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Doctor Chip
Doctor Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 22210
Experience:  20 yrs practice, surgery, general medicine, addiction medicine, pain
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My urine smells bad all the time, I get lower back pain and pee frequently, especially at

Customer Question

My urine smells bad all the time, I get lower back pain and pee frequently, especially at night.
Submitted: 2 years ago.
Category: Medical
Expert:  Doctor Chip replied 2 years ago.
So is your question about the smell of your urine or about your frequent urination, or both?
Customer: replied 2 years ago.
My question is about both as both problems have occured within the same time frame. Honestly speaking, the problem started some 3 years ago. All of the aforementioned treatments occured over the first 18 months and when they could not find anything wrong with me I just gave up. However I am frequently awoken early in the morning having to urinate. I am 6ft, 12.5 stone, very healty in my diet and exercise and weight train often. I take no supplements.

One thing I do not do is drink much liquids, maybe only 1 litre a day of water, more if I exercise.
Expert:  Doctor Chip replied 2 years ago.
I take it you've been screened for diabetes? What about something called diabetes insipidus? What about spastic bladder? I assume your prostate gland is normal?
Customer: replied 2 years ago.
I cannot be 100% about the diabetes test, but I am pretty certain at least one of the four bloods was diabetes. My doctors end diagnoses was an irritable bladder some 18 months ago, but that to me did not explain the lower back pain or roasted urine smell. I had a brief prostate gland check (some 15 seconds) and my doctor said it felt normal, no hardening.

With the 24 hour urine collection, I peed some 1800ml if I remember correctly, having consumed 1700ml of liquid that day. Not sure if thats normal or not, that was a day of no exercise.

The only thing I can link to the start of my symptoms was starting my own business. It is somewhat stressful, but it does not consume me. I do however work some 50 hours a week on my feet.

Could stress be a factor?
Thank you.
Expert:  Doctor Chip replied 2 years ago.
But first--do you urinate excessively during the day, or is the problem more of having to get up at night? Have your doctors agreed you have a strange smelling urine?
Customer: replied 2 years ago.
During the day I do not urinate excessively, however I put this down to lack of hydration, I may only consume maybe 300ml of water throughout my 8 hour working day. But even when I am fully hydrated with clear urine, it smells foul, something akin to roast beef.

I am woken around 6.00am to pee, then would have to pee again on rising around 10am, and I may have to pee again after breakfast. All normal amounts of urine, not little small amounts. After drinking tea or water in the evening, I will have to pee within 15 minutes of finishing the cup.

Doctors have no smelt my urine so have not commented, however it really does smell very poor. :/
Expert:  Doctor Chip replied 2 years ago.
OK--I'm a bit unclear here--what is it exactly about your urination and when it occurs that you find unusual?
Customer: replied 2 years ago.
Sorry for the lack of clarity.
Firstly, being awoken every morning with the need to urinate at 27 years old seems highly irregular to me. And then having to urinate several times after without having consumed any liquid within a few hours.

Secondly, the smell is really quite foul and regardless of colour it always smells the same.

Thirdly, whenever I consume any liquid, its pretty much excreted within 15 minutes of being consumed. If I drank any more liquid throughout the day, I would be going to the toilet every 15 minutes.

The lower back pain also causes me concern, which alternates between my left and right side and is present throughout maybe 5% of my day.
Expert:  Doctor Chip replied 2 years ago.
Without drinking any liquid for a few hours after you last urinate, how much do you urinate when you do?
Customer: replied 2 years ago.
I would estimate about a cupful, approx 250-300ml. This seems to be a pretty constant amount, regardless of how much I have been drinking.
Expert:  Doctor Chip replied 2 years ago.
Why would you think that was an abnormal volume for someone to produce, say, after having urinated a few hours before and not having drunk much in the way of fluids in between?
Customer: replied 2 years ago.
Its not necessarily the amount, its more the frequency that bothers me. Three times peeing between 6am and 11am is very frustrating.

If I was not awoken in the mornings, didnt have foul smelling urine and had no lower back pain, I would not think anything of the amounts of urine I was producing.
Expert:  Doctor Chip replied 2 years ago.
Do you feel an uncontrollable need to urine when you only urinate about a cupful?
Customer: replied 2 years ago.
Not uncontrollable, I have never once felt I was about to burst as such after a regular amount of intake. One thing I have noticed before though is that if I get stuck on a long car journey etc and really have a strong urge to urinate over a long period of time, when I actually get to a toilet the urine only trickles out.
Expert:  Doctor Chip replied 2 years ago.
Trickles out but eventually the volume is normal?
Customer: replied 2 years ago.
I would say it builds up to a 50% normal level. I do suffer from Paruresis so that could be related .
Expert:  Doctor Chip replied 2 years ago.
Well, what I'm trying to get at with all the question is wheter or not you actually have a physical problem with, say, the bladder or the prostate. Do you think this could all be more of a, say, mind over matter situation?
Customer: replied 2 years ago.
Honestly, I don't know.
I'm something of an anxious person but am open and friendly in general. I mentioned this to my doctor and we tried a few weeks of light anti-anxiety medication and it had no effect.

