Oily Urine & Liver Diseases, Key Facts:

Oily urine can be a sign of liver disease as bilirubinuria may cause deep yellow or orange oily-looking urine. See a doctor if you have oily urine with liver disease symptoms such as jaundice, fatigue, or liver pain.

• Oily urine can be a sign of liver disease, but it is not the sole cause of such urine look.
• Bilirubin in urine leads to orange oily-looking urine. Severe cases lead to brown urine rather than oily.
• Common diseases that may cause orange oily urine include acute and chronic viral hepatitis, alcoholic hepatitis, fatty inflammation of the liver, and drug-induced liver injury.
• Other causes of oily urine include chyluria, low carb ketogenic diet, diabetic or alcoholic ketoacidosis, severe dehydration, Nephrotic syndrome, UTI, urine mixing with toilet detergents, urine contamination with genital discharges, and too many vitamin supplements such as vitamin B, vitamin C, or vitamin A.
• See a doctor if you have persistent oily urine for unclear cause or if you have signs and symptoms of liver diseases.
• See a doctor if you have unexplained persistent oily urine or symptoms and signs of liver disease.

What is oily urine?

Oily urine is a term I hear every now and then from my patients. Oily urine doesn’t necessarily mean you have “fat” or “oily substances” in your urine.

The condition often describes the impression of people about the look of their urine. Here are the common descriptions of what oily urine is:

• Dark yellow or orange oily urine (common with liver diseases).
• Oil droplets in urine.
• The presence of oil film on the urine surface (typically a rainbow pattern resembling oil specks
• Greasy or fatty feel of urine (urine is sticky to surfaces).

Fat in urine is a very rare condition, and it usually occurs secondary to chyluria (lymphatic fluid in urine), which makes the urine look like milk rather than fat.

So, oily urine is about the look of urine rather than the presence of fat in urine.

Does Liver Diseases cause oily-looking urine?

Patients with liver diseases (acute and chronic) may pass bilirubin (a brown pigment) in urine. Mild cases of bilirubinuria (bilirubin in urine) may lead to orange oily-looking urine. However, severe cases of bilirubin lead to brown (cola-like) urine rather than oily.

Liver diseases sometimes cause oily-looking urine when there is bilirubin in urine. However, it is not the only cause of oily-looking urine. Many other conditions may cause such look of the urine, such as dehydration, ketosis, chyluria, etc. (see later).

You cannot conclude that you have a liver disease depending solely on the look of your urine. Liver diseases typically cause other symptoms and signs that typically coexist with urine changes (such as orange oily urine).

Conclusion:

Liver disease may cause oily-looking urine. However, it is not the sole cause of such urine looks. Moreover, patients with oily urine due to liver diseases typically have other symptoms and signs of liver affection.

Common liver diseases that may cause orange oily urine?

Any inflammation or damage to the liver (whether acute or chronic) leads to the appearance of bilirubin in urine, which gives the urine an orange oily look.

Common diseases include:

Acute hepatitis (A, B, C, etc.).

Acute viral hepatitis is an inflammation of the liver caused by a viral infection. The most common causes of acute viral hepatitis are hepatitis A, hepatitis B, and hepatitis C.

These viruses are transmitted through contact with infected bodily fluids, such as blood or seminal fluid, or through contaminated food or water.

The symptoms of acute viral hepatitis can include fatigue, nausea, vomiting, abdominal pain, and jaundice. In some cases, acute viral hepatitis can lead to chronic hepatitis, liver failure, or liver cancer.

Chronic Viral hepatitis.

Chronic viral hepatitis is a long-term liver inflammation caused by a viral infection lasting longer than six months.

The most common causes of chronic viral hepatitis are hepatitis B and hepatitis C.

Chronic viral hepatitis can cause liver damage, including cirrhosis and liver cancer if left untreated.

Alcoholic Hepatitis.

Inflammation of the liver in patients with chronic alcoholism may also lead to jaundice and orange oily urine.

Fatty inflammation of the liver (steatohepatitis).

Nonalcoholic fatty liver disease (NAFLD) is a condition where there is too much fat in the liver. It is called “nonalcoholic” because it is not caused by alcohol consumption.

NAFLD is often associated with obesity, type 2 diabetes, and metabolic syndrome. It can range from mild to severe and can lead to liver inflammation and scarring (cirrhosis) in some cases.

Drug-induced liver injury.

Drug-induced liver injury (DILI) is a condition in which medications or other substances cause damage to the liver. This damage can range from mild to severe and can lead to liver failure if left untreated.

Some common examples of medications that can cause DILI to include acetaminophen, antibiotics (such as amoxicillin and tetracycline), and statins (used to lower cholesterol levels).

Many medications may lead to cholestasis and increased bilirubin in urine.

Symptoms of liver disease.

• Fatigue
• Nausea
• Vomiting
• Abdominal pain
• Jaundice
• Orange oily urine (in some cases)
• Liver inflammation or scarring
• Liver failure (in severe cases): swollen abdomen (ascites), swollen limbs, hepatic coma, vomiting of blood, etc.

Other causes of oily urine?

Oily urine look can be a result of any condition. We’ve discussed the causes of oily urine in detail in this article.

Causes of oily urine other than liver disease include:

• Chyluria (presence of lymph in the urine).
• Low-carb ketogenic diet.
• Diabetic or alcoholic ketoacidosis.
• Severe dehydration.
• Nephrotic syndrome
• UTI
• Urine mixing with toilet detergents.
• Urine contamination with genital discharges (vaginal or prostatic).
• Too many vitamin supplements, such as vitamins B, C, or A.

When to see a doctor

See a doctor if you have persistent oily urine for unclear cause or if you have signs and symptoms of liver diseases.

Common reasons to see a doctor for oily urine include:

• Deep orange or light brown oily urine.
• Turbid urine.
• Sweet urine smell (ketonuria).
• Dysuria (painful urination).
• Too much or too little urine (polyuria or oliguria).
• Foamy or turbid urine.
• Fever or chills.
• Blood or blood clots in urine.
• Severe lower abdominal or loin pain.
• Weight loss.
• Jaundice.
• Liver pain (right upper abdominal pain).
• Clay stools.
• Swollen abdomen or limbs.
• Swollen eyelids.