Paroxysmal nocturnal hemoglobinuria: brown, smelly urine

It may happen that when you wake up you urinate in the morning and the urine is very dark in color and smells unpleasant. This condition is called paroxysmal nocturnal hemoglobinuria and is caused by poor disposal of bodily waste. What does bilirubin as a waste product of hemoglobin have to do with this, why does the pee turn dark especially in the morning and why does it smell unpleasant?

Paroxysmal nocturnal hemoglobinuria

  • What is paroxysmal nocturnal hemoglobinuria?
  • What is bilirubin?
  • Liver and gallbladder
  • Waste disposal
  • Different colors of urine
  • Smelly pee

What is paroxysmal nocturnal hemoglobinuria?

Due to excessive production of waste products and/or poor drainage, bilirubin must be removed through the urine. It causes people to have a very brown or dark, smelly pee when they get up. As the day progresses the color will change to a lighter color. The proportion of waste products decreases during the day when liquids are ingested, causing the odor and color intensity to change. What causes this urinary problem?

What is bilirubin?

In our blood, red blood cells containing hemoglobin are responsible for the transport of oxygen. These blood cells normally last about a hundred days or more, after which they are replaced. This is changed every day, so that the blood level remains normal, so to speak. If hemoglobin is broken down, bilirubin remains. This is a harmful substance and must be removed so that the body is, as it were, purified.

Liver and gallbladder

The liver and gallbladder are responsible for removing bilirubin. Bile is produced by the liver and is normally stored in the gallbladder before being passed into the feces. Bilirubin is also added to the bile, which gives the stool a dark color. Due to a temporary increase in blood breakdown or a poorly functioning liver or gallbladder, the drainage cannot cope. Insufficient waste is then removed, causing bilirubin to accumulate as waste in the body. It is the cause of jaundice, which causes the eyes to turn yellow and the skin to appear yellowish. In that case, the body looks for another way to remove the waste.

Waste disposal

In order to effectively remove bilirubin, the second route must be used, i.e. urine. The substance is then removed from the body by the kidneys and added to the urine. It causes the normally clear or yellow pee to completely change color and cause an unpleasant odor. The characteristic feature is that the urine is deeply dark, comparable to the color of feces. Please note that with a poorly functioning liver or gallbladder, the stool may be white, while urine takes on a dark color.

Different colors of urine

It is called nocturnal hemoglobinuria because the discoloration occurs mainly at night. The morning pee has a darker color, because waste products are relatively more concentrated. This is because we consume little fluid during sleep and the removal of waste products continues as usual. If you suffer from the condition, the first puddle will be extra dark brown. As the day progresses, the color of the urine may change to light brown, red or sometimes yellow. The rinse therefore becomes thinner as the day progresses.

Smelly pee

Because bilirubin is a residual product of blood, it will not give a pleasant odor. It is normally also logically added to the stool, so that it is easily removed and we are less bothered by it. Because the waste material is now added to the urine, the smell of the pee will also change significantly.

If you regularly have a dark puddle and an unpleasant smell, you may have various conditions. The blood breakdown via the spleen and liver works too quickly or the drainage via the liver and gallbladder does not work properly. In addition, it can be due to various blood disorders. So get a medical examination so that the culprit can be treated.

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