilet bowl. If foamy urine persists, then see your doctor to have a urinalysis test done to evaluate for other problems that are outlined below. The 24-hour urine collection test is more accurate than a standard dipstick test. Rest assured that most cases of foamy urine are normal without underlying serious cause.
Causes of Normal Foamy Urine
1. Rapid Urination
Rapid urination introduces air and bubbles into the urine stream. When the bladder is full and stretched to capacity, the bladder will contract forcefully and the urine hits the toilet bowel rapidly and generates foam. This type of foam usually disappears in a few minutes.
2. Concentrated Urine
Mild dehydration, such as during pregnancy or exercise, causes the urine to appear darker and more concentrated. This often results in foamy appearing urine. Rehydrate and drink plenty of fluids and the problem is solved. As fluid balance is restored, the urine will appear a pale yellow. If foamy urine still continues, another problem is at hand.
3. Toilet Cleaner
A variety of chemicals in toilet cleaners cause foamy urine to appear. Urinate in a sterile container and if no foam appears, the chemical in the toilet is the culprit.
4. Semen in Urine
Small amounts of semen are left in the male urethra after sex. This tiny amount won't cause foamy urine. If the bladder sphincter malfunctions the semen is propelled backward into the bladder and this amount will cause the urine to appear foamy. Certain medications can also cause this to occur and the medical term is retrograde ejaculation. If this happens on a regular basis, be sure to see your doctor.
Causes of Abnormal Foamy Urine
1. Proteinuria
This condition results in excess protein being excreted in the urine and can cause foamy urine. A small amount is normally present in urine, but large amounts of protein in the urine are abnormal and termed proteinuria. This can occur after extremely intense exercise, excessive dietary intake or supplementation of protein and in diseases that damage the kidneys. Untreated high blood pressure and diabetes are the two most common medical conditions that damage the kidneys filtering ability and cause proteinuria. These conditions require the evaluation and care of a doctor.
Other risk factors for proteinuria include trauma, toxins, infections, medications and diseases such as multiple myeloma and amyloidosis. Obese persons, those over age over 65, family history, pregnancy and certain races and ethnic groups have a higher likelihood of developing proteinuria.
Treatment is aimed at treating the underlying cause. Proper management of diabetes and blood pressure, weight loss and removal of offending medications are all effective in treating proteinuria. The addition of an ACE inhibiotor or angiotensin receptor blockers is helpful for proteinuria in diabetic patients and can help protect the kidney's ability to filter the blood.
2. Proteinuria or Preeclampsia during Pregnancy
Proteinuria in pregnancy can herald the development of a serious problem called eclampsia. The condition is progressive and causes leg swelling, proteinuria, elevated blood pressure and headaches. This is termed preeclampsia. This often starts after 20 weeks of pregnancy and blood pressure rises above 140/90. As the condition progresses, all the symptoms and proteinuria worsen, abdominal pain can occur as well as vision changes. Severe cases result in marked elevation of blood pressure and can result in seizures or bleeding into the brain. Without medical treatment, eclampsia can be fatal to the mother and unborn baby.
Any pregnant patient with a severe headache, blurred vision, abdominal pain or blood pressure elevation needs to see a doctor immediately or go to the emergency room.
3. Urinary Tract Infection
Urinary tract infection (UTI) and bladder infection are synonymous. As bacteria enter the bladder and multiply, infectious symptoms occur such as burning with urination, frequency and urgency, foamy appearing urine and sometimes bloody looking urine.
See a doctor when these symptoms develop or persist, nausea or vomiting are present, or if a fever occurs. Severe abdominal pain or back pain can signify a more serious infection and require immediate medical attention. The doctor will determine if an infection (UTI) is the cause of your symptoms and prescribe an antibiotic. Other medications can relieve the pain and unpleasant symptoms while the antibiotic kills off the infection.
4. Vesicocolic Fistula
This condition occurs when an abnormal connection develops between the bladder and colon. This allows air, gas and bacteria to travel into the bladder. The result is foamy urine and frequent infections. This causes the same type of symptoms as a UTI. Vesicocolic fistulas occur due to surgical complications, tumors or inflammatory conditions such as Crohn's disease. Diagnosis requires specialized imaging tests or visualization with a small camera placed through the urethra into the bladder to locate the abnormal communication. Treatment consists of treating any infections and closing off the abnormal communication through surgical or radiologic procedures.
5. Kidney Problem
The kidneys provide essential filtration of the blood and produce urine as a byproduct of that process. Any disease or condition that affects the kidneys can result in foamy urine and proteinuria. Common culprits include diabetes, high blood pressure, kidney stones, frequent kidney infections, trauma, certain medications and illicit drug use.
Signs and symptoms of kidney problems can include leg swelling, fatigue, nausea, anorexia, back pain and weakness. Foamy urine, bloody urine or a consistently abnormal color or odor to the urine all signal a problem and deserve medical evaluation.
Diagnosis requires a thorough evaluation by a doctor and can include blood tests to measure kidney function and filtration rate, electrolyte levels, blood pressure assessment and a comprehensive urinalysis. A 24-hour urine collection will provide a more accurate gage of the degree of proteinuria.