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Quick reference medical handouts used by Pediatric offices


My 5 yr old son has a very strong smell to his urine. He has been potty-trained for quite some time, but still wakes up wet alot of times. The smell is so strong that we can smell it before we even enter the room...can you give me any idea of what can cause the smell to be so strong? His older brother never had this odor to his urine. Thanks,
    

Thanks for your question.

Most strong-smelling urine is produced when a child is mildly dehydrated. Exercise, a fever, hot weather, or a hot room can also lead to slight dehydration and an abnormal smell to the urine. Children in cloth diapers can acquire a strong odor of ammonia if the bacteria in the stool have time to break down the urine. These conditions are only temporary, however, and the urine smell tends to disappear quickly.

There are some medical conditions that will produce the same problem.

  • Certain drugs (e.g., penicillin and ampicillin) are excreted in the urine and cause an unusual odor.
  • Certain foods (e.g., asparagus) or a high-protein diet lead to strong-smelling urine.
  • Urinary tract infections can cause a foul smelling urine
  • Severe liver disease
  • Ketonuria - When carbohydrates are unavailable or unable to be used as an energy source, fat becomes the body's fuel instead of carbohydrates and excessive amounts of ketones are formed as a result. A finding of ketones in the urine indicates that the body is using fat as the major source of energy.
  • Maple sugar urine disease  - a very rare genetic disorder that is screened for at birth.
  • Phenylketonuria , another rare genetic disorder that would have been discovered at birth
  • Rectal fistula - there is a connection vetween the urinary tract system and the large intestine, so that stool products are excreted in the urine.

We would recommend that you have your child's urine checked by his doctor. If everything is okay, then we would look for something in his diet that is causing the abnormal smeell to the urine, and would encourage him to drink more water.

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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