tag:theconversation.com,2011:/us/topics/urine-9328/articlesUrine – The Conversation2023-09-18T12:19:01Ztag:theconversation.com,2011:article/2047892023-09-18T12:19:01Z2023-09-18T12:19:01ZWhat happens if you need to pee while you’re asleep?<figure><img src="https://images.theconversation.com/files/536919/original/file-20230711-19-qt6put.jpg?ixlib=rb-1.1.0&rect=703%2C209%2C4288%2C2597&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Your bladder can signal the brain when it's full, even while you're asleep.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/toilet-bowl-in-the-restroom-dramatic-lighting-copy-royalty-free-image/1303857822?adppopup=true">Happyphoton/iStock via Getty Images</a></span></figcaption></figure><p><em><a href="https://theconversation.com/us/topics/curious-kids-us-74795">Curious Kids</a> is a series for children of all ages. If you have a question you’d like an expert to answer, send it to <a href="mailto:curiouskidsus@theconversation.com">curiouskidsus@theconversation.com</a>.</em></p>
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<blockquote>
<p><strong>What happens if you have to go to the bathroom in your sleep? – Calleigh H., age 11, Oklahoma</strong></p>
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<p>As you drink water during the day, your body turns extra liquid it doesn’t need into pee. Your bladder stores the urine and eventually alerts you when it’s time to take a trip to the toilet.</p>
<p>But what about at night? How does your body know not to pee while you’re asleep?</p>
<p>Just because you’re snoozing doesn’t mean your body is totally offline – continuous processes like breathing, digestion and, yes, making pee, still happen while you’re asleep. Your bladder and your brain work together to know what to do with that big glass of water you drank before bed.</p>
<p>Using the bathroom every day is routine for many people, so it’s something you might not pay much attention to. But as a <a href="https://www.seattlechildrens.org/directory/jennifer-jihyun-ahn/">pediatric urologist</a>, understanding how the brain and bladder work together – and sometimes miscommunicate – is an important part of my job. </p>
<h2>The bladder and the brain</h2>
<p>The bladder has two main jobs: to safely store urine and to empty it out. While it seems simple, these two tasks take <a href="https://www.mea.elsevierhealth.com/campbell-walsh-wein-urology-9780323546423.html">a lot of complex coordination</a> of muscles and nerves – that’s the brain’s job.</p>
<p>For babies and young kids, the bladder has reflexes, meaning it automatically knows when to squeeze the muscles to empty the urine. Since babies can’t control this consciously, they typically wear diapers. But <a href="https://www.seattlechildrens.org/health-safety/keeping-kids-healthy/development/toliet-potty-training/">as kids grow</a>, the bladder muscles and nerves also grow, which gives a youngster more control over their bladder. </p>
<p>During <a href="https://pubmed.ncbi.nlm.nih.gov/31613577/">toilet training</a>, which usually happens by the age of 3 or 4 in the U.S., kids learn how to use the toilet voluntarily. This means that they can feel when the bladder is getting full and their brain can receive and understand that signal. The brain can then tell the bladder to “hold it” until they’ve made it to the toilet and it’s safe to pee.</p>
<h2>What happens in sleep mode?</h2>
<p>Most children first learn how to use the toilet during the day. Using the bathroom overnight <a href="https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Bedwetting.aspx">can be more difficult</a> because the sleeping brain doesn’t receive signals in the same way as when awake. </p>
<p>While awake, if there’s a loud noise or a bright light, the body senses it and reacts. But during sleep, the body may not hear that noise or see that light because the brain is in <a href="https://doi.org/10.1016/j.smrv.2019.101228">sleep mode</a>. Imagine sleeping through an overnight thunderstorm that you didn’t realize happened until you hear people talking about it in the morning. Your brain didn’t process the loud noises because it was focusing on sleep.</p>
<p>The same thing can happen with bladder signals. The bladder fills with urine 24 hours a day, even while you’re snoozing, and it sends signals to the brain when it’s full. In order to help you get enough sleep, your brain will tell your bladder to hold it until morning.</p>
<p>Sometimes, if you really need to go, your brain will tell your body to wake up so you can go empty your full bladder. While it’s normal to wake up to pee sometimes – especially if you drank a big cup of hot chocolate right before bed – most older kids can usually sleep through the night without needing to use the toilet.</p>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/p/CseFST5M8Ur/?hl=en","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
<p>When the brain and bladder are working together well, your bladder gradually fills up overnight and hangs on til morning when you stumble into the bathroom to empty it.</p>
<h2>Nighttime accidents</h2>
<p>But there are many ways the communication between the brain and the bladder can break down. For one, the brain may not get the bladder’s message that it’s time to go. Even if the brain gets the message, it may not be able to tell the bladder to hold on. Or, when the bladder can’t wait, the brain might not tell your body to wake up. If the signals and messages aren’t sent, or are received incorrectly, the bladder will go into <a href="https://doi.org/10.1016/j.smrv.2019.101228">reflex mode</a> – it squeezes to empty itself of pee, even though you’re fast asleep in bed.</p>
<p>Wetting the bed at night, which doctors call nocturnal <a href="https://www.britannica.com/science/enuresis">enuresis</a>, is more common than you might think. <a href="https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Bedwetting.aspx">About 15%</a> of kids between ages 5 and 7 wet the bed sometimes. Even some teenagers experience it. It’s more common in boys, and often there’s a family history, meaning parents or relatives may have dealt with nighttime accidents too.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A child's legs, wearing pajama pants, against a grey floor. A wet stain is visible on their bottom and on the ground behind them." src="https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Many children wet the bed at night.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/unrecognizable-child-legs-on-wet-bed-incontinence-royalty-free-image/1398170112?adppopup=true">Olga Rolenko/Moment via Getty Images</a></span>
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<p>There are a few reasons why nighttime wetting happens. Since kids’ brains are growing and developing, nighttime communication between the brain and bladder can take longer. </p>
<p>Some bodies make more pee at night, making it more likely the bladder will get full during sleep. Some people have smaller bladders that fill up fast. Sometimes having difficulties with sleep or being a deep sleeper <a href="https://doi.org/10.1016/j.smrv.2019.101228">can make it harder</a> to wake up at night if you really need to pee.</p>
<p>Most kids who wet the bed at night outgrow it as their brains and bodies continue to develop. At that point, they can sleep through the night without needing to pee, or their bodies are able to wake up at night to use the bathroom when they need to. </p>
<p>If wetting the bed is an issue, there are <a href="https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Nocturnal-Enuresis-in-Teens.aspx">some things that can help</a>, like drinking less liquid in the evening or using the bathroom right before you go to bed. These precautions make it less likely that the bladder will be too full during sleep. There are also bedwetting alarms that can help train the body to wake up when the bladder needs to be emptied. If there are concerns about nighttime accidents, or if accidents start happening in older children, I recommend consulting a doctor. </p>
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<p class="fine-print"><em><span>Jennifer Ahn does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A pediatric urologist explains how the bladder and the brain communicate to wake you up when you need to ‘go’ – and how that communication might break down.Jennifer Ahn, Assistant Professor of Urology, School of Medicine, University of WashingtonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2132692023-09-14T11:59:04Z2023-09-14T11:59:04ZPollen in pee: fossilised urine from a small African mammal helps us understand past environments<figure><img src="https://images.theconversation.com/files/547771/original/file-20230912-27-za8r9z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The lessons pollen can teach us are not to be sneezed at.</span> <span class="attribution"><span class="source">Elisa Manzati</span></span></figcaption></figure><p>If you are allergic to pollen, you are likely to curse the existence of these microscopic particles. You’re not alone: <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4829390/#:%7E:text=Allergies%20on%20the%20Rise,people%20worldwide%20affected%20by%20asthma">up to 30%</a> of the world’s population suffers from hay fever, which is often driven by pollen allergies. Shifting global climates are likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4829390/">push that figure even higher</a>.</p>
<p>However, pollen represents one of the most powerful tools to uncover the nature of past environmental change. </p>
<p>I am the head of the <a href="https://drlynnequick.com/nelson-mandela-palaeolab/">Palaeoecology Laboratory</a> at <a href="https://www.mandela.ac.za/">Nelson Mandela University</a> in South Africa. My research focuses on unravelling the secrets of ancient environments and ecosystems by examining fossil pollen grains. These tiny time capsules hold a wealth of information about the earth’s past. They help scientists to reconstruct ecosystems, track climate change and understand the evolution of plant life.</p>
<p>But it can be difficult to source pollen deposits in arid regions. That’s because such deposits are often found in large lakes, which are in short supply in southern Africa. That’s where an unlikely scientific ally enters the picture: the fossilised urine of a small mammal, the <a href="https://www.awf.org/wildlife-conservation/hyrax">rock hyrax</a> (South Africans call them “dassies”). </p>
<h2>Looking back</h2>
<p>Pollen grains are incredibly durable because they are made of an organic substance (called sporopollenin) that is very resistant to decay. Pollen is released into the air, often in large quantities, and can settle on surfaces like lakes, and become preserved in sediment deposits over thousands, or even millions, of years.</p>
<p>In the lab, we examine the pollen found in these deposits using a microscope. By identifying the different types of pollen grains found within the different layers (representing different time slices) we can reconstruct the area’s vegetation history. Plants grow under specific climatic conditions: for instance, desert plants can grow under low rainfall conditions whereas forest plants need high amounts of rainfall. So we can make inferences about the climate at the time that the pollen was incorporated into the deposit.</p>
<figure class="align-center ">
<img alt="A rather chubby small rodent with dark brown fur and protruding front teeth regards the photographer." src="https://images.theconversation.com/files/547484/original/file-20230911-23-arxq3p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/547484/original/file-20230911-23-arxq3p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/547484/original/file-20230911-23-arxq3p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/547484/original/file-20230911-23-arxq3p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/547484/original/file-20230911-23-arxq3p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/547484/original/file-20230911-23-arxq3p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/547484/original/file-20230911-23-arxq3p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The fossilised urine of rock hyraxes helps in the study of pollen.</span>
<span class="attribution"><span class="source">Kiev Victor</span></span>
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</figure>
<p>As I’ve said, southern Africa’s arid climates mean there are very few large lakes in the region. This makes it a challenge to source deposits that adequately preserve pollen within them over long periods of time. That’s where <a href="https://www.sciencedirect.com/science/article/abs/pii/S0277379112003319">fossilised dassie urine</a> comes in. </p>
<p>These sticky deposits called “middens” accumulate in rock crevices in mountainous areas over thousands to tens of thousands of years and contain beautifully preserved pollen grains. As they also contain various other types of evidence (such as geochemical data) and can be accurately dated, they represent the most valuable archive of past climate data in southern Africa. The oldest middens we’ve worked with date back 50,000 years.</p>
<h2>Ancient sites</h2>
<p>The research my lab conducts, focusing on harnessing the power of the humble pollen grain and utilising unique archives such as hyrax middens, is strongly multidisciplinary. It draws together elements from botany, geography, geology, climatology and archaeology. </p>
<p>We are currently generating fossil pollen records from several sites within the Cape Fold Belt mountains of South Africa. For example, we have a midden sequence that covers the last 6,000 years from the Baviaanskloof in the Eastern Cape province. The fossil pollen from this sequence shows that there was a dramatic shift in vegetation about 3,300 years ago, driven by a large fire event and increased temperatures. We’re hoping to publish this research soon.</p>
<p>This information provides baselines of variability in natural systems and can help inform current conservation efforts within the Baviaanskloof, which is a biodiversity hotspot. </p>
<p><a href="https://www.africanpaleoscienceslab.org/fieldwork/capp">Another project</a> that we are involved in is centred on the archaeological excavation within South Africa’s southern Cape region at a site called Boomplaas Cave. By using the fossil pollen within hyrax middens found within the vicinity of Boomplaas Cave, we hope to provide the environmental context to the archaeological record which can help to decipher how early humans responded to climate change.</p>
<h2>And looking forward</h2>
<p>We are not only working within the realm of the past: as pollen is one of the main sources of allergies it is important to monitor the types and amounts of pollen currently present in the air we breathe. My lab is part of the <a href="https://pollencount.co.za/">South African Pollen Monitoring network</a> and we generate pollen data for the city of Gqeberha in the Eastern Cape province. </p>
<p>This initiative focuses on analysing pollen captured in the air across several different parts of South Africa and ensuring that this information is publicly available. This project is particularly important as, <a href="https://journals.co.za/doi/abs/10.10520/EJC21714">due to climate change</a>, pollen seasons are lengthening and <a href="https://www.immunology.theclinics.com/article/S0889-8561(20)30061-8/fulltext">allergenic pollen is increasing</a>.</p><img src="https://counter.theconversation.com/content/213269/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lynne Quick receives funding from the National Research Foundation of South Africa: African Origins Platform and
GENUS: DSI-NRF Centre of Excellence in Palaeosciences
