Bubbles in Urine?

If you have been noticing bubbles in urine then it may be the indication of an underlying problem. The presence of bubbles in urine or foamy urine is a common clinical symptom hinting at proteinuria in kidney failure patients. But urine with bubbles does not necessarily mean that you are suffering from kidney disease. Bubbly urine can be due to a relatively benign or harmless condition as well. A through medical exam can help you distinguish the cause and treat the condition.

What causes bubbles in urine?

When addressing the question of what does bubbles in urine mean, we can discuss both normal and an abnormal pathology leading to bubbles in urine. Here are some of the causes for urine bubbles.

– Normal causes for bubbles in urine

Foamy urine does not necessarily hint at some serious underlying cause. Sometimes bubbles in urine may disappear after hours or days and can be due to benign reasons. Some of the more common harmless conditions for bubbles in urine are listed below:

1. Rapid urination

When a person urinates forcefully, air gets trapped with the stream of urine results in the appearance of foam in urine. Commonly early morning urination is more forcefully and air bubbles in urine may be observed in the stream. Early morning urine is also more concentrated hence leads to the formation of bubbles in urine. It should not be treated as an alarming condition unless it starts occurring too often.

2. Mild dehydration

Mild dehydration can occur when your body is deprived of the adequate water requirements of our body. Symptoms include headache, fatigue, decrease in urine output, dry mouth and bubbles in urine. This causes the urine to become concentrated and the concentrated consistency causes the formation of bubbles in urine. Some conditions like diabetes may cause urine with bubbles because of a higher risk of dehydration. Because this frequent bubbling of urine may be a cause of concern for these individuals there is a simple test to differentiate it from a mild dehydration due to benign causes. If the bubbles in urine are reversed upon maintaining adequate hydration that this provides the proof that the cause was truly mild dehydration only.

3. Pregnancy

An enlarged kidney can be a normal finding in some pregnant woman. This is explained by the fact that a pregnant woman’s body has a fluid overload which puts pressure on the kidney causing enlargement due to the phenomenon called hydronephrosis. This leads to the bubbles in urine. Moreover, a pregnant woman’s kidney has to filter more amino acids. When this exceeds the kidneys ability to reabsorb them, the protein passes out in the urine and present as bubbly urine.

Risk indicator: Bubbles in urine can be an indication of preeclampsia in pregnant woman. It is a condition in which presence of excess protein in the urine causes foam in urine. If bubbles in urine are accompanied with other symptoms of preeclampsia like high blood pressure, swelling of face, hands and feet then you should seek medical attention immediately.

4. Menstruation

It is normal for a few women to experience bubbles in urine during the first two days of menstruation simply due to dehydration. This is a normal condition and should not be a cause of worry.

5. Too much intake of meat products and high-protein foods

6. After sexual intercourse

– Abnormal causes for bubbles in urine

If the symptom of urine with bubbles last for a longer duration of time without alleviation, you might want to rule out more serious conditions like renal damage or kidney failure. Here are a few abnormal conditions that may present as foamy urine.

1. Proteinuria

This is a condition causes by abnormal amounts of protein present in the urine. This is a sign of damaged kidney because kidney damage causes an increased permeability of the kidney’s filtering apparatus called the glomerulus. Proteinuria causes bubbles in urine and can be detected in the urine by the help of a laboratory test. This is helpful because the presence of protein can hint at the progression of kidney disease.

Other causes of proteinuria can be excessive ingestion of protein or overproduction of protein in the body. Other common causes of developing proteinuria leading to urine bubbles are as follows:

• Hypertension
• Diabetes
• Old age (over 65 years)
• Obese
• Genetic forms of kidney disease
• Trauma
• Toxins
• Immune disorder
• Certain medications
• Infection

2. Urinary tract infection

Bubbles in urine can also be caused by the presence of urinary tract infections. It is more common in women and signs include fever, frequency of urge to urinate, dysuria, abdominal pain, green-yellow discharge, foul smelling urine and traces of blood in urine. This is because the microorganisms causing the infection release gas which presents as urine with bubbles. These bubbles in urine are also accompanied by the symptom of burning sensation or pain while urinating. This condition can easily be identified by a physician who can order a urine test to confirm the presence of infection.

3. Vesicocolic fistula

This rare condition can also be a cause of bubbles in urine. A fistula is defined as an abnormal communication between two organs. A vesicocolic fistula is a connection that forms between the bladder and its surrounding colon. This kind of a fistula is three times more common in men as compared to women. The phenomenon of air bubbles in urine in this condition is known as pneumaturia. The bubbles caused in this condition can be due to inflammation at the base of the bladder. Gas collects under the skin which leads to bubbles in urine.

4. Kidney disease

Any kind of kidney damage or infection can damage the filtering apparatus of the kidney. This leads more protein being lost than it can be reabsorb due to the increased permeability. This increased protein concentration can lead to bubbles in urine. Other symptoms that may hint at kidney disease include loss of appetite, uncontrolled hypertension and generalized fatigue.

Treatment for bubbles in urine

1. Proteinuria

Treatment of bubbles in urine basically involves addressing the underlying cause. When the underlying cause is a notified kidney disease, it is important to seek urgent and appropriate medical help. Drugs for hypertension like ACE inhibitors or ARBs are prescribed to patients suffering from these medical conditions. Similarly the respective cause of proteinuria should be addressed individually to alleviate the symptom of bubbly urine.

2. Urinary tract infection

With the help of various tests like urinanalysis, your physician may be able to determine the cause and type of infection leading to the presence of bubbles in urine. Once determined, the physician can prescribe drugs like antibiotics, antifungal or anti parasitic drugs to treat the cause of infection causing fo♦amy urine.

3. Vesicocolic fistula

A vesicocolic fistula can occur due to the several underlying condition like Crohn’s disease or various tumors. A physician will be able to further help you with diagnosis and treatment of the symptom of bubbles in urine in this condition.

4. Kidney disease

The best way to slow the progress of kidney disease is by initiating early and effective treatment. Moreover foam in urine is due to proteinuria which can be a helpful laboratory indicator to monitor the progress of kidney disease. Other conditions which worsen kidney disease like diabetes and hypertension also need to be monitored and kept in check because they may serve as the underlying cause for bubbles in urine.

References:
http://kidney.niddk.nih.gov/kudiseases/pubs/proteinuria/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3539097/