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Crohn's Disease Forum » General IBD Discussion » Red brown urine? Medication side effect or what?


05-03-2012, 08:15 PM   #1
Mia E
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Red brown urine? Medication side effect or what?

Hi!
I'd appreciate some opinions please as to how to react :/
Twice today my pee was a deep brown red colour. I went in between and it was normal urine colour, should I worry about this? is it blood?

I'm 4weeks post surgery for a resection. None of my medication has changed from what's below, and I took my last 5mg prednisolone today (reduced it by 5mg a week). the only medication leaflet that mentions this as a side effect is pentasa and that I should inform my dr. Don't want to go without evidence as the other times I peed it was normal colour. Can this happen or would blood be in all urine if it's in there?

Thanks in advance, I hope someone can enlighten me!x
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05-03-2012, 08:37 PM   #2
Mountaingem
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Hmmm have you been on Flagyl lately? That always gives me brown urine, maybe get a UTI test just to be safe. Since you are post-op you might have a UTI from the catheter, it's not uncommon.

Hope you feel better soon!
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05-03-2012, 09:52 PM   #3
Miss Underestimated
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Have you called your doctor or nurse? It might be nothing, or might might be serious. Brown urine is one symptom that your liver is not happy with your meds.
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05-03-2012, 10:16 PM   #4
Mountaingem
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Good call about the liver-can't hurt to check it out. Keep us posted

OT awesome quote Miss Underestimated!
05-03-2012, 10:28 PM   #5
2thFairy
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Pentasa can make your pee brownish red and Lialda can make your pee reddish purple, but definitely get it checked out by a doctor!
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05-03-2012, 10:43 PM   #6
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I have heard hepatitis can make your wee brownish/red and mine went brownish red when my liver wasn't happy with Immuran.. Like the others said I would get it checked...
05-04-2012, 01:50 PM   #7
Mia E
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Thanks so much everyone for the support! :hugs:

I went to the nurse today and she dipped my urine (which was back to normal colour) and said it was fine. She took my bloods to check my b12,liver and kidney function, Folic acid levels and inflammatory markers. Should get results next tue or wed, let's hope liver and kidney all ok- I'm going to keep taking pentasa until I get results- what u think?

Loving the love from this forum
05-04-2012, 03:54 PM   #8
2thFairy
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Sounds good! Glad you got it checked.
05-04-2012, 05:16 PM   #9
Mountaingem
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SO glad you're better and on the right track for answers!
05-07-2012, 08:53 PM   #10
Miss Underestimated
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Excellent!!
05-07-2012, 10:30 PM   #11
crohnicaly stinky
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Lialda makes my pee darker yellow than normal, almost orange, at least the first time I pee after my morning coffee and breakfast.
05-08-2012, 03:29 AM   #12
EmAitch88
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i have had dark brown/red pee only once ever, many months ago. i'm on Asacol and Immuran. like i said, it only ever happened once (knock on wood!) very interesting to hear others have had this happen.

happen anymore for ya, Mia?
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05-09-2012, 10:28 AM   #13
Mia E
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thanks everyone for your advice!

I called the GP and they said my results were normal or satisfactory. I'm happy with that as it hasn't happened since, but I wonder what 'satisfactory' means? I know some people on this forum get actual numbers of results given to them or emailed? Does that happen in the UK or is just in countries where people are paying for their healthcare?

thanks again for advice!x
05-09-2012, 06:00 PM   #14
Miss Underestimated
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I think it means they don't think anything is wrong. If it was affecting your liver, you would turn yellow and get very sick, and if it was blood they would know - so unless you feel bad, I think I'd just figure it was a little discoloration from the medicine, and not serious.
07-27-2012, 05:33 AM   #15
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i have had dark brown/red pee only once ever, many months ago. i'm on Asacol and Immuran. like i said, it only ever happened once (knock on wood!) very interesting to hear others have had this happen.

happen anymore for ya, Mia?
I am on Lialda and azathioprine with Ulcerative colitis and and every once in a while I notice purple stains on the toilet but not all the time. I see this happen on occasion and usually have no problems. However, when they are really pronounced I usually wind up with acute and unexplained severe abdominal pain that lands me in the hospital.

I noticed the red pee and thought it was blood at first then when I came back to the bathroom later I noticed the purple splotches on the toilet. The sun must have reacted with the residue from the pee that must have splashed up on the rim of the bowl.

If it were due to the drug then I would assume this would happen all the time, however I think that it might be a good idea for the doctor to include porphyria in the differential diagnosis.