</span></em></p>Pollen can become preserved in sediment deposits over thousands, or even millions, of years.Lynne Quick, Senior Research Fellow, Nelson Mandela UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2068692023-06-16T03:37:43Z2023-06-16T03:37:43ZDoes it matter if you sit or stand to pee? And what about peeing in the shower?<figure><img src="https://images.theconversation.com/files/532080/original/file-20230614-29-n8jj3y.jpg?ixlib=rb-1.1.0&rect=0%2C2%2C1000%2C663&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/closeup-young-caucasian-man-using-his-656574232">Shutterstock</a></span></figcaption></figure><p>Do you sit or stand? That is the question about <a href="https://docs.cdn.yougov.com/0l6u6ha4yz/YouGov%20-%20Sit%20down%20urination%20men%20international.pdf">7,000 men</a> around the world <a href="https://today.yougov.com/topics/society/articles-reports/2023/05/16/where-world-are-men-most-likely-sit-down-wee">have been asked</a> about how they pee.</p>
<p>We’ll get to their answers soon. But the <a href="https://www.news.com.au/lifestyle/health/health-problems/urologist-reveals-men-are-emptying-their-bladders-wrong/news-story/b3a86aeab9cc97825554dfef5b28a7f0">media interest</a> that followed prompted one urologist <a href="https://www.telegraph.co.uk/health-fitness/body/the-health-benefits-of-sitting-down-to-pee/">to recommend</a> some men sit to urinate, especially as they age.</p>
<p>What is the best way to urinate? Does that apply to women? We research the <a href="https://www.tandfonline.com/doi/abs/10.1080/21688370.2022.2099214?journalCode=ktib20">bladder</a> and <a href="https://journals.physiology.org/doi/full/10.1152/ajpcell.00441.2022">lower urinary tract</a>. Here’s what the evidence says.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-can-your-doctor-tell-from-your-urine-74990">Health Check: what can your doctor tell from your urine?</a>
</strong>
</em>
</p>
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<h2>Do most men stand to pee?</h2>
<p>The survey found men in different countries differ in how they pee. </p>
<p>In Germany, 40% of men report sitting while they pee every time, as do 25% of Australians. In the United States, it’s just 10%. </p>
<p>Some people even view <a href="https://www.bmj.com/content/1/1174/1281.1">standing to pee</a> as “superior” and sitting inferior. In German, the word <a href="https://www.urbandictionary.com/define.php?term=Sitzpinkler">Sitzpinkler</a> means
someone who sits to pee; it can also be used as an insult.</p>
<p>But habits may be changing. In Australia, for instance, the survey found younger men are more likely to sit down than older men. Some 36% of younger men sit down most or every time, while only 20% of men aged 55 and older report doing so.</p>
<h2>So should men stand or sit?</h2>
<p><strong>When it doesn’t matter</strong></p>
<p>In general, the literature suggests it <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0101320">doesn’t matter</a> if a healthy man stands or sits when he pees.</p>
<p>Regardless of the position, there seems to be no difference in the time taken to pee, the flow rate, and how completely the bladder is emptied.</p>
<p>So long as there are no urinary concerns, men are free to choose their preferred position. If you chose to stand, just be sure to aim well.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/is-urine-sterile-do-urine-therapies-work-experts-debunk-common-pee-myths-191862">Is urine sterile? Do urine 'therapies' work? Experts debunk common pee myths</a>
</strong>
</em>
</p>
<hr>
<p><strong>When it can</strong></p>
<p>Recommendations for sitting or standing become less clear for men with <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/nau.24839">lower urinary tract symptoms</a>. These include issues such as having poor stream (for example, a dribble rather than a steady flow of urine), straining while urinating or feeling the bladder has not <a href="https://www.ics.org/committees/standardisation/terminologydiscussions/feelingofincompletebladderemptying">completely emptied</a> after finishing.</p>
<p>For some of these men <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0101320">sitting</a> is preferred to help increase the flow and empty the bladder. Others find the same relief comes from standing.</p>
<p>For men with <a href="https://www.continence.org.au/news/novembers-all-about-mens-health-so-whats-bph-anyway">benign prostatic hyperplasia</a>, otherwise known as an enlarged prostate, there is evidence <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361486/">standing</a> may help fully empty the bladder. But this advice may not work for all. That’s because how much the prostate has become enlarged, and the impact this has on urinary flow, can be different between people.</p>
<p>As standing or sitting <em>can</em> matter, for some men, it’s worth having a chat with your doctor about what’s best for you.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/do-men-really-take-longer-to-poo-152233">Do men really take longer to poo?</a>
</strong>
</em>
</p>
<hr>
<h2>How about women?</h2>
<p>The structure of the female pelvic area is quite different to males, as it accommodates the vagina, uterus and reproductive structures. And the female anatomy is just not designed to pee standing up. So, making a habit of, say, peeing in the shower, is not advised.</p>
<p>Females do not have a prostate, which helps supports the male bladder while standing. This lack of support can place extra strain on the bladder region when not sitting down, making it harder for the bladder to fully empty.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Illustration of female pelvic floor muscles and urinary tract" src="https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=480&fit=crop&dpr=1 600w, https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=480&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=480&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=603&fit=crop&dpr=1 754w, https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=603&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/532082/original/file-20230614-22-pxzvyy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=603&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">When standing, women’s pelvic floor muscles don’t relax properly, so their bladder may not fully empty.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/female-pelvic-floor-labeled-157672304">Alila Medical Media/Shutterstock</a></span>
</figcaption>
</figure>
<p>The structure of the <a href="https://www.continence.org.au/about-continence/continence-health/pelvic-floor">pelvic floor</a> muscles are also different in females. For females, it is particularly important to allow these muscles to fully relax to allow the urine to flow freely.</p>
<p>If the bladder doesn’t <a href="https://www.continence.org.au/types-incontinence/urinary-incontinence/chronic-urinary-retention">empty fully</a>, it can lead to increased infections, bladder stones, and even impact kidney health in the long term.</p>
<p>Even with one leg up, the pelvic floor does not rest properly, so the bladder may not be able to fully empty. As such, sitting down is usually the best position to let these muscles relax.</p>
<p>Standing and “hovering” over the loo may keep these muscles slightly constricted, making it hard to fully empty the bladder. A contracted pelvic floor can also cause the urine to spray more than usual, which is why you might often find drops of urine on a toilet seat after someone before you has tried to hover over it.</p>
<h2>How about peeing in the shower?</h2>
<p>Peeing in the shower not only makes it harder for your muscles to relax, it can be unhygienic. It might also cause an association between water and urination, leading to issues where hearing water might make you need to rush to the bathroom.</p>
<p>So, for both males and females, peeing in the shower is a clear no-no.</p>
<hr>
<p><em>If you or someone you know has bladder or bowel issues, the Continence Foundation of Australia has <a href="https://www.continence.org.au">online resources</a> and a <a href="https://www.continence.org.au/get-support/who-can-help/national-continence-helpline">helpline</a> (1800 33 00 66).</em></p><img src="https://counter.theconversation.com/content/206869/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The recent survey confirmed what many people think – men prefer to stand when peeing. But is that the best way?Christian Moro, Associate Professor of Science & Medicine, Bond UniversityCharlotte Phelps, PhD Candidate, Health Science and Medicine, Bond UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1991662023-02-27T12:05:07Z2023-02-27T12:05:07ZSwimming pools v wild swimming – a germs expert on which is worse<figure><img src="https://images.theconversation.com/files/511428/original/file-20230221-18-axh3j6.jpg?ixlib=rb-1.1.0&rect=0%2C40%2C5464%2C3432&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.alamy.com/wild-or-open-water-women-swimmers-wearing-wetsuits-with-buoyancy-floats-enter-the-firth-of-forth-sea-north-berwick-east-lothian-scotland-uk-image416629506.html?imageid=FCA7E8A4-6ACE-4DCC-94AB-64CDB9B6F5C2&p=373051&pn=1&searchId=bf5dfdc822516e443cf4c25d554e4dd2&searchtype=0"> Sally Anderson/Alamy Stock Photo</a></span></figcaption></figure><p><a href="https://www.bbc.com/travel/article/20210603-why-wild-swimming-is-britains-new-craze">Wild swimming</a> has grown massively in popularity in recent times. Not only is swimming outdoors a pleasant way to enjoy the sunshine, fresh air and green leafy surroundings, it can also <a href="https://www.swimnow.co.uk/the-psychology-of-swimming/why-do-humans-like-to-swim/">help to</a> relieve stress and elevate our endorphins. This creates a sense of wellbeing as well as burning calories and exercising muscles. </p>
<p>But along with the joys of outdoor swimming come some dangers. Not only are wild swimmers more at risk from tides, currents and swells, there can also be nasty bugs and bacteria lurking in the water. And with <a href="https://www.gov.uk/government/news/sewage-in-water-a-growing-public-health-problem">untreated sewage</a> regularly flowing into seas, rivers and lakes across the country, it can be hard to find a safe spot for a paddle.</p>
<p>Of course, swimming in a pool comes with its <a href="https://www.cdc.gov/dotw/rwis/index.html">own set of risks</a>. Urinary tract infections, ear infections and tummy bugs are the most common illnesses caught here. <a href="https://www.iflscience.com/a-grim-amount-of-people-pee-in-the-pool-heres-why-you-shouldnt-63515#:%7E:text=In%20one%20survey%2C%20at%20least,as%20high%20as%2040%20percent.">Dirty pools</a> can also cause your eyes to sting and harbour all sorts of bacteria and germs – including urine, faeces and sweat. In many ways, swimming pools are like a <a href="https://theconversation.com/faeces-urine-and-sweat-just-how-gross-are-hot-tubs-a-microbiologist-explains-198367">big bath</a> filled with lots of strangers.</p>
<p>But while it’s clear that swimming in outdoor waters carries different risks from swimming in a pool, the question of where’s safest to swim may not seem immediately obvious. So where’s cleanest for a dip: swimming pools, or rivers, lakes, canals and the sea? Let’s look at the evidence.</p>
<h2>Toxic waters</h2>
<p>Unlike swimming pools where waters are carefully monitored, outdoor waters are constantly changing in composition. This means that chemicals can leach into wild waters from nearby farms or industrial areas, animals can defecate in water, and in certain areas human sewage may be legally or otherwise dumped into the water (if you can see pipes, do not get in). </p>
<p>There may not be signposts warning of local dangers, and the presence of toxic agents might not be obvious. When in doubt about the <a href="https://www.gov.uk/government/publications/swim-healthy-leaflet/swim-healthy#:%7E:text=designated%20bathing%20waters.-,Health%20risks,are%20more%20susceptible%20to%20infection">chemical safety of outdoor waters</a>, it’s better to not enter them. If the water <a href="https://outdoorswimmer.com/featured/wild-swimming-how-to-spot-a-clean-river/">doesn’t look or smell right</a>, trust your instinct.</p>
<p>There are also natural hazards to outdoor waters compared with pools, especially in the summer. <a href="https://consult.environment-agency.gov.uk/cumbria-and-lancashire/blue-green-algae-in-cumbria-and-lancashire/user_uploads/blue-green-algae-leaflet.pdf">Blue–green algae</a> is a type of bacteria naturally found in lake ecosystems. In warm summers, the algae tends to multiply and form a <a href="https://www.theguardian.com/uk-news/2022/aug/24/it-stinks-lake-windermere-plagued-by-blue-green-algae-as-toxic-as-cobra-venom">powdery green scum</a> (known as a bloom) on the surface of the lake. This blue-green algae bloom can release toxins which are harmful to humans and occasionally <a href="https://www.bluecross.org.uk/advice/dog/blue-green-algae-and-its-dangers-to-dogs">lethal to pets</a>.<br>
Swimming in or swallowing water containing toxin-releasing algal blooms can lead to skin rashes, eye irritation, severe gastrointestinal upset, fever, and muscle and joint pain.</p>
<h2>Bacteria and viruses</h2>
<p>Diarrhoea is the most common illness linked to open-water swimming, often due to sewage contamination. You become ill if you swallow <a href="https://www.cdc.gov/healthywater/swimming/swimmers/rwi/diarrheal-illness.html">contaminated water</a>, which can contain bacteria and viruses such as E.coli and Norovirus. </p>
<p>Rats living in sewers adjacent to freshwater rivers or canals can also carry in their urine the bacterial pathogen Leptospira, which causes <a href="https://www.nhs.uk/conditions/leptospirosis/">Leptospirosis</a> (Weil’s disease). The infection occurs if soil or water from a lake, river or canal that contains urine from infected animals is swallowed, gets in a swimmer’s eyes or a cut. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/faeces-urine-and-sweat-just-how-gross-are-hot-tubs-a-microbiologist-explains-198367">Faeces, urine and sweat – just how gross are hot tubs? A microbiologist explains</a>
</strong>
</em>
</p>
<hr>
<p>Leptospirosis can cause liver and kidney damage, and may be fatal if left untreated. If you develop flu or jaundice symptoms up to two weeks after swimming in a river or canal, it may be a good idea to ask your doctor for a Leptospirosis test.</p>
<p>As for the sea, <a href="https://evidence.nihr.ac.uk/alert/swimming-in-seawater-is-linked-with-an-increased-chance-of-some-illnesses/">a 2018 study</a> found that people swimming in seawater were more likely to experience infections of the ear, nose, throat and gastrointestinal system than those who stayed on the beach. So it’s a good idea to wash after swimming in any outdoor waters, and certainly before eating food.</p>
<h2>The verdict</h2>
<p>When you add it all up, even with the possibility of people peeing and pooping in the pool, a managed swimming pool will always be a safer environment for a swim. Especially when you consider things like jellyfish stings and the additional risks that come with <a href="https://rnli.org/safety/know-the-risks/cold-water-shock">swimming in cold water</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Man swimming in pool." src="https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Swimming pools are a safer bet.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fit-swimmer-training-swimming-pool-professional-516633376">Jacob Lund/Shutterstock</a></span>
</figcaption>
</figure>
<p>Compared with a pool, wild swimmers are more likely to become unwell from swimming in outdoor water as there will always be potentially <a href="https://evidence.nihr.ac.uk/alert/swimming-in-seawater-is-linked-with-an-increased-chance-of-some-illnesses/">disease-causing microbes present</a>. </p>
<p>Swimming pool water, with adequate chlorine disinfection levels and pH maintenance, is much less likely to contain infectious microorganisms and so represents a much safer environment for recreational swimming. Injuries and drowning are also much less likely in pools where trained <a href="https://www.lifeguardtv.com/why-you-should-swim-near-a-lifeguard/">lifeguards</a> and safety equipment are present.</p>
