Cirrhosis and Dark Urine: What to Know

A damaged liver may not process and excrete bilirubin normally. Extra bilirubin can enter the urine, making it tea-coloured, brown or noticeably darker than usual. Yellowing of the eyes or skin, pale stools, itching, nausea or unusual tiredness may occur at the same time.

Urine that is simply concentrated after sweating, vomiting, diarrhoea or not drinking enough may improve after fluids. Dark urine can also reflect a urinary infection, blood, a medicine or a separate liver condition such as hepatitis. Colour alone cannot show whether cirrhosis is present or how advanced it may be.

Arrange a medical review if dark urine is new, persists, returns or appears with jaundice, pale stools, itching, swelling or abdominal discomfort. A clinician may ask about alcohol, prescribed and non-prescription medicines, supplements, fluid loss and previous liver disease. They may examine you and order urine and blood tests to assess liver function, bilirubin, infection and hydration.

Keep taking prescribed cirrhosis medicines unless a clinician tells you otherwise. Do not start herbal products or pain medicines without checking first, because some products can add stress to the liver. If dehydration seems possible and you have not been given a fluid restriction, take small, regular sips; people with cirrhosis may need individual fluid advice.

Seek urgent medical help for dark urine with confusion, extreme sleepiness, fainting, vomiting blood, black or bloody stools, severe abdominal pain, fever, repeated vomiting or rapidly worsening yellowing. These symptoms can signal bleeding, infection, worsening liver function or another condition needing prompt treatment.

If you cannot keep fluids down, are passing very little urine, feel dizzy when standing or have severe weakness, seek prompt assessment for possible dehydration. Do not wait for the urine colour to settle if you have known cirrhosis and feel suddenly unwell.

Ask what may be causing the colour change, whether your medicines or supplements need review, which tests are appropriate and whether you need a personal fluid limit. Also ask which changes in jaundice, stools, swelling, alertness or bleeding should prompt immediate help.