Dark brown urine and liver disease: what to know

Liver and bile-flow disorders can allow bile pigments to enter urine, making it tea-coloured or brown. Hepatitis A and Hepatitis B are examples of liver infections that may present with dark urine. Dark urine alone does not identify the cause. Concentrated urine after sweating, vomiting, diarrhoea or limited fluids is another possibility. New medicines, foods, blood, or muscle breakdown can also change urine colour. Look for yellowing of the eyes or skin, pale stools, itching, nausea, unusual tiredness, pain beneath the right ribs, fever, or reduced urination.

Notice when the change began and whether it followed exercise, heat, illness, a new medicine, or a change in fluid intake. If you have been losing fluids and can drink normally, take regular sips of water and observe whether the colour lightens. Do not stop prescribed medicine without advice. Arrange a clinical assessment if the colour persists, returns, or comes with jaundice, pale stools, itching, nausea, or abdominal discomfort. A clinician may review your history, examine you, test urine, and request blood tests for liver function and other causes.

Seek urgent care for confusion, fainting, severe weakness, inability to keep fluids down, very little urine, severe abdominal pain, or rapidly worsening yellow skin or eyes. Dark urine after intense exertion with marked muscle pain or weakness also needs prompt assessment. If none of these warning signs is present, contact a healthcare professional soon when the change is unexplained or does not clear with ordinary hydration.

Ask: Could this colour reflect dehydration, bile pigments, blood, or a medicine? Which urine and blood tests would clarify the cause? Should I avoid any medicine, supplement, alcohol, or strenuous activity while this is assessed? What symptoms should make me seek urgent help?