<p>Perhaps, then, an outdoor managed swimming pool offers the best of both worlds – a swim with the sun on your back in a sanitary environment.</p><img src="https://counter.theconversation.com/content/199166/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Primrose Freestone does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>As well as the joy that comes with swimming, there can also be some dirty risks.Primrose Freestone, Senior Lecturer in Clinical Microbiology, University of LeicesterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1918622022-10-21T01:56:23Z2022-10-21T01:56:23ZIs urine sterile? Do urine ‘therapies’ work? Experts debunk common pee myths<figure><img src="https://images.theconversation.com/files/490990/original/file-20221021-24-lcopfp.jpeg?ixlib=rb-1.1.0&rect=62%2C80%2C5928%2C3907&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Urine therapy (or urotherapy) is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032615/">longstanding practice</a> based on the concept that urine can be drunk, bathed in, or otherwise applied to bring good health or even heal the body of certain ailments. </p>
<p>Unusual as it may sound to most people, it’s an idea that persists even today. And like most things of this nature, it has taken on a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032615/">life of</a> <a href="https://7news.com.au/lifestyle/health-wellbeing/urine-therapy-meet-the-woman-who-claims-drinking-your-own-pee-is-a-recipe-for-good-health-c-385374">its own</a> <a href="https://www.sbs.com.au/topics/voices/health/article/2016/10/13/urine-therapy-new-health-fad">online</a>. But is there any evidence urine therapy works?</p>
<p>To cut to the chase, no. Urine is waste and should be left excreted from the body. </p>
<h2>Early origins</h2>
<p>Before modern medicine, various cultures had <a href="https://edition.cnn.com/2018/08/31/health/ancient-egypt-medical-knowledge/index.html">innovative</a> ways to manage health. The early Egyptians, Chinese, Indians, <a href="https://www.winchesterhospital.org/health-library/article?id=161688">Aztecs</a> and Romans reportedly used urine as a treatment for various ailments, such as to heal battle wounds or <a href="https://www.smithsonianmag.com/science-nature/from-gunpowder-to-teeth-whitener-the-science-behind-historic-uses-of-urine-442390/">whiten teeth</a>.</p>
<p>There was some logic to these practices. For example, without access to clean water, urine might be used to wash a wound. Or in the absence of a gas mask, a <a href="https://www.theguardian.com/commentisfree/2011/mar/10/unusual-uses-of-urine">urine-soaked rag</a> could be used to filter out nasties during a chlorine gas attack.</p>
<p>Historically, these uses were only justified in contexts where no medical alternative was available. Nonetheless, some continue to recommend using urine <a href="https://books.google.com.au/books/about/The_Water_of_Life.html?id=G-l7dOYcKwUC">for various ailments today</a>.</p>
<p>With our current health and treatment options, there is no reason to engage with any form of urine treatment. And there is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032615/">no scientific evidence</a> drinking urine or engaging in any other urine therapy has benefits. </p>
<p>In all modern contexts, there are more hygienic and effective solutions than urine therapy – regardless of what ailment or problem is being addressed.</p>
<p>If you’re seeking a therapeutic benefit from one of the compounds found in urine, it’s best to get this over a pharmacist’s counter and not from a cup in the loo!</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-do-i-need-to-pee-more-in-the-cold-184236">Why do I need to pee more in the cold?</a>
</strong>
</em>
</p>
<hr>
<h2>What is in urine?</h2>
<p>Urine is excreted from the kidneys as they filter blood, keeping what the body needs and removing the waste as urine, which is <a href="https://www.tandfonline.com/doi/full/10.1080/21688370.2022.2099214">stored in the bladder</a> until we pee. </p>
<p>Urine is 95% water. The remaining ingredients include urea (2%) and creatinine (0.1%) – a breakdown product from muscle and protein metabolism – alongside trace elements of <a href="https://www.nature.com/articles/s41598-019-56693-4">various salts and proteins</a>. </p>
<p><a href="https://www.acs.org/content/acs/en/molecule-of-the-week/archive/u/urea.html">Urea</a> is a safe organic compound, which occurs naturally when proteins are metabolised. Urea-based formulations can be found in skin and nail softening lotions, acting as an effective moisturiser and helping to improve the skin’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611129/">barrier function</a>.</p>
<p>However, although urea is present in urine, its concentration is simply too low to offer any therapeutic benefit.</p>
<p>Apart from urea and creatinine, more than <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0073076">3,000 different compounds</a> have been found in urine. This means, as we learn more about the <a href="https://pubmed.ncbi.nlm.nih.gov/35431993/">urinary system</a>, future screening for a wide variety of health issues, including cancers, might be obtained through a simple <a href="https://www.frontiersin.org/articles/10.3389/fphys.2020.00705/full">urine test</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/489310/original/file-20221012-18-u6tzkg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/489310/original/file-20221012-18-u6tzkg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=429&fit=crop&dpr=1 600w, https://images.theconversation.com/files/489310/original/file-20221012-18-u6tzkg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=429&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/489310/original/file-20221012-18-u6tzkg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=429&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/489310/original/file-20221012-18-u6tzkg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=539&fit=crop&dpr=1 754w, https://images.theconversation.com/files/489310/original/file-20221012-18-u6tzkg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=539&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/489310/original/file-20221012-18-u6tzkg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=539&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Urine tests can identify a variety of health issues.</span>
<span class="attribution"><span class="source">Christian Moro, Author provided</span></span>
</figcaption>
</figure>
<h2>Might urine therapies be harmful?</h2>
<p>In some cases public interest in urine therapies has been so strong, governments have had to ban proposed urine-based “<a href="http://news.bbc.co.uk/2/hi/africa/2847557.stm">health drinks</a>”.</p>
<p>The fact is excreted urine can be quite harmful. There are only a few ways the body can remove waste from its system, and this is done primarily through urine, faeces and sweat. </p>
<p>This means urine might contain environmental <a href="https://www.ncbi.nlm.nih.gov/books/NBK232061/">toxins</a> and other nasties your body has worked hard to remove. Some medications are also excreted in urine, so drinking it can accumulate <a href="https://web.archive.org/web/20140725232444/http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/pharmacologicalandbiologicaltreatment/urotherapy">toxic levels</a> of these drugs. In some cases urine can also have pathogenic bacteria that, if <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457377/">ingested</a>, can cause serious diarrhoea, nausea, vomiting, an upset stomach and infections.</p>
<p>And no, urinating on the site is <em>not</em> recommended for jellyfish stings. This has the potential to cause even more pain by aggravating the stingers and inducing them to release <a href="https://www.canberratimes.com.au/story/7061035/what-to-do-if-youre-stung-by-a-jellyfish/">more venom</a>.</p>
<p>Even drinking urine in a survival situation isn’t as helpful as it’s often touted to be. Although it may make <a href="https://www.winchesterhospital.org/health-library/article?id=161688">some sense</a> to return fluid to your system, at the same time reintroducing excreted salts will be unhelpful for hydration. </p>
<p>Also, as dehydration sets in you won’t be making much urine anyway, so drinking urine in a survival situation is unlikely to be a viable option.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/we-know-hand-dryers-can-circulate-germs-through-the-air-why-are-they-still-used-everywhere-157410">We know hand dryers can circulate germs through the air. Why are they still used everywhere?</a>
</strong>
</em>
</p>
<hr>
<h2>Is urine ‘sterile’?</h2>
<p>In most cases only very low levels of bacteria are excreted in urine. But the idea urine might be sterile is <a href="https://journals.asm.org/doi/10.1128/JCM.02876-13">simply a myth</a>. The word <a href="https://dictionary.cambridge.org/dictionary/english/sterile">sterile</a> means “completely clean and free from dirt and bacteria”.</p>
<p>Our body is full of resident bacterial colonies that maintain our health and assist with general daily functions. This means <a href="https://www.sciencenews.org/blog/gory-details/urine-not-sterile-and-neither-rest-you">most</a> of our body is not sterile, and the <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/nau.24839">bladder</a> is <a href="https://journals.asm.org/doi/10.1128/JCM.02876-13">no exception</a>.</p>
<p>A high level of bacteria is usually associated with <a href="https://www.nature.com/articles/s41598-019-40384-1">urinary tract</a> infections. Nonetheless, there’s an ever-growing <a href="https://www.sciencedirect.com/science/article/pii/S0302283815002067">body of research</a> identifying all kinds of healthy bacteria living in our bladder, which can be excreted in the urine of healthy people. </p>
<p>Peeing in the shower is also a no-no, as urine can cause infections if it comes in contact with cuts or wounds on your legs. This practice can even make disorders such as <a href="https://bmcurol.biomedcentral.com/articles/10.1186/s12894-020-00619-0">overactive bladder</a> or <a href="https://www.continence.org.au/news/all-about-urge-incontinence">incontinence</a> worse, by causing our brains to <a href="https://www.insider.com/peeing-in-the-shower-could-cause-bladder-leaks-doctor-says-2021-8">associate</a> running water with the “need to pee”. This particularly impacts females as their pelvic area anatomy just isn’t designed to pee standing up.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/490801/original/file-20221020-13-go51c4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/490801/original/file-20221020-13-go51c4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/490801/original/file-20221020-13-go51c4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/490801/original/file-20221020-13-go51c4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/490801/original/file-20221020-13-go51c4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/490801/original/file-20221020-13-go51c4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/490801/original/file-20221020-13-go51c4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Don’t wait until the shower if you need to pee.</span>
<span class="attribution"><span class="source">Christian Moro, Author provided</span></span>
</figcaption>
</figure>
<p>While standing, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106761/">muscles</a> may struggle to <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/nau.24839">contract and relax</a> properly, or even <a href="https://link.springer.com/article/10.1007/s00192-010-1204-3">slow the stream</a> of urine. This means the bladder may not be completely emptied and increases the chance of <a href="https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-retention/definition-facts">infections</a>.</p>
<p>The bottom line is there are no scientifically supported benefits for urine therapies. If you need a particular treatment, you should talk to your doctor rather than turning to a urine-based prospect. </p>
<p>If you <a href="https://missouripoisoncenter.org/is-this-a-poison/urine">accidentally drink urine</a>, call your local poisons information centre for advice.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/blVmyrBPves?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Can you have a small bladder?</span></figcaption>
</figure><img src="https://counter.theconversation.com/content/191862/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Urine therapies have been used across cultures for millennia (notably at times when modern medical alternatives weren’t available). Do they still have a place today?Christian Moro, Associate Professor of Science & Medicine, Bond UniversityCharlotte Phelps, PhD Candidate, Centre for Urology Research, Bond UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1883322022-08-23T12:24:02Z2022-08-23T12:24:02ZDolphins use signature whistles to represent other dolphins – similarly to how humans use names<figure><img src="https://images.theconversation.com/files/479186/original/file-20220815-11-q79gbl.jpg?ixlib=rb-1.1.0&rect=120%2C699%2C4365%2C2869&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Bottlenose dolphins are extremely social animals that communicate constantly.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/dolphins-underwater-royalty-free-image/89619678?adppopup=true">Micha Pawlitzki/Corbis Documentary via Getty Images</a></span></figcaption></figure><p>Bottlenose dolphins’ signature whistles just passed an important test in animal psychology. A new study by my colleagues and me has shown that these animals may use their whistles as namelike concepts.</p>
<p>By presenting urine and the sounds of signature whistles to dolphins, my colleagues <a href="https://scholar.google.com/citations?user=KhKIWqcAAAAJ&hl=en&oi=ao">Vincent Janik</a>, <a href="https://scholar.google.com/citations?user=LdOMUTYAAAAJ&hl=en&oi=ao">Sam Walmsey</a> and <a href="https://scholar.google.com/citations?user=Z9Z9u2EAAAAJ&hl=en&oi=ao">I</a> recently showed that these whistles <a href="https://doi.org/10.1126/sciadv.abm7684">act as representations of the individuals who own them</a>, similar to human names. For behavioral biologists like us, this is an incredibly exciting result. It is the first time this type of representational naming has been found in any other animal aside from humans.</p>
<h2>The meaning of a name</h2>
<p>When you hear your friend’s name, you probably picture their face. Likewise, when you smell a friend’s perfume, that can also elicit an image of the friend. This is because humans build mental pictures of each other using more than just one sense. All of the different information from your senses that is associated with a person converges to form a mental representation of that individual - a name with a face, a smell and many other sensory characteristics.</p>
<p>Within the <a href="https://doi.org/10.1080/09524622.1997.9753352">first few months of life</a>, dolphins invent their own specific identity calls – called <a href="https://doi.org/10.1038/207434a0">signature whistles</a>. Dolphins often announce their location to or greet other individuals in a pod by sending out their own signature whistles. But researchers have not known if, when a dolphin hears the signature whistle of a dolphin they are familiar with, they actively picture the calling individual. My colleagues and I were interested in determining if dolphin calls are representational in the same way human names invoke many thoughts of an individual.</p>
<p><audio preload="metadata" controls="controls" data-duration="1" data-image="" data-title="Dolphins use signature whistles to identify themselves." data-size="32290" data-source="Jason Bruck" data-source-url="" data-license="CC BY-ND" data-license-url="http://creativecommons.org/licenses/by-nd/4.0/">
<source src="https://cdn.theconversation.com/audio/2569/dolphin-1-signature-whistle.m4a" type="audio/mp4">
</audio>
<div class="audio-player-caption">
Dolphins use signature whistles to identify themselves.
