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What causes green urine? Related conditions and treatments

Medically reviewed by Leslie Greenberg, MD
Board-Certified Family Physician
Updated May. 8, 2024  •  Published Jan. 23, 2024
Fact Checked
What causes green urine? Related conditions and treatments
In this article:

What does green urine look and feel like?

Green pee in the toilet bowl is hardly a welcome sight. Normally, urine is yellow to pale yellow because of urochrome, but it may turn to a dark yellow color due to inadequate hydration. Any change in urine color—red urine, pink urine, blue urine, orange urine, brown urine, or green urine—is understandably alarming. By itself, with no other symptoms, green pee in the toilet bowl is rarely a cause for concern. When the cause is more serious, there will probably be other symptoms such as pain during urination, frequent urination, and other urination abnormalities, or there may be symptoms such as yellow eyes, yellow skin, pale stools, or abdominal pain. These other symptoms are more reliable indicators than green urine about what’s going on in the body.

Key takeaways:

  • Green urine is an uncommon symptom that food coloring, medication side effects, liver dysfunction, or a specific type of urinary tract infection may cause.

  • Typically, green urine does not require immediate medical attention.

  • Green urine generally does not require treatment unless it persists for several days or there are other symptoms. It typically resolves without treatment in a day or two. However, if it is due to an infection or liver issues, it may take several days of treatment or longer to resolve.

  • Treatments of green urine vary by cause, which can include urinary tract infections, hepatitis C, and gallstones.

  • Green urine can be managed with dietary changes or taking measures to prevent urinary tract infections.

  • Use coupons for green urine treatments, like Zosyn (piperacillin-tazobactam), cefepime, ceftazidime, and Cipro (ciprofloxacin), to save up to 80%.

RELATED: Best antibiotics for UTIs in women

What causes green urine?

The most common causes of green urine are harmless colored substances such as dyes from foods and medications. In these cases, green urine is usually nothing to worry about and may persist until that specific food ingestion or medication is stopped. Less common causes of green urine include Pseudomonas urinary tract infections or liver disease.

Foods commonly cause abnormal urine color. Beets, fava beans, and rhubarb can turn urine red or pink, for instance. The most common foods that cause green urine have green dye or food coloring in them. Foods without dyes, such as asparagus, only rarely cause green urine. It usually requires consuming a large amount of these foods.

Medications with phenols can turn the urine green. These include:

Other medications may turn your pee green because of dyes or other reasons. These include:

Green urine can also be due to a urinary tract infection caused by Pseudomonas bacteria. One of the toxic compounds produced by , which is blue-green. 

Finally, green urine may be caused by liver dysfunction or bile blockage. The green pigment is due to biliverdin, a compound produced when the body routinely breaks down red blood cells. Biliverdin is transformed into bilirubin, which is then reprocessed by the liver. If the liver is not working well, bilirubin and sometimes biliverdin build up in the bloodstream, which is then excreted in the urine. Excess bilirubin will produce brown or dark brown urine, but excess biliverdin turns it green. A dark, greenish pigment in the urine may be a sign of liver impairment or bile blockage.

A rare cause of green urine is a fistula (an abnormal connection) between the intestines and the bladder called an enterovesical fistula. Green urine is a possible symptom of this specific fistula, but the most common signs are “bubbly” urine, bad-smelling urine, feces in the urine, and frequent urinary tract infections.

RELATED: What causes dark urine? Related conditions and treatments

Should I be worried about green urine?

If there are no other symptoms, green urine is nothing to worry about if it goes away in a day or two. If the green color doesn’t go away, call a healthcare provider for medical advice.

Let other symptoms be your guide. Other than food coloring or harmless medication side effects, the only other causes of green urine are a urinary tract infection or liver problems.

In addition to discolored urine, the common symptoms of a urinary tract infection are:

  • Pain when urinating

  • Urinary urgency

  • Lower abdominal or lower back pain

  • Fever

  • Increased frequency of urination

  • Increase in the number of times urinating after falling asleep

In addition to discolored urine, liver problems usually have other symptoms such as:

  • Jaundice (yellowing of the whites of the eyes or the skin)

  • Pale or clay-colored stools

  • Abdominal pain

  • Itching

  • Weight loss

  • Fatigue

Suppose there are symptoms such as severe pain, high fever, severe nausea, severe vomiting, pain on the sides of the abdomen, or tenderness above the kidneys. With any of these symptoms, get immediate medical care.

How is the cause of green urine diagnosed?

