Mucus

What is Mucus?

Mucus is a thick, slippery fluid that coats and moistens certain parts of the body, including the nose, mouth, throat, and urinary tract. The body produces mucus to lubricate and protect certain parts of the body, including the urinary tract.

Mucus can vary in quantity. It is typically clear, white, or off-white. 

What is the function of mucus in the urinary tract?

As the mucus moves through the urinary tract, it flushes out germs that may otherwise cause infection.

What amount of mucus in the urine is normal?

A small amount of mucus in your urine (pee) is normal. Having too much mucus may be a sign of a urinary tract infection (UTI) or other medical condition. If a person notices large amounts of mucus or mucus that changes color, they might have an infection or another health issue.

Sometimes, people may think that there is more mucus in their urine when this mucus is actually coming from the vagina.

Cervical mucus, which leaves the body as discharge, varies in color, thickness, and quantity at different stages of the menstrual cycle, as well as during pregnancy.

What is a urinalysis?

A urinalysis is often part of a routine checkup. Your provider may include a mucus in urine test in your urinalysis if you have symptoms of a UTI (Urinary tract infection). A normal test result usually shows a small or moderate amount of mucus in your urine. 

What are typical UTI symptoms?

→ Frequent urge to urinate, even when you have little urine in your bladder

→ Painful urination

→ Dark, cloudy, or reddish-colored urine

→ Bad smelling urine

→ Weakness

→ Fatigue

Elevated levels:

A large amount of mucus may be a sign of a medical problem, including:

→ A urinary tract infection (UTI)

→ A sexually transmitted disease (STD)

→ Kidney stones

→ Irritable bowel syndrome (IBS)

→ Bladder cancer

Urinary tract infection (UTI):

UTIs are among the most common types of infection that doctors treat every year. Although anyone can get a UTI, they are much more common among females. According to the National Institute of Diabetes and Digestive and Kidney Diseases, about 40 - 60% of females will experience at least one UTI in their lifetime.

The symptoms of a UTI include:

• mucus in the urine
• blood in the urine
• burning sensation when urinating
• urinary urgency

Sexually transmitted infection (STI):

STIs are common, with an estimated 20 million new infections occurring every year in the United States. People aged 15 - 24 years are most at risk.

Both chlamydia and gonorrhea can cause excess mucus in the urine. This symptom is particularly noticeable in males.

Other symptoms of these STIs include:

Chlamydia:

• burning sensation when urinating
• general pain and discomfort in the pelvic area
• testicular pain and inflammation
• vaginal bleeding (unrelated to menstruation)
• white, cloudy discharge 

Gonorrhea:

• general pain and discomfort in the pelvic area
• pain when urinating
• vaginal bleeding (unrelated to menstruation)
• yellow or green discharge

Potential treatment options:

Since chlamydia and gonorrhea are bacterial infections, they are treated with antibiotics. For chlamydia, azithromycin is usually prescribed in a single, large dose. In some cases, your doctor may prescribe doxycycline, which is taken twice per day orally for approximately a week. As recommended by the Centers for Disease Control and Prevention (CDC), the most effective treatment for gonorrhea is a single dose of 500 mg of intramuscular ceftriaxone.

Irritable bowel syndrome (IBS):

IBS is a functional digestive disorder, which means that the digestive tract does not function normally despite showing no signs of damage or inflammation. IBS is the most common functional gastrointestinal disorder, affecting 10 - 15% of people worldwide.

One possible symptom of IBS is mucus in the digestive tract. This mucus is present in the large intestine, or colon, but after leaving the body through the anus, it may mix with urine in the toilet bowl and lead people to think that the mucus is in their urine.

Other common IBS symptoms include:

• abdominal pain
• bloating
• constipation
• diarrhea
• gas

Potential treatment options:

There is no cure for IBS, but there are several treatment options that effectively alleviate symptoms. The right treatment for you will depend on identifying what is causing your IBS and what symptoms are most affecting you.

Fiber supplements such as psyllium (Metamucil), taken with lots of fluids, may help control constipation. Over-the-counter (OTC) laxatives may also be recommended.

Loperamide (Imodium A-D) is an anti-diarrheal medication that can help control diarrhea. Additionally, your doctor might prescribe a bile acid binder, such as cholestyramine (Prevalite), colestipol (Colestid), or colesevelam (Welchol).

Where stress and anxiety are the cause of IBS, antidepressants may be prescribed by your doctor.

Ulcerative colitis (UC):

UC is a form of inflammatory bowel disease.

To combat damage to the colon, the body may produce excess mucus, which passes from the body in the stool. Again, it can mix with urine in the toilet, giving the impression that there is too much mucus in the urine.

Additional symptoms of UC include:

• abdominal pain and cramps
• anemia
• bleeding from the anus
• diarrhea
• fatigue
• fever
• weight loss

Potential treatment options:

Depending on the severity of your condition, drug therapy and surgery are the treatment options for ulcerative colitis. Anti-inflammatory drugs are often the first step in the treatment plan, while immune system suppressors suppress the immune system response that begins the process of inflammation.