<span class="attribution"><span class="source">Jason Bruck</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a><span class="download"><span>31.5 KB</span> <a target="_blank" href="https://cdn.theconversation.com/audio/2569/dolphin-1-signature-whistle.m4a">(download)</a></span></span>
</div></p>
<p><audio preload="metadata" controls="controls" data-duration="1" data-image="" data-title="No two signature whistles are the same." data-size="47219" data-source="Jason Bruck" data-source-url="" data-license="CC BY-ND" data-license-url="http://creativecommons.org/licenses/by-nd/4.0/">
<source src="https://cdn.theconversation.com/audio/2570/dolphin-2-signature-whistle.m4a" type="audio/mp4">
</audio>
<div class="audio-player-caption">
No two signature whistles are the same.
<span class="attribution"><span class="source">Jason Bruck</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a><span class="download"><span>46.1 KB</span> <a target="_blank" href="https://cdn.theconversation.com/audio/2570/dolphin-2-signature-whistle.m4a">(download)</a></span></span>
</div></p>
<p>Because <a href="https://www.elsevier.com/books/anatomy-of-dolphins/cozzi/978-0-12-407229-9">dolphins cannot smell</a>, they rely principally on signature whistles to identify each other in the ocean. Dolphins can also copy another dolphin’s whistles as a <a href="https://doi.org/10.1073/pnas.1304459110">way to address each other</a>.</p>
<p>My previous research showed that dolphins have great memory for <a href="https://doi.org/10.1098/rspb.2013.1726">each other’s whistles</a>, but scientists argued that a dolphin might hear a whistle, know it sounds familiar, but <a href="https://doi.org/10.1038/nature.2013.13519">not remember who</a> the whistle belongs to. My colleagues and I wanted to determine if dolphins could associate signature whistles with the specific owner of that whistle. This would address whether or not dolphins remember and hold representations of other dolphins in their minds.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/479189/original/file-20220815-19-iv7nt8.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A person standing next to a dolphin holding a vial of urine." src="https://images.theconversation.com/files/479189/original/file-20220815-19-iv7nt8.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/479189/original/file-20220815-19-iv7nt8.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/479189/original/file-20220815-19-iv7nt8.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/479189/original/file-20220815-19-iv7nt8.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/479189/original/file-20220815-19-iv7nt8.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=499&fit=crop&dpr=1 754w, https://images.theconversation.com/files/479189/original/file-20220815-19-iv7nt8.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=499&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/479189/original/file-20220815-19-iv7nt8.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=499&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The researchers found that dolphins can identify each other by swimming through and tasting urine, the liquid in the syringe in this photo.</span>
<span class="attribution"><span class="source">Dolphin Quest</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<h2>Urine as an identifier</h2>
<p>The first thing my colleagues and I needed to do was find another sense that dolphins use to identify each other. In the 1980s and 1990s, researchers studying spinner dolphins in Hawaii noticed that the dolphins were occasionally <a href="https://www.ucpress.edu/book/9780520082083/the-hawaiian-spinner-dolphin">swimming through each other’s urine</a> and feces with their mouths open. Using these observations as a springboard, my colleagues and I decided to test if dolphins were able to identify each other from urine.</p>
<p>We began by first collecting urine from dolphins under managed care and simply pouring small amounts of it into lagoons where the dolphins live. The dolphins immediately showed interest, and with little training, quickly began to follow the research team anytime we carried poles with cups filled with urine. When we poured urine into the water, the dolphins would open their mouths and swim through the urine plume.</p>
<p>Our team then got urine from dolphins at other facilities to see if the subjects could differentiate between familiar and unfamiliar urine. The dolphins spent more than twice the amount of time with their mouths open tasting familiar urine compared to unfamiliar urine, providing the first evidence that <a href="https://doi.org/10.1126/sciadv.abm7684">dolphins can identify other individuals by taste</a>. </p>
<p>With this, my colleagues and I had what we needed to test representation in signature whistles.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/479191/original/file-20220815-11-9s4ix2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A person with a long pole leading a dolphin towards a speaker" src="https://images.theconversation.com/files/479191/original/file-20220815-11-9s4ix2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/479191/original/file-20220815-11-9s4ix2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/479191/original/file-20220815-11-9s4ix2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/479191/original/file-20220815-11-9s4ix2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/479191/original/file-20220815-11-9s4ix2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/479191/original/file-20220815-11-9s4ix2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/479191/original/file-20220815-11-9s4ix2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">By pairing urine samples – in the cup at the end of the pole – with the sounds of signature whistles played from an underwater speaker, it was possible to test whether dolphins would recognize if the urine and a whistle were from the same individual.</span>
<span class="attribution"><span class="source">Dolphin Quest</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<h2>Pairing urine and whistles</h2>
<p><a href="https://doi.org/10.1016/j.pneurobio.2007.10.005">Previous studies in children</a> have successfully used multiple senses to show that pre-linguistic infants can form conceptual representations of people. My colleagues and I used this type of work as a theoretical basis for our second experiment.</p>
<p>In our experiment, the team first led a dolphin to a speaker before pouring a small amount of urine into the water. After the dolphin tasted the urine, we quickly played the sound of another dolphin’s signature whistle. Sometimes that whistle would be from the same individual as the pee sample. Other times the urine and whistle would not match. The goal was to test if the dolphins react differently if the urine and whistle were from the same dolphin compared with if the urine and whistle were from two different dolphins. If there was a consistent difference in how long the dolphins hovered close to the speaker in the matched or unmatched scenarios, it would indicate the dolphins <a href="https://doi.org/10.1073/pnas.1008169108">knew and recognized when a whistle and urine sample</a> were from the same individual – the same way a person might connect the name of a friend to that friend’s favorite perfume</p>
<p>We found that, on average, when the urine and whistle matched, dolphins spent about 30 seconds investigating the speaker. When there was a mismatch, they <a href="https://doi.org/10.1126/sciadv.abm7684">only stuck around for about 20 seconds</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/479190/original/file-20220815-485-6v7b4b.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A person collecting data while a dolphin swims behind him." src="https://images.theconversation.com/files/479190/original/file-20220815-485-6v7b4b.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/479190/original/file-20220815-485-6v7b4b.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/479190/original/file-20220815-485-6v7b4b.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/479190/original/file-20220815-485-6v7b4b.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/479190/original/file-20220815-485-6v7b4b.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/479190/original/file-20220815-485-6v7b4b.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/479190/original/file-20220815-485-6v7b4b.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">When dolphins were presented with matching urine and whistles, they hovered near the speaker longer than when the samples were not from the same individual.</span>
<span class="attribution"><span class="source">Dolphin Quest</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>The fact that the dolphins consistently reacted more strongly to matches than mismatches indicates that they understand which whistles correspond with which urine. This uses the same framework as other studies that use matching sensory information to <a href="https://doi.org/10.1073/pnas.1008169108">demonstrate that animals have mental representations of individuals</a>.</p>
<p>But what makes dolphins different is that they aren’t just matching physical qualities – face with a smell, for example. They are doing this with signature whistles they invent themselves. Just as you can hear a name and imagine a face with all the associated memories, dolphins can hear a signature whistle and match the urine cue. </p>
<h2>Dolphin language?</h2>
<p>This work demonstrates that dolphins have self-created signals that are representational, just as humans have invented names that are representational. Representation opens the possibility that dolphins could theoretically make third-dolphin references – where two dolphins that are communicating refer to a third dolphin that is not in the immediate vicinity. If dolphins can refer to dolphins that aren’t around them presently, this would be similar to the mental time travel a person does when speaking about a friend they haven’t seen in years.</p>
<p>Signature whistles represent the most language-like aspect of dolphin communication currently known. However, the scientific community knows little about <a href="https://doi.org/10.1006/anbe.1998.0881">dolphin non-signature calls</a> or the functions of their <a href="https://www.researchgate.net/publication/255649978_High-Frequency_Burst-Pulse_Sounds_in_AgonisticAggressive_Interactions_in_Bottlenose_Dolphins_Tursiops_truncatus">other acoustic signals</a>. With further research into how dolphins communicate with sound – as well as with chemicals – it may be possible to better understand the minds of these mammals.</p><img src="https://counter.theconversation.com/content/188332/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jason Bruck does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Using urine and signature whistles from other dolphins, a team of scientists has shown that dolphins use signature whistles like names and hold mental representations of other dolphins in their minds.Jason Bruck, Assistant Professor of Biology, Stephen F. Austin State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1842362022-06-02T01:52:03Z2022-06-02T01:52:03ZWhy do I need to pee more in the cold?<figure><img src="https://images.theconversation.com/files/466532/original/file-20220601-49081-pmkbqo.jpg?ixlib=rb-1.1.0&rect=0%2C4%2C1000%2C658&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/male-female-distress-having-go-restroom-1882909777">Shutterstock</a></span></figcaption></figure><p>You’re taking a stroll through the park on a cold winter’s morning, when it hits you – the need to find a bathroom, and quick! This didn’t used to happen in summer.</p>
<p>Is there something about winter that makes us need to pee more?</p>
<p>We study the bladder and lower urinary tract. Here are two main explanations for what’s going on.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-are-my-hands-and-feet-always-cold-and-when-should-i-be-worried-184154">Why are my hands and feet always cold? And when should I be worried?</a>
</strong>
</em>
</p>
<hr>
<h2>1. Our lifestyle changes</h2>
<p>In summer, we tend to be outside and more active. We sweat more (to lose heat) and it’s easy to become dehydrated if we don’t drink enough water.</p>
<p>This impacts the amount of free fluid our body is willing to <a href="https://www.nature.com/articles/ejcn2015233">excrete</a>, and our urine volume is often reduced because of this.</p>
<p>In winter, we’re often indoors, around water sources, so we are more likely to be hydrated, less active, and to sweat less. As such, we tend to have more free fluid to excrete via our urine.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/curious-kids-if-our-bodies-are-happy-at-37-why-do-we-feel-so-unhappy-when-its-too-hot-outside-159134">Curious Kids: if our bodies are happy at 37℃, why do we feel so unhappy when it's too hot outside?</a>