A healthcare professional will diagnose the cause of green urine by taking a medical history, reviewing symptoms, and performing a physical exam. An in-office urinalysis may be performed. If there are no other problems and a benign cause is readily identified, you may be sent home. If the urinalysis reveals an infection, antibiotics will be prescribed.  A urine culture may also be ordered. A culture will show which bacteria caused the infection and which antibiotic will work on that specific infection. These often take 5 days to have a final result. 

If the cause is excess biliverdin, the clinician will order blood tests to measure liver function. If these tests show liver dysfunction, an ultrasound of the liver may be necessary. In some cases, a sample of liver tissue may be needed for biopsy.

RELATED: What can be detected in a urine test? 

Is green urine contagious? 

None of the causes of green urine are contagious. Even though bacteria cause Pseudomonas urinary tract infections, the bacteria are already in or on the body and spread to the urinary tract and are unlikely to be transmitted to even close contacts.

How long does green urine last?

If the cause of green urine is harmless, like food or medications, it’s typically a short-lived phenomenon. If it’s a food dye, urine returns to its normal color in a day. If it’s caused by a medication, urine discoloration may last as long as the medicine is being taken.

Green urine due to a Pseudomonas urinary tract infection will continue for as long as the infection is active. Antibiotic treatment will quickly scale down the infection, so people should notice their urine returning to normal within a few days.

Urine discoloration due to liver disease may be a more chronic condition. Green is not the most common symptom of liver disease. Rather, people may notice the color changing to brown or dark brown.

How to stop green urine

Treatments of green urine will depend on the cause.

If food dyes cause green urine, the easiest fix is to stop eating those foods.

Green or blue-green urine resulting from medications is usually no cause for concern. The medication can be switched, but the therapeutic benefits of the drug usually outweigh the inconvenience of discolored urine.

Urine discoloration due to supplements is often a sign that too many supplements are being taken. Some supplements may not need to be taken, such as methylene blue drops. Urine discoloration caused by supplements usually clears up when the supplements are stopped or reduced.

A Pseudomonas urinary tract infection is usually treated with an antibiotic regimen specific to Pseudomonas. The most common antibiotics used are piperacillin-tazobactam, cefepime, ceftazidime, or fluoroquinolones like ciprofloxacin or levofloxacin.

On the other hand, liver problems have many possible causes, including chronic alcohol abuse, poisoning, hepatitis, infection, cirrhosis, cancer, autoimmune diseases, and other medical conditions. Bile blockage can be due to other problems like pancreatitis or gallstones. Treatments will vary widely depending on the cause.

RELATED: What you should know about ciprofloxacin for UTIs

Living with green urine

Green urine is usually a temporary and harmless issue that clears up in a day or two. In some cases, it may persist or recur for many reasons. Here are some tips:

If urine discoloration is due to a prescription drug that you need to take, then there’s little to do except live with it. If urine discoloration is due to supplements, then consider alternatives.

If urine discoloration is due to recurrent urinary tract infections, then there are several measures you can take to prevent these repeated infections:

  • See a doctor

  • Don’t douche (spray water or medication into the vagina)

  • Keep the genitals and anal area clean but don’t overdo it

  • Keep the genital area dry

  • Drink plenty of fluids every day

  • Urinate frequently throughout the day

  • Urinate immediately after sexual intercourse

  • When using the toilet, wipe the vagina or the anus front to back

  • Since UTIs can be caused by using spermicides, diaphragms, or condoms, consider using other types of birth control

Most importantly, don’t panic

As alarming as a toilet full of green pee can be, it’s probably not a life-altering event. In most cases, it’s something you ate. If there are no other signs of trouble, give it a day to see what happens. However, if there are other symptoms, they are a more reliable guide to your general health. Depending on the symptoms, call a healthcare professional for medical advice or see a healthcare provider in person. They know how to read the symptoms, make an accurate diagnosis, and start the most appropriate treatment.

What’s next? Additional resources for people with green urine

Test and diagnostics

Treatments

Scientific studies and clinical trials

Medically reviewed by Leslie Greenberg, MD
Board-Certified Family Physician

Leslie Greenberg, MD, is a board-certified practicing family physician with more than 25 years of doctoring experience. She was a psychology major at Northwestern University near Chicago, then graduated with an MD from the University of Nevada School of Medicine. She completed her family medicine residency at St. Joseph Hospital in Wichita, Kansas. She has trained more than 350 family medicine resident-physicians, been in private practice, and delivered babies for 22 years.

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