Your healthcare provider may prescribe biologics, which target levels of protein made by the immune system. In more severe cases where drugs may not be effective, surgery might be required.

This procedure, known as ileoanal anastomosis (J-pouch) surgery, involves removing your entire colon and rectum (proctocolectomy).

Your surgeon constructs a pouch from the end of your small intestine, which is then attached directly to your anus, eliminating the need to wear a bag to collect a stool.

If you think that you may have ulcerative colitis or Crohn’s disease, another type of inflammatory bowel disease, please see your doctor right away.

Kidney stones:

Kidney stones are hard deposits that form inside the kidneys and comprise various minerals and salts. The lifetime risk of getting kidney stones is 11% for males and 9% for females.

Stones that remain in the kidneys do not cause symptoms. However, if they move into the urinary tract, they can cause increased mucus, as well as:

• a persistent need to urinate
• blood in the urine
• nausea
• pain in the abdomen and lower back
• vomiting

Potential treatment options:

It can be incredibly painful to pass kidney stones, but they can be passed most of the time by drinking plenty of water, and do not require invasive treatment.

Pain relievers such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can help with managing discomfort for a few days, but should not be taken long term.

In more severe cases, your doctor may prescribe alpha-blockers such as tamsulosin (Flomax) and the drug combination dutasteride and tamsulosin (Jalyn) to help pass your kidney stone, though how effective they are is still uncertain.

Alpha-blockers relax the muscles in your ureter. This helps you pass the kidney stone more quickly and with less pain. If you think that you are passing a kidney stone and the pain is not improving after 1-2 days, see your doctor for further evaluation. 

Signs of bladder cancer:

Bladder cancer can cause urinary changes such as a burning sensation when you pee, or having to urinate more often. If mucus in urine is a sign of cancer, it is usually accompanied by other symptoms such as blood in urine, weight loss, lower back pain, bone pain, or swollen feet. These are signs of advanced bladder cancer.

In rare cases, mucus in the urine may be a sign of bladder cancer. However, it is unlikely to be the first symptom of the condition. 

Symptoms that usually present first include:

• blood in the urine
• difficulty urinating
• fatigue
• painful urination
• the urge to urinate frequently

It is more likely that mucus in the urine is related to an infection, a digestive condition, or another cause.

Despite this, it is important to see a doctor as soon as possible to rule out severe causes such as bladder cancer.

Regular Discharge:

Normal vaginal discharge is a common cause of mucus in urine. For women, a small to moderate amount of vaginal discharge is completely natural. In fact, it serves an important cleansing function in the female reproductive system, preventing harmful bacteria from entering and spreading throughout the body. Small glands located in the vagina and cervix secrete fluid that helps wash away dead cells and bacteria to keep it clean. This discharge may have a subtle scent, but is usually not unpleasant. The color and density of the discharge will change throughout a menstrual cycle, especially during ovulation and menstruation. Vaginal discharge also produces lubrication during sexual intercourse. Unfortunately, the amount the body produces decreases with age, and is significantly less after menopause. The color and smell of your vaginal discharge can be a sign that you are healthy, or in some cases, it can indicate an infection. If you notice changes in your vaginal discharge that are not related to your menstrual cycle, speak with a healthcare provider.

Potential treatment options:

If you’re experiencing an unpleasant odor, you can gently cleanse the vaginal area with warm water and a non-fragranced soap. If you suspect that you have a yeast infection, you can treat this with over-the-counter antifungal medications, which will reduce the itching and associated discharge. 

References:

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American Society of Clinical Oncology. Bladder Cancer: Symptoms and Signs. 10/2017. Accessed at www.cancer.net/cancer-types/bladder-cancer/symptoms-and-signs on December 19, 2018.

DeGeorge KC, Holt HR, Hodges SC. Bladder Cancer: Diagnosis and Treatment. Am Fam Physician. 2017;96(8):507-514.

National Cancer Institute. Bladder Cancer Symptoms, Tests, Prognosis, and Stages (PDQ®)–Patient Version. October 19, 2018. Accessed at www.cancer.gov/types/bladder/patient/about-bladder-cancer-pdq#section/all on December 19, 2018.

Hisano M, Bruschini H, Nicodemo AC, Srougi M. Cranberries and lower urinary tract infection prevention. Clinics (Sao Paulo). 2012;67(6):661-8. doi: 10.6061/clinics/2012(06)18. PMID: 22760907; PMCID: PMC3370320.

Cornish J, Lecamwasam JP, Harrison G, Vanderwee MA, Miller TE. Host defence mechanisms in the bladder. II. Disruption of the layer of mucus. Br J Exp Pathol. 1988 Dec;69(6):759-70. PMID: 3064799; PMCID: PMC2013295.

McCollum BJ, Garigan T, Earwood J. PURL: Can drinking more water prevent urinary tract infections? J Fam Pract. 2020 Apr;69(3):E19-E20. PMID: 32289134; PMCID: PMC7271893.

Bono, M.J., Leslie, S.W., Raygaert, W.C., "Urinary Tract Infection," Treasure Island (FL): StatPearls Publishing, 2022.

Links:

https://medlineplus.gov/lab-tests/mucus-in-urine/