</strong>
</em>
</p>
<hr>
<h2>2. Our body wants to avoid losing too much heat</h2>
<p>If we become cold very quickly, the body protects our internal organs in a number of ways.</p>
<p>One is “<a href="https://pubmed.ncbi.nlm.nih.gov/4655205/">cold-induced diuresis</a>”, or an increase in urine excretion in response to the <a href="https://journals.physiology.org/doi/abs/10.1152/ajpregu.1993.264.3.R524">cold</a>.</p>
<p>Initially, blood is diverted away from the skin to avoid losing its heat to the outside air. This means more blood ends up flushing through your internal organs.</p>
<p>In particular, blood rushes to your kidneys in a greater volume and at a higher pressure. This increases the amount the kidneys need to <a href="https://journals.physiology.org/doi/full/10.1152/ajprenal.00430.2005">filter</a>. As a result, your rate of <a href="https://www.frontiersin.org/articles/10.3389/fphys.2022.841181/full">urine excretion</a> increases.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-is-it-so-cold-right-now-and-how-long-will-it-last-a-climate-scientist-explains-184155">Why is it so cold right now? And how long will it last? A climate scientist explains</a>
</strong>
</em>
</p>
<hr>
<h2>What should I do?</h2>
<p>Our diet, age, blood pressure, and personal situation can all impact how much we urinate.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/blVmyrBPves?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Could you have a small bladder? Or an overactive bladder?</span></figcaption>
</figure>
<p>Producing more urine can also be a sign of <a href="https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-201X.1998.0314f.x">hypothermia</a>. This is your body responding to the cold as a stressor, so act quickly. Find somewhere away from the cold, and slowly warm up your body. </p>
<p>If the increased urine is also accompanied by <a href="https://www.healthdirect.gov.au/hypothermia">other symptoms</a>, such as extensive shivering, breathing difficulties, or confusion, seek medical attention immediately.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-why-do-some-people-feel-the-cold-more-than-others-37805">Health Check: why do some people feel the cold more than others?</a>
</strong>
</em>
</p>
<hr>
<h2>Keep up the fluids in winter too</h2>
<p>If you’re out in the cold, you may not feel thirsty. Nonetheless, be sure to drink plenty of fluids during the day. Although it may be tempting to avoid drinking so you don’t need to keep rushing to the bathroom, this can lead to dehydration.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/466716/original/file-20220602-18-4l0pci.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Smiling woman wearing yellow puffer jacket holding water bottle" src="https://images.theconversation.com/files/466716/original/file-20220602-18-4l0pci.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/466716/original/file-20220602-18-4l0pci.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/466716/original/file-20220602-18-4l0pci.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/466716/original/file-20220602-18-4l0pci.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/466716/original/file-20220602-18-4l0pci.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/466716/original/file-20220602-18-4l0pci.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/466716/original/file-20220602-18-4l0pci.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Keep drinking fluids, even in winter.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-hispanic-girl-smiling-happy-drinking-2053295111">Shutterstock</a></span>
</figcaption>
</figure>
<p>If you’re often out in the cold in light gear, and you find this increases your urinary output, there can be impacts over the long term.</p>
<p>Frequent urination can be <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/osmotic-diuresis">detrimental</a> to your body’s natural salt balance (particularly sodium and <a href="https://www.mayoclinic.org/symptoms/low-potassium/basics/causes/sym-20050632">potassium</a>). So be sure to maintain a healthy diet.</p>
<p>It does seem like a bit of a balancing game. The key, however, is to avoid stressing your body this way when it’s cold. To do this, be sure to dress appropriately and keep warm.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/forget-heatwaves-our-cold-houses-are-much-more-likely-to-kill-us-83030">Forget heatwaves, our cold houses are much more likely to kill us</a>
</strong>
</em>
</p>
<hr>
<h2>What if you don’t notice a difference?</h2>
<p>Although the body has mechanisms to make you <a href="https://pubmed.ncbi.nlm.nih.gov/7330607/">urinate more</a> in the cold, not everyone notices peeing more in winter.</p>
<p>If you keep warm, there’s no reason to think your body would often be “shocked” into responding to cold temperatures.</p>
<p>In fact, when tracked in research studies, it has been common for researchers to record no difference in <a href="https://pubmed.ncbi.nlm.nih.gov/7330607/">urinary</a> <a href="https://pubmed.ncbi.nlm.nih.gov/1172/">output</a> between the <a href="https://pubmed.ncbi.nlm.nih.gov/29757578/">seasons</a>.</p>
<h2>What about the urine?</h2>
<p>It’s not just the volume of urine that might be different in winter. The composition can change too.</p>
<p>The body excretes a higher amount of <a href="https://pubmed.ncbi.nlm.nih.gov/29757578/">calcium</a> in the urine during <a href="https://pubmed.ncbi.nlm.nih.gov/7106963/">winter</a>.</p>
<p>This is more likely due to lifestyle during cold seasons rather than anything internal. We tend to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800047/">less active</a> in winter, gain <a href="https://pubmed.ncbi.nlm.nih.gov/31093925/">extra weight</a>, and eat more salty, preserved and processed foods.</p>
<p>This means there can be a higher risk of developing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237522/">kidney stones</a> during winter for people who are susceptible.</p>
<p>So as the weather cools down, be sure to maintain a healthy lifestyle, stay warm, and don’t forget to stay hydrated, even when it’s cold.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/curious-kids-why-is-urine-yellow-117747">Curious Kids: why is urine yellow?</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/184236/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>No, you’re not imagining it. You can pee more in winter. Mostly, there’s nothing to worry about. But it could be a sign of hypothermia.Christian Moro, Associate Professor of Science & Medicine, Bond UniversityCharlotte Phelps, PhD Student, Bond UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1676282021-09-20T05:51:48Z2021-09-20T05:51:48ZWhy you shouldn’t make a habit of doing a ‘just in case’ wee — and don’t tell your kids to either<figure><img src="https://images.theconversation.com/files/420190/original/file-20210909-25-123ez87.jpg?ixlib=rb-1.1.0&rect=0%2C8%2C6000%2C3979&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>We’ve all done done a quick “just in case” wee before heading out or because we’re passing the bathroom. If you’re a parent, you might have also told the kids to “do a wee now so we don’t have to find a toilet later.”</p>
<p>Doing a “just in case” wee isn’t a problem if it’s just occasional and if you have normal bladder function.</p>
<p>But doing it too often, making a lifetime habit of it, can kick off a vicious cycle. You can end up training your bladder to “think” it needs to go when it’s only slightly full. And the problem can worsen over time.</p>
<p>If you’re always ducking to the loo to wee at even the slightest tingling sensation, have a go at resisting that first urge — and consider seeing your GP or a pelvic floor physiotherapist about it.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/curious-kids-why-is-urine-yellow-117747">Curious Kids: why is urine yellow?</a>
</strong>
</em>
</p>
<hr>
<h2>Your bladder can probably hold more than you think</h2>
<p>Most bladders are actually capable of holding quite a lot of fluid. </p>
<p>For those with normal bladders (that is, you haven’t been diagnosed as having an overactive or irritable bladder), every day capacity is between 400–600 mls. It should take about two hours for the water you drink to make its way to the bladder. </p>
<p>So if you drink a 600ml bottle of water, it would be perfectly reasonable not to actually need to go to the toilet until a couple of hours later. In reality, however, I know of people who say they drink just a small amount and head off to the bathroom shortly after.</p>
<h2>What happens if you get into the ‘just in case’ habit?</h2>
<p>To pass urine easily, we need the bladder muscle to contract and the muscles around the urethra and pelvic floor to relax. </p>
<p>This nice, coordinated pattern does not occur nearly as well if there is no real urge to void. You’ll probably be able to squeeze some urine out, but it’s not how the muscles are supposed to work.</p>
<p>The bladder’s response is to spasm and contract more aggressively and inappropriately.</p>
<p>The bladder gets used to holding a certain amount and if you are always emptying at that amount, it gets harder to hold more. The bladder “thinks” it is at capacity, when it is not. You end up with a pattern of uncoordinated emptying.</p>
<p>The good news is most people with a normal bladder can train themselves out of this habit. It’s about learning to recognise the signs and differentiate between a small urge and a real <em>need</em>. </p>
<p>You don’t need to run off at the first urge — have a go at resisting it and see what happens.</p>
<p>Of course, nobody is saying you should hold on until you feel absolutely tortured. If ignoring the first urge is causing real distress, you should talk to your GP or a pelvic floor physiotherapist.</p>
<h2>Let your kids go to the toilet when they actually need to</h2>
<p>Everyone remembers the kids who wet their pants at school or those who were always in trouble “because they should have gone to the toilet at recess”.</p>
<p>In fact, it’s better just to let kids go to the toilet when they need to, instead of berating them about not having gone at recess or “before we left”. </p>
<p>You can cause more damage (physical and psychological) in the long run if you give kids a hard time about toileting, load it with emotion, or train them into the habit of always going “just in case”. Don’t always prompt them to go to the toilet.</p>
<p>(In some situations, such as with people with dementia, it can be appropriate to prompt people to go to the toilet. But this is done after a reasonable number of hours when there should be a good amount of urine in the bladder. And it is a compromise arrangement where we try to minimise incontinence episodes and patient distress.) </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A parent talks to her child." src="https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">It’s better just to let kids go to the toilet when they need to, instead of berating them about not having gone at recess or ‘before we left’.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>Not everyone has a ‘normal’ bladder</h2>
<p>The aim with toilet training is to learn to recognise the sensation of bladder filling and gradually develop the ability to resist bladder emptying until convenient and socially appropriate. </p>
<p>But for some people this is never completely or consistently achieved.</p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/21256571/">Many people</a> – perhaps <a href="https://pubmed.ncbi.nlm.nih.gov/17049716/">30% of adults</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/11412210/">large numbers of children</a> – do not have a normal bladder. Rather, they have an overactive or irritable bladder.</p>
<p>This can make people want to go all the time or cause sudden urgency. They may not always make it to the toilet quickly enough. It can be impossible to prevent bladder leakage. Some people cope by limiting fluids or forever going “just in case”. </p>
<p>As with all bladder problems, it’s more common for women than men and tends to become more troublesome as we age.</p>
<p>Overactive bladders are unlikely to spontaneously improve. A good place to start would be to talk with your GP, a continence nurse or a specialist physiotherapist. These bladders need to be retrained using techniques learned from a specialist physio. Medication can sometimes help. </p>
<p>For most of us, though, overly frequent visits to the loo, or going “just in case” is a habit worth quitting. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-how-do-i-tell-if-im-dehydrated-107437">Health Check: how do I tell if I'm dehydrated?</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/167628/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer King is the chair of the Education Committee of the International Urogynecology Association and state chair of the NSW Continence Foundation. The positions are unpaid.
