In a healthy person, urine is light yellow and clear. When urine looks discolored or doesn’t appear clear it is referred to as cloudy, foamy or turbid urine. Urine may become cloudy due to presence of pus, blood or mucus. Sediments of urates and phosphates can also make the appearance of urine cloudy. Cloudy urine may be accompanied by other symptoms such as abdominal pain, foul odor, pain or burning when passing urine.

What Are the Causes of Cloudy Urine and Abdominal Pain?

1. Urinary Tract Infections

A UTI (urinary tract infection) is infection of any organ of the urinary tract that includes the kidneys, bladder, ureters and urethra. The majority of the infections affect the lower part of the urinary tract (bladder and urethra). UTIs are usually caused by bacteria. Females are more prone to develop UTI in comparison to males.

Symptoms of a UTI (lower tract) are:

• Burning during urination
• Increased frequency to pass urine (the amount of urine passed is not much)
• Increased urge to pass urine
• Blood in urine
• Cloudy urine
• Passing urine that appears like tea or cola
• Urine with strong odor
• Lower abdominal pain in females
• Rectal pain in males

UTIs affecting the upper urinary tract infect the kidneys and can become life-threatening if the bacteria are transmitted from the kidney to the blood.

Symptoms of a UTI (upper tract) are:

• Chills
• Fever
• Vomiting
• Nausea
• Tenderness and pain in upper part of back and the sides

Treatment

Antibiotics are given for bacterial UTIs-oral for UTI of the lower tract and intravenous for the UTI of the upper tract.

How to prevent UTI:

• Drink at least 8 glasses of water every da.
• Avoid holding urine for long duration
• Discuss with your physician if you have difficulties with emptying your bladder completely or urinary incontinence
• Using cranberry supplements daily can prevent UTI in females
• Similarly, utilizing vaginal probiotics such as lactobacillus can also prevent the condition

2. Acute Bacterial Prostatitis

Another cause of cloudy urine and abdominal pain is acute bacterial Prostatitis. It is characterized by sudden inflammation of the prostate gland. The infection is caused by the same bacteria which cause UTIs (such as Escherichia coli, Klebsiella species and Proteus species) or STDs (sexually transmitted infections such as gonorrhea and chlamydia). Bacteria may reach the prostate through the bloodstream. It may also enter the prostate gland during a medical procedure, for instance a biopsy.

Symptoms of acute Prostatitis:

• Chills
• Fever
• Pain in the pelvic region
• Pain or difficulty while passing urine
• Bloody urine
• Foul smell in urine
• Difficulty in passing urine
• Decreased stream of urine
• Increased frequency to pass urine
• Blood in semen
• Pain during ejaculation
• Discomfort while passing stools
• Pain above pubic bone
• Pain in genitals, rectum or testicles

Treatment

Your physician will prescribe antibiotics to treat your symptoms for a period of 4-6 weeks. They may also give you alpha-blockers such as doxazosin, tamsulosin and terazosin to ease your symptoms of urinary discomfort as these medicines relax muscles of the bladder. You may also be given OTC pain killers such as ibuprofen and acetaminophen.

Your physician may advice you to do the following:

• Avoid caffeine, alcohol, acidic and spicy foods
• Take regular warm baths
• Sit on donut cushion or a pillow
• Avoid cycling
• Wear shorts that are padded to reduce pressure on the prostate gland

Acute Prostatitis generally gets better with lifestyle changes and antibiotics. However, in some people it recurs and gets converted into chronic Prostatitis. Discuss with your physician about taking certain steps to reduce your risks of recurring infection.

3. Gonorrhea

Gonorrhea is another cause of cloudy urine and abdominal pain. Gonorrhea is a type of sexually transmitted infection caused by bacterium Neisseria gonorrhoeae. It can cause infection in both females and males and is transmitted through sexual contact during anal, vaginal or oral intercourse.

Risk factors

The risk factors of gonorrhea are:

• Young age
• Previous diagnosis of gonorrhea
• Having a history of another STIs
• Having a sex partner who has multiple sexual partners
• Having a new sexual partner
• Having multiple sexual partners

Symptoms

Symptoms of gonorrhea when it affects the genital tract:

In males

• Pain while urinating
• Discharge (pus like) at the tip of penis
• Swelling or pain in one testicle

In females

• Pain while urinating
• Increased discharge from vagina
• Pain during intercourse
• Pain in abdomen or pelvic region
• Bleeding from vagina between menses, such as bleeding after sexual intercourse

Symptoms of gonorrhea when it affects other organs of your body:

• Rectum: Itching at anus, rectal discharge, blood on toilet paper and straining while passing stools.
• Eyes: Pain in eyes, light sensitivity and discharge from eyes.
• Throat: Sore throat and swelling of lymph nodes in neck.
• Joints: Affected joints become red, warm, extremely painful particularly on movement and swollen.

Treatment

Adults who develop gonorrhea are given antibiotics to treat the infection. According to the recommendation of the Centers for Disease Control and Prevention uncomplicated gonorrhea is treated by giving an injection of antibiotic ceftriaxone in combination with either doxycycline (Vibramycin and Monodox) or azithromycin (Zmax and Zithromax)-antibiotics that can be taken orally.

Your partner, even if they have no symptoms or signs of the disease should undergo treatment and testing for gonorrhea. They get the same treatment as you do.

Babies who are born to females who have gonorrhea get a medicine in their eyes immediately after birth to prevent the spread of infection.

4. Kidney Stones

Kidney stones also cause symptoms of cloudy urine and abdominal pain. Kidney stones are hard deposits of salts and minerals that are formed inside the kidneys.

There is no single, definite cause of kidney stones, though there are several factors that may increase the risk of formation of kidney stones. They form when more substances that form crystals such as oxalate, uric acid and calcium are present in your urine than can be diluted by the fluid in the urine. Additionally, your urine may be lacking substances, which prevent the sticking together of crystals.

The risk factors of kidney stones are:

• Having a personal or family history of kidney stones
• Lack of drinking enough water
• Consuming a diet high in sodium, protein and sugar
• Being overweight and obese and having a large waist size
• Inflammatory bowel disease, chronic diarrhea and gastric bypass surgery may change the digestive process affecting the absorption of water and calcium, thereby, increasing substances that may form stones in the urine.
• Other diseases are cystinuria, hyperparathyroidism, renal tubular acidosis and certain medicines.

Treatment

Treatment varies and depends on the cause and kind of stone. Small stones don’t need invasive treatment and are usually passed by:

• Drinking around 2-2.8 liters of water every day
• Taking pain killers such as acetaminophen or ibuprofen to relieve mild discomfort
• Your physician may give you a medicine such as an alpha blocker that relaxes ureteric muscles, thereby, helping the kidney stones to pass quickly and with little discomfort

Large stones that can’t pass on their own or that cause symptoms may need extensive treatment. These procedures are:

• Extracorporeal shock wave lithotripsy: In this procedure, sound waves are used to produce strong vibrations, which break the stones into small pieces that pass in the urine.
• Percutaneous nephrolithotomy: In this surgical procedure, instruments are inserted into the kidney via a small incision made in the back and the stone is removed.

A stone may be removed using uretroscope that is passed via the urethra and bladder into the ureters and kidney.

You can prevent kidney stones by drinking enough water every day, eating fewer foods rich in oxalate, eating a diet low in animal protein and salt and avoiding calcium supplements.