Apparently, many of the labs have trouble conducting tests for porphyria accurately since the specimen must be handled with strict adherence to specific guidelines. Adding to this, false negatives are quite common since these labs also use an unreliable colorimetirc method to test. So I decided to test on my own. The next time I noticed these dark spots on the toilet I peed in a jar and poured 1/2 into a 2nd jar. I put the first jar in a dark closet and the second out in the sunlight all day. At the end of the day I compared the two and the jar that was out in the sun had turned much darker. That is a finding specific to porphyria which by the way seems to be associated with people that have auto immune disorders.

I hope this helps. :P
07-27-2012, 05:37 AM   #16
2thFairy
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Lialda and Pentasa will stain toilet seats. Sometimes the color is more pronounced if your urine is more concentrated depending on how much fluid you consume. I partially dissolved a Pentasa in glass of water. After several hours the water was a light purple color. I ended up buying plastic toilet seats for my house.
07-27-2012, 05:44 AM   #17
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When I have to go on nitrofuratoin my wee turns fluorescent green. Its quite impressive really.

I am glad you went to the docs though as it pays to be on top of anything like this. I have bladder issues & mild kidney disease & know after 5 bladder surgeries you need to be very careful with colour & output & well any other changes to your pee really especially if it is accompanied by pain or recent frequency changes.
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07-27-2012, 07:56 AM   #18
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You are right that mesalamine can stain toilet seats. I have used mesalamine enemas before and the stains were a hassle to deal with. However, I think it was more of a tan color. I don't remember peeing purple after using those either.

Sulfasalazine can definitely change the color of urine or stool since it's an AZO dye but mesalamine (Lialda and Pentasa) is not an AZO dye. Mesalamine is a light pinkish crystal so in and of itself it should not change the color of urine.

I called Shire and Warner Chilcott yesterday to get more information. Shire did mention that Pentasa could discolor stool but could not confirm that purple urine was a side effect with either Pentasa or Lialda. They took down my report of purple urine in their post marketing reporting process. Warner Chilcott is still getting back to me.

I looked at the package inserts to see the inactive ingredients and noticed that there were various food colorings added to Pentasa (D&C Yellow #1, FD&C Blue #1, FD&C Green #3) but these dyes are poorly absorbed by the intestines so they wouldn't be able to change the color of urine.

I know personally, that I have eaten foods that contain similar dyes and have not been able to observed a change in the color of my urine as a consequence, even after eating a whole bag of M&M's. So I can't attribute the purple stains on the toilet bowl from those dyes. I am trying very hard to tie the drug to these changes but I can't.

Then I also have to question the amount of purple staining that I noticed. At it's worst it was everywhere on the rim of the toilet bowl and it was a very deep indigo, who knows how much was in the pee I flushed down the toilet. When I was actually using the bathroom, I couldn't tell there were going to be purple stains because to me it just looked like concentrated urine at the time maybe slightly red, I actually thought it might have been peeing blood. There was no reason to suspect purple stains anywhere. I didn't see the purple until I came back later and it was everywhere on the rim of the toilet that was not drawn down by the flushed water. Unless something else is going on a drug can't make such huge and extremely noticeable color change in urine all of a sudden then stop after a week or two and leave no trace at all after that. I should be able to detect some purple staining now but I haven't seen any purple stains in weeks. Sometimes when I pee my urine is concentrated because I am a bit dehydrated but I don't even see a hint of purple.

Drugs can cause urine to change color, there is no doubt about that. The changes are predictable and well documented. There is nothing in the literature that indicates mesalamine causes purple pee. However, there is documentation in the literature that people with autoimmune disorders have been linked to porphyria which actually means purple pee in Greek.
12-18-2012, 01:57 AM   #19
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I have also had the same problem, dark brown red urine . I also have vaginal bleeding only spotting. This is after a full abdominal hysterectomy. I have so many other symptoms and am having tests done . I have a mild flare of UC and am on Pentasa 1 grm I take 2 in the morning and 2 in the evening. I am on at least 19 tablets a day for gastro problems mostly ....
The test was clear for urine infection, I have a history of kidney stones, the bladder is clear , and no blockages in the kidneys , I have to have 1 more test on the kidneys, then go see Gynea.
I have recently found out I have a heart problem and am having test for this. Then going to see a neurologist as I have nerve damage due to having a fall recently.
I have never had dark urine like this before , and it is worrying .
03-22-2015, 06:05 PM   #20
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Hi, thanks for clearing up the mystery of my 'Guinness pee', suspected it was the Methotrexate and now I'm pretty sure. Taking a sample to the Doc's tomorrow to get it checked out. Been on a 'low dose', (10mg per week) for last six weeks. Totally shocked at the brown urine this morning. Apparently the remedy is to take Bicarb to neutralise the acid.
Peace and best wishes to all
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