</span></em></p>Doing a ‘just in case’ wee too often, making a lifetime habit of it, can kick off a vicious cycle. You can end up training your bladder to ‘think’ it needs to go when it’s only slightly full.Jennifer King, Honorary Clinical Lecturer, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1488772020-11-06T14:30:47Z2020-11-06T14:30:47ZWe found a way to turn urine into solid fertiliser – it could make farming more sustainable<figure><img src="https://images.theconversation.com/files/367925/original/file-20201106-23-1uqu5iu.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C3865%2C2575&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/gardener-blending-organic-fertiliser-humic-granules-1364887628">Zlikovec/Shutterstock</a></span></figcaption></figure><p>It’s likely that most of the food you’ll eat today was not farmed sustainably. </p>
<p>The global system of food production is the largest human influence on the planet’s <a href="https://science.sciencemag.org/content/347/6223/1259855.abstract">natural cycles</a> of nitrogen and phosphorus. How much crops can grow is limited by the amount of these two elements in the soil, so they’re applied as fertilisers. </p>
<p>But the majority of fertilisers are either made by converting nitrogen in the air to ammonia, which alone consumes <a href="http://www.iipinetwork.org/wp-content/Ietd/content/ammonia.html#key-data">2% of the world’s energy</a> and relies heavily on fossil fuels, or by mining finite resources, like <a href="https://www.sciencedirect.com/science/article/pii/S095937800800099X">phosphate rock</a>. </p>
<p><a href="https://doi.org/10.2166/9781780401072">A solution</a> to this problem could be much closer than people realise. Most of the nutrients we consume in food are passed in our urine, because our bodies already have enough. But instead of being recaptured, these nutrients are flushed, diluted, and sent to wastewater treatment plants where they’re scrubbed out, leaving effluents that can be safely released into the environment. </p>
<p>The most nutrient-rich part of wastewater is <a href="https://www.sciencedirect.com/science/article/pii/S0960852409002806">human urine</a>, which makes up less than 1% of the total volume but contains 80% of the nitrogen and 50% of the phosphorus. We discovered how to recycle this urine into valuable – and sustainable – farmland fertiliser.</p>
<figure class="align-center ">
<img alt="A pair of gloved hands hold a pot containing a urine sample." src="https://images.theconversation.com/files/367922/original/file-20201106-13-8ngh5x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/367922/original/file-20201106-13-8ngh5x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/367922/original/file-20201106-13-8ngh5x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/367922/original/file-20201106-13-8ngh5x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/367922/original/file-20201106-13-8ngh5x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/367922/original/file-20201106-13-8ngh5x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/367922/original/file-20201106-13-8ngh5x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Urine is surprisingly rich in the nutrients needed for growing food.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/preparation-urine-samples-laboratory-hospital-study-1257550750">Tati9/Shutterstock</a></span>
</figcaption>
</figure>
<h2>How to recycle urine</h2>
<p>You can capture urine with <a href="https://www.treehugger.com/urine-separating-toilets-are-not-quite-wonderful-we-keep-saying-they-are-4858530">special toilets</a> that separate it from faeces after you flush. But because urine is mostly water, farmers would have to spread 15,000kg of it just to fertilise a hectare of land. If there was a way to remove the water and extract just the nutrients, farmers would only need to apply 400kg of it for the same effect.</p>
<p>Evaporating the water from urine is surprisingly difficult, as urine is a complex chemical solution. Almost all of the valuable nitrogen in urine is in the form of urea, a chemical that is used as the world’s <a href="http://nmsp.cals.cornell.edu/publications/factsheets/factsheet80.pdf">most commonly applied</a> nitrogen fertiliser. </p>
<p>But a fast-acting enzyme called urease is invariably present inside wastewater pipes and <a href="https://www.sciencedirect.com/science/article/pii/S0043135418304457">converts urea to ammonia</a>. When exposed to air, the ammonia quickly evaporates, taking the nitrogen from the urine with it and giving off a very pungent odour – think the stale urine smell of public toilets. </p>
<p>Fortunately, we’ve discovered that <a href="https://iwaponline.com/wst/article-abstract/74/6/1436/19385">increasing the pH of urine</a> to make it alkaline ensures the urea doesn’t break down or end up smelling really bad. Using this technique, we’ve developed a process that can reduce the volume of urine and transform it into a solid fertiliser. We call this process <a href="https://www.sciencedirect.com/science/article/pii/B978044464309400009X">alkaline urine dehydration</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/366976/original/file-20201102-23-17rt15y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A petri dish full of a dry, soil-like powder." src="https://images.theconversation.com/files/366976/original/file-20201102-23-17rt15y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/366976/original/file-20201102-23-17rt15y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=326&fit=crop&dpr=1 600w, https://images.theconversation.com/files/366976/original/file-20201102-23-17rt15y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=326&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/366976/original/file-20201102-23-17rt15y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=326&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/366976/original/file-20201102-23-17rt15y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=410&fit=crop&dpr=1 754w, https://images.theconversation.com/files/366976/original/file-20201102-23-17rt15y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=410&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/366976/original/file-20201102-23-17rt15y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=410&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Some of the fertiliser produced by drying human urine.</span>
<span class="attribution"><span class="source">Prithvi Simha</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>The idea behind it is rather simple. Fresh urine is collected from urinals or <a href="https://www.sciencedirect.com/science/article/pii/S2352710219308460">specially designed toilets</a> and channelled into a dryer, where an alkalising agent, such as <a href="https://www.sciencedirect.com/science/article/pii/S0048969720328308">calcium or magnesium hydroxide</a>, raises its pH. Any water in the now alkaline urine is evaporated and only the nutrients are left behind. We can even <a href="https://www.frontiersin.org/articles/10.3389/fenvs.2020.570637/full">condense the evaporated water</a> and reuse it for flushing toilets or washing hands. </p>
<h2>A circular pee-conomy</h2>
<p>Doing this is quite easy: you just fill a urine dryer with an alkalising agent, connect it to your toilet, pee as usual and the urine is converted into dried fertiliser. A smart design could even make the dryer fit below the toilet so it doesn’t take up a lot of bathroom space. While electricity would be needed for evaporating the water, the dryer could be <a href="https://www.sciencedirect.com/science/article/pii/S0048969717302796">coupled with solar energy</a> to take its energy use off the grid.</p>
<p>We estimate that it would cost just US$5 (£4.20) to supply an average family of four with a year’s supply of alkalising agent. The output from the dryer is a solid fertiliser containing 10% nitrogen, 1% phosphorus and 4% potassium – a similar combination to <a href="https://doi.org/10.1016/j.scitotenv.2020.139313">blended mineral fertilisers</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/367238/original/file-20201103-15-qoz66f.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Left: a scientist spreads fertiliser on soil. Right: the same area with short, green crops growing." src="https://images.theconversation.com/files/367238/original/file-20201103-15-qoz66f.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/367238/original/file-20201103-15-qoz66f.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=226&fit=crop&dpr=1 600w, https://images.theconversation.com/files/367238/original/file-20201103-15-qoz66f.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=226&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/367238/original/file-20201103-15-qoz66f.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=226&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/367238/original/file-20201103-15-qoz66f.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=283&fit=crop&dpr=1 754w, https://images.theconversation.com/files/367238/original/file-20201103-15-qoz66f.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=283&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/367238/original/file-20201103-15-qoz66f.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=283&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Field trials on farmland outside Paris revealed that dried urine works as well as synthetic crop fertilisers.</span>
<span class="attribution"><span class="source">Tristan Martin</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p><a href="https://www.baus.org.uk/museum/164/a_brief_history_of_the_flush_toilet">The first flush toilet</a>, invented by Alexander Cummings in 1775, revolutionised sanitation. Drying urine could kickstart a second revolution in how we manage wastewater. If implemented worldwide, recycled urine could replace nearly a quarter of all the synthetic nitrogen fertiliser used in agriculture. </p>
<p>But that would require <a href="https://www.sciencedirect.com/science/article/pii/B978044464309400009X">a service chain</a> capable of supplying homes with alkalising agent, collecting the dried urine and processing it into fertiliser for farmers to use. A similar service chain already exists for the recycling of plastics, metals, paper and glass – dried urine could simply be another component. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/366972/original/file-20201102-19-nvrah4.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A world map highlighted to show where urine could replace more synthetic fertiliser use." src="https://images.theconversation.com/files/366972/original/file-20201102-19-nvrah4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/366972/original/file-20201102-19-nvrah4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=296&fit=crop&dpr=1 600w, https://images.theconversation.com/files/366972/original/file-20201102-19-nvrah4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=296&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/366972/original/file-20201102-19-nvrah4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=296&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/366972/original/file-20201102-19-nvrah4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=372&fit=crop&dpr=1 754w, https://images.theconversation.com/files/366972/original/file-20201102-19-nvrah4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=372&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/366972/original/file-20201102-19-nvrah4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=372&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Countries with large populations and low rates of fertiliser use are most suitable for replacing synthetic fertilisers with urine.</span>
<span class="attribution"><span class="source">Prithvi Simha/Datawrapper and FAOSTAT</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p><a href="https://www.sciencedirect.com/science/article/pii/S004896971730044X">Research</a> suggests that people are <a href="https://www.sciencedirect.com/science/article/pii/S0043135418305384">open to the idea</a> of recycling urine. A survey of nearly 3,800 people across 16 countries even revealed that people would buy and eat <a href="https://data.mendeley.com/datasets/kccc8m9pn9/1">food grown using human urine</a>. With technology like this, ordinary people would have a safe and convenient way to make modern life more sustainable every time they go to the bathroom.</p><img src="https://counter.theconversation.com/content/148877/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Prithvi Simha owns shares in Sanitation360, a company which aims to commercialise urine dehydration technology.</span></em></p><p class="fine-print"><em><span>Björn Vinnerås owns shares in Sanitation360 AB. He receives funding from the Swedish Research Council Vetenskapsrådet, Formas, VINNOVA (the Swedish Innovation agency), and the EU H2020 projects Run4Life and REWAISE. </span></em></p><p class="fine-print"><em><span> Jenna Senecal is CEO of Sanitation360, a company which aims to commercialise urine dehydration technology.</span></em></p>If rolled out worldwide, our method could replace a quarter of all the synthetic nitrogen fertiliser used in agriculture.Prithvi Simha, PhD Candidate in Environmental Engineering, Swedish University of Agricultural SciencesBjörn Vinnerås, Professor of Environmental Engineering, Swedish University of Agricultural SciencesJenna Senecal, Postdoctoral Researcher in Environmental Engineering, Swedish University of Agricultural SciencesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1177472019-08-06T20:07:46Z2019-08-06T20:07:46ZCurious Kids: why is urine yellow?<figure><img src="https://images.theconversation.com/files/286166/original/file-20190730-43153-osy3ym.jpg?ixlib=rb-1.1.0&rect=11%2C7%2C2486%2C1699&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">If you have been drinking more water than your body needs, the body tells the kidney filters to get rid of the spare water. That's when your urine will look paler.</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=293&fit=crop&dpr=1 600w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=293&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=293&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=368&fit=crop&dpr=1 754w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=368&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=368&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption"></span>
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<p><em>If you have a question you’d like an expert to answer, send it to curiouskids@theconversation.edu.au.</em> </p>
<hr>
<blockquote>
<p><strong>Why is urine yellow? – Ronan, aged 9, Greenslopes, Brisbane.</strong> </p>
</blockquote>
<hr>
<p>Thank you for your question, Ronan. </p>
<p>Our bodies use nutrients from the food we eat. But the processes involved in digestion also create what we call “byproducts”. That’s where a new chemical is created along the way. </p>
<p>Some of these byproducts in the body are waste and our bodies have clever waste processing systems to get rid of them. </p>
<p>Some of the waste goes out in your poo. And waste that can be dissolved in water goes out in your wee. We call this “water-soluble” waste. Water-soluble means it can be dissolved in water. </p>
<p>And the parts of your body in charge of “making” the wee are called the kidneys. They’re shaped like kidney beans.</p>
<h2>A delicate balance</h2>
