What should you know about dark orange smelly urine?

Urine becomes darker and stronger-smelling when it is concentrated, particularly after sleep, sweating, exercise, vomiting, or diarrhoea. Dehydration is more likely with thirst, dry mouth, headache, dizziness, or reduced urination. Certain foods, vitamins, and medicines can change both colour and odour without causing illness.

A strong smell with burning, urgency, frequent small amounts, lower abdominal pain, fever, or cloudy urine can fit a urinary infection and needs clinical advice. Orange-brown urine with yellow eyes or skin, pale stools, nausea, or upper abdominal discomfort can occur with liver or bile problems such as hepatitis A or hepatitis B. The smell alone cannot identify the cause.

Drink fluids regularly if you are able to do so and have not been given a fluid restriction. Check whether the colour and smell improve as urine becomes less concentrated. Make a note of new medicines, supplements, foods, heat exposure, exercise, pain, burning, fever, and how often you urinate. Do not use leftover antibiotics or stop prescribed treatment without speaking with a clinician.

Arrange prompt medical review for strong-smelling urine with fever, back or side pain, vomiting, pregnancy, or painful urination. Seek urgent help for confusion, fainting, severe weakness, very little urine, inability to keep fluids down, or severe symptoms after heat exposure. Brown urine, yellowing of the eyes or skin, visible blood, or a persistent change also warrants prompt assessment.

Could concentration, a medicine, or an infection explain the smell? Do I need a urine culture or other test? What symptoms would suggest a kidney or liver problem? How should I manage fluids with my medical history?