Dark, painful urine: what should you know?

Urine may look darker when it is concentrated after sweating, vomiting, diarrhoea, or not drinking enough. Burning, urgency, or lower abdominal discomfort can point to irritation or a urinary infection. Pink, red, tea-coloured, or cola-coloured urine may reflect blood or pigment from another source. Yellowing of the eyes or skin, pale stools, nausea, or pain under the ribs makes a liver or bile problem more concerning. Food, supplements, and some medicines can also alter colour.

Drink water regularly if you can do so safely, and note whether the colour lightens. Do not use leftover antibiotics; treatment depends on the cause and may require a urine test. Record when the change began, any new medicines or supplements, fluid loss, fever, and whether the pain is in the back, side, or lower abdomen. A clinician can check urine, hydration, and other symptoms.

Seek urgent medical help for severe side or back pain, fever with shivering, vomiting that prevents drinking, confusion, faintness, or very little urine. Arrange prompt assessment if visible blood, yellow skin or eyes, worsening pain, or dark urine continues despite normal drinking. Pregnancy, kidney disease, or a weakened immune system lowers the threshold for contacting a clinician.

Ask whether you need a urine test, whether a medicine or supplement could explain the colour, and which warning signs should prompt same-day care.