Urine Color Changes in Pancreatitis (Acute & Chronic) & Pancreatic Cancer.
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Acute pancreatitis can cause concentrated deep yellow urine due to dehydration. Also, the obstruction of bile outflow due to pancreatic cancer or gallstone pancreatitis may cause dark or tea-colored urine.
Also, Urinary tract infections are common in patients with acute pancreatitis. UTI may alter the color of urine (cloudy or turbid urine).
Today, we will discuss the possible color changes in the urine of patients with pancreatitis diseases such as acute pancreatitis, chronic pancreatitis, and pancreatic cancer.
1. Very dark (tea-colored) urine with pancreatitis and pancreatic cancer.
Your pancreas secretes its digestive enzymes through its duct (the pancreatic duct) to the duodenum.
The pancreatic duct joins the common bile duct near its end to form a common duct called (the ampulla of Vater). The ampulla of Vater then opens into the duodenum through an opening with a sphincter.
One of the most common causes of acute pancreatitis is the obstruction of the main pancreatic duct with a gallstone.
When a small gallstone slips from the gallbladder, it may reach the ampulla and obstruct both the common bile duct and the pancreatic duct.
In such a case, the patient with acute pancreatitis will have obstructive jaundice and pancreatitis.
This condition is called gallstone pancreatitis. With gallstone pancreatitis, the urine color may become very dark in color (tea or cola-colored urine).
The urine is dark in this case because of the elevation of blood bilirubin due to the obstruction of bile outflow from the liver. As a result, the excess bilirubin is excreted through urine, causing the dark or tea-colored urine with acute pancreatitis.
The symptoms of combined pancreatitis and obstructive jaundice:
- Jaundice (yellowish skin and eye whites).
- Dark urine (cola- or tea-colored urine).
- Clay or pale stools.
- Right upper abdominal pain (biliary colics).
- Severe upper middle abdominal pain (pancreatic pain).
- Other symptoms of pancreatitis include fever, vomiting, nausea, diarrhea, etc.
The dark color of urine is not linked directly to pancreatitis. But it occurs in a specific type of pancreatitis when a gallstone obstruction both the pancreatic and biliary secretions.
Also, no dark (tea-colored) urine in acute pancreatitis without clinical jaundice. Jaundice often accompanies clay stools and dark urine color.
Treatment of gallstone pancreatitis:
The condition is often temporary, and the stone often passes on its own to the duodenum. Jaundice, pancreatitis, and dark urine often resolve after the stone passes into the duodenum.
If the stone doesn’t pass, an intervention with a specialized endoscope to relieve the obstruction is called the ERCP (Endoscopic retrograde cholangiopancreatography).
The obstruction of the pancreatic and common bile duct can also be caused by cancers in the head of the pancreas, causing both acute pancreatitis and tea-colored urine.
2. Deep yellow urine with acute pancreatitis.
Pancreatitis causes significant dehydration due to several factors such as lack of oral intake, vomiting, diarrhea, fever, and intraabdominal collections.
Patients with untreated or undertreated pancreatitis often develop severe dehydration unless properly hydrated.
The dehydration with acute pancreatitis may cause passage of scanty, concentrated (deep yellow) urine.
Symptoms of dehydration with acute pancreatitis include:
- Low blood pressure (hypovolemic shock).
- Tachycardia (fast heartbeats).
- Dry mouths.
- Lack of tears (dry eyes).
- Extreme thirst.
- Peeing too little urine.
- Concentrated urine color (deep yellow urine).
The deep yellow, scanty urine often improves after good dehydration. Doctors often put the patient on a continuous intravenous fluid infusion for 48 hours.
The fluid continues at a lower rate after correction of dehydration.
The early correction of dehydration with acute pancreatitis is associated with a significant decrease in disease severity and death (reference).
So, we consider a full deep yellow urine color a warning sign of acute pancreatitis. Correction of dehydration is one of the most important goals during the treatment of acute pancreatitis.
3. Turbid (cloudy) urine with acute pancreatitis.
Patients with acute pancreatitis may experience different forms of infection either in the pancreas or in distant organs.
The urinary tract is not immune to infection during acute pancreatitis. The. Urinary tract infection is the most common extra-pancreatic site of infection during acute pancreatitis (reference).
Urine color in urinary tract infection may change into a cloudy (turbid) yellow or greyish color if the infection is severe. Also, there is maybe reddish color due to blood in urine in severe cases.
A. Does pancreatitis always change urine color?
Patients with acute pancreatitis commonly experience urine color changes due to several factors such as dehydration, biliary obstruction, and urinary tract infection. However, Urine color is not affected with proper treatment of dehydration and management of complications.
D. Can a urine test detect pancreatic problems?
There is no approved or widely used urine test that can diagnose pancreatitis. However, some tests under trial may potentially help diagnose acute pancreatitis, such as urinary amylase, and urinary trypsinogen-2.
The gold standard for an acute pancreatitis diagnosis is still serum lipase, amylase, and abdominal imaging techniques such as Abdominal CT.