<p>The kidneys work around the clock to make sure the body has the right balance of water, salt and chemicals and not too much water-soluble waste in it. </p>
<p>Kidneys have special filters in them that help sort out the useful bits from the waste. They also are in charge of transporting the water-soluble waste from your kidneys, down two special pipes called “ureters” and into your bladder (which is down near the genitals). </p>
<p>When the bladder gets full, it sends a message along your nerves to your brain that makes you feel like you need to wee. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/286168/original/file-20190730-43118-jirbhy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/286168/original/file-20190730-43118-jirbhy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/286168/original/file-20190730-43118-jirbhy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/286168/original/file-20190730-43118-jirbhy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/286168/original/file-20190730-43118-jirbhy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/286168/original/file-20190730-43118-jirbhy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/286168/original/file-20190730-43118-jirbhy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/286168/original/file-20190730-43118-jirbhy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Kidneys also are in charge of transporting the water-soluble waste from your kidneys, down two special pipes called ‘ureters’ and into your bladder.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/curious-kids-why-do-we-have-two-kidneys-when-we-can-live-with-only-one-113201">Curious Kids: why do we have two kidneys when we can live with only one?</a>
</strong>
</em>
</p>
<hr>
<h2>So…. why is it yellow?</h2>
<p>One of the water-soluble waste products that your kidneys put into your urine is a chemical called urobilin, and it is yellow. </p>
<p>The colour of your urine depends on how much urobilin is in it and how much water is in it. </p>
<p>If your urine is light yellow, it means you have been drinking a lot of water and there’s a lot of water in your urine. We call this being “hydrated”.</p>
<p>If your urine is dark yellow, that means there’s less water, and a relatively high amount of urobilin. It probably means you haven’t been drinking enough water and could be dehydrated.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/286167/original/file-20190730-43126-18hz1l7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/286167/original/file-20190730-43126-18hz1l7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/286167/original/file-20190730-43126-18hz1l7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=457&fit=crop&dpr=1 600w, https://images.theconversation.com/files/286167/original/file-20190730-43126-18hz1l7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=457&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/286167/original/file-20190730-43126-18hz1l7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=457&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/286167/original/file-20190730-43126-18hz1l7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=574&fit=crop&dpr=1 754w, https://images.theconversation.com/files/286167/original/file-20190730-43126-18hz1l7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=574&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/286167/original/file-20190730-43126-18hz1l7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=574&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">If your urine is light yellow, it means you have been drinking a lot of water.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>Too much water versus not enough</h2>
<p>When you haven’t been drinking enough water, the kidneys get a message from your brain to try to keep more water in your body (and out of your bladder). You will also start to feel thirsty. </p>
<p>If people can’t drink water (because they have a vomiting illness, for example), they might need water put directly into their blood. This usually happens in a hospital using a drip (which is where a bag of salt water is put into your blood via a needle in your arm).</p>
<p>If you have been drinking more water than your body needs, the body tells the kidney filters to get rid of the spare water. That’s when your urine will look paler.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/curious-kids-what-is-a-headache-is-it-our-brain-hurting-112951">Curious Kids: what is a headache? Is it our brain hurting?</a>
</strong>
</em>
</p>
<hr>
<p><em>Hello, curious kids! Have you got a question you’d like an expert to answer? Ask an adult to send your question to curiouskids@theconversation.edu.au</em></p><img src="https://counter.theconversation.com/content/117747/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dr Jaqui Hughes is a Torres Strait Islander woman, a specialist physician (kidney doctor) at Royal Darwin Hospital, and a kidney health researcher at Menzies School of Health Research in Darwin. She is employed by the Top End Health Service as a specialist nephrologist, and funded by the National Health and Medical Research Council to lead innovating kidney health research which advances health for Australians.</span></em></p>One of the waste products that your kidneys put into your urine is a chemical called urobilin, and it is yellow.Jaquelyne Hughes, Research Fellow, Menzies School of Health ResearchLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1202212019-07-18T23:48:43Z2019-07-18T23:48:43ZExplainer: what is leptospirosis and how can it harm us and our pets?<figure><img src="https://images.theconversation.com/files/284629/original/file-20190718-147284-9extc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">When a game of fetch can harm: leptospirosis can be transmitted to dogs (and humans) from stagnant water contaminated with rat urine.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/dog-fetching-stick-lake-1307577760?studio=1">from www.shutterstock.com</a></span></figcaption></figure><p><a href="https://www.theguardian.com/australia-news/2019/jul/10/rare-disease-spread-via-rat-urine-kills-seven-dogs-and-leaves-dozens-of-australians-ill">Recently reported cases</a> of the often fatal bacterial infection leptospirosis in dogs in Sydney have raised the issue of animal diseases that also affect humans.</p>
<p>This zoonotic disease is spread by rats and other rodents. However, this latest cluster in dogs has not been accompanied by human cases in the Sydney area so far; dog cases aren’t always accompanied by human cases nearby.</p>
<p>So what is leptospirosis? And what can we do to protect ourselves and our pets from this potentially fatal disease?</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-bugs-can-you-catch-from-your-pets-40954">Health Check: what bugs can you catch from your pets?</a>
</strong>
</em>
</p>
<hr>
<p>There have been at least six confirmed cases of canine leptospirosis so far in Sydney’s inner west and city in 2019, with three in May and June. Five of the six dogs died.</p>
<p>So far, these cases have been confined to one part of Sydney but we don’t know the source of the infection. Some people have speculated that recent building work may have dispersed rats and spread contaminated water through flooding.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1148184618249490432"}"></div></p>
<h2>How is it spread?</h2>
<p>Leptospirosis is caused by <em>Leptospira</em> bacteria that rodents and other animals can transmit to animals and humans. </p>
<p>Dogs can become infected by direct contact (for instance, from a rat bite or from eating rats) or via indirect contact (for instance, by drinking urine-contaminated water).</p>
<p>Clinical signs might not show up in dogs for about seven days. Early signs can be vague — fever, lethargy, anorexia (loss of appetite), vomiting and diarrhoea.</p>
<p>Dogs can also shed bacteria in their urine without being clinically sick (“silent shedders”). This and contact with sick dogs poses a potential risk to other dogs and people coming in contact with their urine.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/hidden-housemates-rats-in-the-ranks-59379">Hidden housemates: rats in the ranks</a>
</strong>
</em>
</p>
<hr>
<p>Severely affected dogs can develop acute kidney failure, liver injury and jaundice (yellow discoloration of the skin), uveitis (inflammation of the eyes), bleeding and in severe cases bleeding into the lungs leading to breathing difficulties. These clinical signs are the result of damage to the blood vessels (vasculitis) and resulting damage to organ blood supply.</p>
<p>Veterinarians can confirm the diagnosis after taking blood and urine samples. In suspicious cases, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3040842/">treatment</a> with antibiotics needs to start quickly, even before the disease is confirmed by lab tests, to minimise organ damage. Severely ill dogs will require intensive care, ideally in an intensive care unit.</p>
<h2>How do humans catch it?</h2>
<p>As well as being exposed to bacteria from their infected pets’ urine, humans can become infected by rodents themselves. This can be directly (from a rat bite) or if a wound is exposed to soil or water contaminated with rat urine. Eating contaminated food or drinking contaminated water can also be responsible for transmitting the bacteria.</p>
<p>Humans might not have symptoms for two to 25 days. But in 90% of human cases, these are <a href="https://www.ncbi.nlm.nih.gov/pubmed/25388133">mild and mimic influenza</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-when-are-we-most-likely-to-catch-viral-diseases-36555">Health Check: when are we most likely to catch viral diseases?</a>
</strong>
</em>
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<hr>
<p>Less commonly, more severe disease can develop, which can be similar to what we see in dogs, and is known as <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+topics/health+conditions+prevention+and+treatment/infectious+diseases/leptospirosis/leptospirosis+weils+disease+-+including+symptoms+treatment+and+prevention">Weil’s disease</a>.</p>
<p><a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/leptospirosis.aspx">According to NSW Health</a>, these more severe symptoms include kidney failure, jaundice (yellow colouration of the skin and eye balls which indicates liver disease), and haemorrhage into skin and mucous membranes. Meningitis (inflammation of the lining of the brain) and bleeding in the lungs can also occur. Most people who develop severe disease need to go to hospital, and severe leptospirosis can sometimes be fatal.</p>
<p>Leptospirosis is a notifiable disease in humans which means that laboratories have to notify cases of leptospirosis to the local public health unit. This year, <a href="http://www9.health.gov.au/cda/source/cda-index.cfm">51 cases have been reported so far</a> in Australia, but none of these have been linked to the current outbreak in dogs. </p>
<h2>How do we prevent it?</h2>
<p>We can prevent leptospirosis by limiting contact we and our pets have to sources of infection, and by vaccinating our dogs.</p>
<p>Make sure dogs don’t swim in and drink from stagnant water like ponds, lakes or puddles. </p>
<p>Wash your hands after contact with stagnant water, soil, urine from rodents, dogs or cats or simply after any contact with pets, especially before eating. </p>
<p>Similarly, avoid contact with rodents, and make sure you correctly dispose of garbage to reduce the chance of attracting rats.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/four-ways-having-a-pet-increases-your-lifespan-88640">Four ways having a pet increases your lifespan</a>
</strong>
</em>
</p>
<hr>
<p>Until now, leptospirosis has rarely been reported in Sydney. So, dogs are not routinely vaccinated. But we currently advise vaccination for all dogs in the inner west and city area.</p>
<p>The vaccine available in Australia protects against one serovar (type of the bacterium), and we do not know if this is the only type causing recent problems. Vaccines against multiple serovars are available overseas.</p>
<p>To learn more about the current cluster, we have started a research project. This will investigate the geographical distribution of the recent outbreak and the serovars of the bacteria involved. We are also collaborating with Sydney veterinarians who, with pet owners’ consent, are taking blood and urine samples from dogs before they get vaccinated against leptospirosis.</p>
<p>Hopefully then, we can better understand this latest cluster and how we can protect animal, and ultimately, human health in the future.</p><img src="https://counter.theconversation.com/content/120221/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Leptospirosis is spread by rats and other rodents, potentially killing dogs and humans. But we can protect ourselves and our pets.Christine Griebsch, Specialist and Senior Lecturer in Small Animal Medicine, University Veterinary Teaching Hospital Sydney, Sydney School of Veterinary Science, University of SydneyJacqueline Norris, Professor of Veterinary Microbiology and Infectious Diseases, Sydney School of Veterinary Science, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1074372019-01-09T19:11:26Z2019-01-09T19:11:26ZHealth Check: how do I tell if I’m dehydrated?<figure><img src="https://images.theconversation.com/files/251381/original/file-20181218-27755-1srl4gf.jpg?ixlib=rb-1.1.0&rect=1%2C4%2C997%2C661&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Our bodies are pretty good at telling us when we need to drink water.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/318707438?src=CgB_03VldITQhc4gtSJ0Mg-1-0&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>It’s a message that’s been drummed into us since childhood. Drink water, especially when it’s hot, otherwise you’ll get dehydrated.</p>
<p>But how do you know if you’re dehydrated? Who’s more at risk? And what can you do about it?</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/do-i-have-to-drink-eight-glasses-of-water-per-day-we-asked-five-experts-93025">Do I have to drink eight glasses of water per day? We asked five experts</a>
</strong>
</em>
</p>
<hr>
<h2>What’s dehydration and why does it matter?</h2>
<p>When people use the term dehydration, they usually refer to what doctors call “volume depletion” or hypovolaemia.</p>
<p>Volume depletion is a reduction in the volume of water in the blood vessels. But dehydration is <a href="https://www.sciencedirect.com/science/article/pii/S0272638611008134">quite different</a> and is less common. It’s the loss of water from both blood vessels and the body’s cells.</p>
<p>Doctors are concerned about volume depletion and dehydration because adequate hydration is required for the body to function normally. Water maintains our body temperature and lubricates our joints. Our body’s cells rely on water as does our circulatory, respiratory, gastrointestinal and neurological systems. </p>
<p>Severe cases of volume depletion can lead to shock and collapse. Without resuscitation with fluid, the consequences may be devastating. </p>
<h2>Water, water everywhere</h2>
<p>A 70kg person is made up of 40L (40kg) is water. Two-thirds of that water is in the cells (intracellular), one-third outside the cells (extracellular). </p>
<p>Outside the cells, 20% of body water is in plasma (around 3L), which together with red bloods cells (2L) gives a total 5L of blood. It’s the movement of water between compartments that maintains each one’s biochemical composition, allowing your cells and body to work normally.</p>