In regards XXXXX XXXXX it doesn't severely effect me, after a few beers at the weekend i'm fine, just I tend to use a cubicle in public in normal circumstances.

Some of my initial symptoms 3 years ago were pins and needle sensations in my bladder and prostate areas, hence the scan of my testes and abdomen but they subsided and left me with just the lower back pain and foul urine.

There is a history of IBS in my family and I am somewhat effected, I had a colonoscopy too I neglected to mention about 2 years ago as I was having digestive discomfort also (my whole family has had them), that also came back clear.

I can understand how perhaps stress/anxiety could induce frequent urination, much the same as it triggers IBS, but it doesn't explain the foul smelling urine and back pain.

All this probably makes me sound like a hypochondriac but the doctor was trying to rule everything out.
Expert:  Doctor Chip replied 2 years ago.
Not a hypochondriac necessarily. But one important point here--has anyone else besides yourself said your urine has an unusual smell to it?
Customer: replied 2 years ago.
To this point no, they havent.
Expert:  Doctor Chip replied 2 years ago.
Have you actually asked anyone to smell it?
Customer: replied 2 years ago.
Cant say I have! :D Something i will do within the next 24 hours.
Expert:  Doctor Chip replied 2 years ago.
I'd suggest you try that. Quite frankly, I don't really see how you have a medical problem with, say, the bladder, the prostate, or the kidneys. I think you have perhaps a sort of obsessive/compulsive condition that makes you think you have a urinating and urine smell problem. I say that because it would seem you've had more than enough studies to show it really is a physical problem.
Customer: replied 2 years ago.
I see. How would that diagnoses go inline with being woken with the need to urinate and back pain? Just one other thing to add, whenever I do stomach exercises like situps or crunches once or twice a week in the gym, I get a strong throbbing sensation in my bladder area. It is not a tightened abdominal muscle feeling which I know the feeling of very well with all my other muscle groups, its localised directly in my bladder area. It lasts for approx 20 seconds and then disappears.
Expert:  Doctor Chip replied 2 years ago.
OK--tell me all you can about the back pain.
Customer: replied 2 years ago.
Thanks for the continued replies.
The back pain is localised in my lower back, generally in my kidney area. On a scale of 1 to 10, 10 being very painful, id say its a 4. It comes and goes throughout the day and I notice it most lying in bed at night.

It started being just intermittently on my left side, but then moved to the right and now it can be either side or both sides. Its like a dull ache and sometimes little sharp pains. I recall once I got a very quick sharp pain for a split second on one side, just lying still, but that was the worst it ever was. From day to day its just a dull ache.

I really dont think its muscular as I have complete freedom of movement and no amount of moving about makes the pain worse or better. When I have no pain, I cannot move about to make the pain occur, it just comes and goes.

As said previously, its present maybe 5-10% of my day.
Expert:  Doctor Chip replied 2 years ago.
Any exacerbation with flexing, extending, or rotating the back?
Customer: replied 2 years ago.
Ever so slight exacerbation when bending to the ground when the pain is present. As in, I am more aware of it when bending over. Stetching, left to right etc all fine.
Expert:  Doctor Chip replied 2 years ago.
And no MRI of the back so far?
Customer: replied 2 years ago.
No, I did not progress any further after the CT scan of my abdomen.
Customer: replied 2 years ago.
Just to note, the only observation of the CT scan was "light faecal loading".
Expert:  Doctor Chip replied 2 years ago.
OK. I don't think the back pain has anything to do with your kidneys, bladder, or prostate. It may not be anything serious, although I would get the MRI to look for disk problems.
Doctor Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 22210
Experience: 20 yrs practice, surgery, general medicine, addiction medicine, pain
Doctor Chip and 5 other Medical Specialists are ready to help you
Customer: replied 2 years ago.
Thanks for the all the information and continued help, really appreciate it. Steve
Expert:  Doctor Chip replied 2 years ago.
No problem, but keep me informed.
Customer: replied 2 years ago.
Will do, thanks again.
Expert:  Doctor Chip replied 2 years ago.
Welcome.

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