<p>The total body water volume (water in both the blood vessels and the body’s cells) is remarkably constant given the large variation in how much an individual might take in and lose each day.</p>
<p>Water intake is accounted for mostly by how much and what you drink and eat, and the daily variation is regulated by the kidney, which alters your urine output.</p>
<p>The main function of the kidney is to regulate the volume and composition of body fluids within narrow limits by altering output.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/kidneys-are-amazing-for-all-they-do-be-sure-to-look-after-yours-30966">Kidneys are amazing for all they do, be sure to look after yours</a>
</strong>
</em>
</p>
<hr>
<p>When you drink large volumes of fluid, your body can afford to get rid of increased amounts of dilute urine. But when you drink a minimal amount of fluid, your urine is concentrated and you pass only a small volume.</p>
<p>If you’re urinating less often than normal, or urinating small volumes of darker coloured urine, it may be time to drink more water.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-can-your-doctor-tell-from-your-urine-74990">Health Check: what can your doctor tell from your urine?</a>
</strong>
</em>
</p>
<hr>
<p>Other small losses of water include through stool, sweat and lungs.</p>
<p>So if you have diarrhoea or are exercising in the heat, for instance, you will need to drink more fluids. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/drink-plenty-of-fluids-to-cope-with-the-heat-but-there-is-no-need-to-avoid-caffeine-22077">Drink plenty of fluids to cope with the heat, but there is no need to avoid caffeine</a>
</strong>
</em>
</p>
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<p>As fluid is lost from the extracellular compartment such as in cases of diarrhoea and vomiting or bleeding, you can develop symptoms of volume depletion including:</p>
<ul>
<li>thirst, including a dry mouth</li>
<li>dizziness, particularly when standing due to the low blood pressure (a consequence of volume loss) </li>
<li>and when very severe, confusion (a consequence of inadequate oxygenation of the brain).</li>
</ul>
<p>Doctors might also note:</p>
<ul>
<li>that it takes longer for your skin to bounce back when pinched (known as reduced <a href="https://medlineplus.gov/ency/article/003281.htm">skin turgor</a>)</li>
<li>low blood pressure as a reduction in volume directly affects blood pressure</li>
<li>an increased heart rate, in an attempt by the body to maintain blood pressure</li>
<li>reduced weight as fluid makes up two-thirds of body weight. A loss of 1L of fluid will read as a drop in 1kg on the scales.</li>
</ul>
<p>Blood testing will often reveal a degree of kidney impairment. That’s because the kidneys require a large blood flow to work normally. </p>
<p>In cases of volume depletion and reduction in blood pressure, blood flow to the kidneys is compromised and they go into a state of “shock”. Mostly this is reversible when volume and blood pressure is restored. </p>
<p>As there’s no single test for volume depletion, doctors <a href="https://journals.lww.com/co-clinicalnutrition/Abstract/2016/11000/Diagnosing_dehydration__Blend_evidence_with.6.aspx">will make a diagnosis</a> after taking a note of your history, examining you and a combination of blood and urine tests.</p>
<h2>Here’s what happened to Tom</h2>
<p>I was on call at the hospital recently when, at 9.45pm on a Sunday, I received a call from the emergency department.</p>
<p>Tom, a 78 year old man, had come in by ambulance after neighbours had found him on his bedroom floor. Tom’s cognition was not great at the best of times, and that night he couldn’t tell us how long he had been on the floor.</p>
<p>There were no obvious injuries, his blood pressure was low (100/60mmHg), pulse rate high (98 beats per minute) and his temperature was normal. Blood tests showed he had low sodium salt levels and kidney impairment. </p>
<p>Tom had been in the emergency department for six hours by the time the call came to me; in that time he had not passed urine. It all pointed to volume depletion.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/251384/original/file-20181218-27761-1noco5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/251384/original/file-20181218-27761-1noco5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/251384/original/file-20181218-27761-1noco5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/251384/original/file-20181218-27761-1noco5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/251384/original/file-20181218-27761-1noco5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/251384/original/file-20181218-27761-1noco5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/251384/original/file-20181218-27761-1noco5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/251384/original/file-20181218-27761-1noco5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Elderly people are at increased risk, so keep an eye on relatives and neighbours this summer.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/3356108?src=epNbeK9CfuMh7N5r-SHO-w-1-32&size=medium_jpg">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>We treated Tom with intravenous fluid. He needed 5L over 48 hours, after which he was passing urine again. His blood pressure was back to normal 140/70mmHg, his kidney function had normalised and his weight was up from 46kg on admission to 50kg. </p>
<p>Tom told us he had fallen while getting up at night. He had been on the floor for most of the next day and had not eaten or drunk anything for hours.</p>
<h2>Who’s most at risk and why?</h2>
<p>Some groups are more susceptible to volume depletion, including:</p>
<ul>
<li>elderly people like Tom, as our total body water reduces with age and the elderly often have a reduced sensation of thirst. Many older people also have other health problems including <a href="https://theconversation.com/explainer-what-is-chronic-kidney-disease-and-why-are-one-in-three-at-risk-of-this-silent-killer-81942">chronic kidney disease</a>, which may impact the ability to concentrate urine when the volume is depleted</li>
<li>babies, because they aren’t able to articulate when they’re thirsty. They have a higher metabolic rate than adults meaning they require more fluid</li>
<li>people with impaired thirst mechanisms such as the elderly or people with certain brain injuries </li>
<li>people losing large volumes of fluid via the bowel (from diarrhoea or through a colostomy)</li>
<li>people taking medications that promote water loss, in particular diuretics, often referred to as water tablets.</li>
</ul>
<p>These vulnerable groups need to be aware of the increased risk of volume depletion, minimise their risk by maintaining fluid levels, recognise the symptoms of volume depletion early, and seek prompt treatment, including going to hospital if necessary.</p>
<p>If you experience the symptoms of volume depletion it’s important to take heed. At home, start with water if you’re thirsty. Once dizziness is present, significant volume loss has ensued and a trip to the doctor is in order. Confusion mandates emergency treatment.</p>
<h2>How about physiological dehydration?</h2>
<p>Physiological dehydration, which occurs when water is lost from both the blood vessels and from the body’s cells compartment, <a href="https://www.sciencedirect.com/science/article/pii/S0272638611008134">is distinct</a> from volume depletion. But there are many overlapping symptoms, such as thirst, a drop in blood pressure and when severe, confusion. </p>
<p>Dehydration can happen with prolonged and sustained high blood sugar levels as can occur in someone with diabetes. This is because the high sugar levels in the blood pull water out of the cells in an attempt to lower the levels. High sugar levels also make you pass more urine. So in this instance there is loss of fluid from both the intracellular and extracellular compartments.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-is-diabetes-11842">Explainer: what is diabetes?</a>
</strong>
</em>
</p>
<hr>
<p>So for those with diabetes, monitoring blood sugar levels is important. If the blood sugar is persistently high it’s important to seek medical advice to reduce the level safely and prevent dehydration. </p>
<h2>In a nutshell</h2>
<p>Water is vitally important to the normal function of the body. Volume depletion can occur during anytime of the year, but people are particularly prone over the summer months. The key is prevention and knowing what the signs and symptoms are. So in summer keep your fluids up; talk to your doctor about any medications that may need adjusting (such as diuretics) and keep an eye out for friends, family and neighbours.</p><img src="https://counter.theconversation.com/content/107437/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Karen Dwyer does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Most of us get thirsty when we need to drink more water. But there are other tell-tale signs that not all is well.Karen Dwyer, Deputy Head, School of Medicine, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1070492018-11-18T08:56:44Z2018-11-18T08:56:44ZThere’s a new way to “grow” bio-bricks using human urine. Here’s how it works.<figure><img src="https://images.theconversation.com/files/245771/original/file-20181115-194488-1a8futa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Thanks to a novel process, human urine can be turned into bio-bricks.</span> <span class="attribution"><span class="source">Robyn Walker</span></span></figcaption></figure><p><em>Recently, researchers from the University of Cape Town in South Africa have <a href="https://www.news.uct.ac.za/article/-2018-10-24-world-first-bio-bricks-from-urine">“grown” a bio-brick</a> using bacteria and urea found in human urine. The Conversation Africa’s Natasha Joseph asked Dyllon Randall to explain the research and story behind the bio-bricks.</em></p>
<p><strong>What prompted this project?</strong></p>
<p>Initially, curiosity. Some years ago I read about a US based company called <a href="https://biomason.com/">BioMASON</a> that uses the same process we do to produce bio-bricks, but with synthetic urea rather than urine. I was working in the sanitation field and wondered whether real urine could be used instead. Thanks to a one-year feasibility grant from South Africa’s Water Research Commission in 2017, we were able to test the concept – successfully. </p>
<p><strong>So you’re putting what we usually describe as “waste” to good use?</strong></p>
<p>Yes. <a href="https://scholar.google.co.za/citations?user=hx6LrScAAAAJ&hl=en">My research work</a> focuses on rethinking wastewater as a resource. Some of the things we discard – like urine – can actually be converted into useful resources, as this work has shown. This is important if we’re going to achieve a truly sustainable future because we are running out of natural resources at an unprecedented rate. </p>
<p>It’s also about questioning the status quo and trying to improve processes. </p>
<p>Finally, it’s about using language differently when we describe “waste”. Language is important because it creates subtle paradigm shifts. </p>
<p><strong>Where did you get the urine for this project from? How much does it take to form one bio-brick?</strong></p>
<p>We collected the urine from men working in the New Engineering Building at the University of Cape Town using novel <a href="https://www.sciencedirect.com/science/article/pii/S2213343718306043">fertiliser-producing urinals</a>. In future, we plan to collect urine from women, too. </p>
<p>We typically need between 20 and 30 litres of urine to make one bio-brick. This might sound like a lot, but remember that urine is more than 98% water: for the bio-brick making process we are only after carbonate ions and calcium ions which only accounts for about 1% (by mass) of the total urine. </p>
<p><strong>How does the process work?</strong></p>
<p>The bio-brick is made by a process called microbial induced calcium carbonate precipitation.</p>
<p>It’s partly <a href="https://www.sciencedirect.com/science/article/pii/S0043135416301348">a biological process</a>, and a key part of the process is making sure the urea doesn’t quickly degrade, which is what usually happens. To do this, we increase the pH of the urine by adding calcium hydroxide (lime). If we didn’t do this, most of the urea would degrade during collection or storage. </p>
<p>This initial process <a href="https://www.sciencedirect.com/science/article/pii/S2213343718306043">also produces</a> a solid fertiliser, calcium phosphate. This is removed from the liquid phase by filtration, and we’re left with a solution that’s rich in urea which can be used to make bio-bricks.</p>
<p>Certain bacteria produce an enzyme called urease which acts as a catalyst to breakdown urea into carbonate ions and ammonium ions.</p>
<p>With this in mind, <a href="https://www.sciencedirect.com/science/article/pii/S2213343718304251">we decrease</a> the pH of our solution slightly so the bacteria which degrade the urea can survive, and add food for the bacteria along with extra calcium to make the whole process more efficient. </p>
<p>After this the carbonate ions combine with the calcium ions from the urine to form calcium carbonate – that is, a solid is formed. This solid is the cement that glues any lose material together into a shape of your choice – in this case, a bio-brick. This is also a natural process and occurs in many environments from coral reefs to caves. We merely imitate this in our bio-brick mould.</p>
<p><strong>Do the bio-bricks smell of urine?</strong></p>
<p>They’ll initially have a strong smell. This is the smell of ammonia, a pungent gas that is produced as a by-product when the bacteria degrades the urea. </p>
<p>We can recover this ammonia using a separate process and convert it into a nitrogen rich fertiliser. </p>
<p>Importantly, the bio-bricks lose their ammonia smell after drying at room temperature for a day or two and are safe to use and handle thereafter. </p>
<p><strong>What about waste?</strong></p>
<p>This is an integrated three phase process. Phase one produces the first (solid) fertiliser; phase two produces the bio-brick and phase three, which we haven’t tested yet, has the potential to produce a second (liquid or solid) fertiliser. </p>
<p>The entire process would theoretically produce no “waste”. </p>
<p>There’s also room to optimise the process and reduce the amount of urine required to make the bio-bricks.</p>
<p><strong>Will this work at scale?</strong></p>
<p>I think so. BioMASON has shown that this natural process is commercially viable, albeit not with urine. Back in 2016 they were in the process of upgrading their facilities to grow <a href="https://www.inc.com/kevin-j-ryan/best-industries-2016-sustainable-building-materials.html">2500 bricks per day</a>. </p>
<p>We need to work on the integration of the urine collection to the large-scale bio-brick making process though. I’m confident we will be able to do this in the near future.</p><img src="https://counter.theconversation.com/content/107049/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dyllon Randall receives funding from South Africa's Water Research Commission (WRC K5/2734/3) for this work.</span></em></p>Some of the things we discard - like urine - can actually be useful resources.Dyllon Garth Randall, Senior Lecturer: Water Quality Engineering, University of Cape TownLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/946962018-05-04T10:47:32Z2018-05-04T10:47:32ZThat distinctive springtime smell: Asparagus pee<figure><img src="https://images.theconversation.com/files/217076/original/file-20180501-135837-1nmkwlg.jpg?ixlib=rb-1.1.0&rect=178%2C0%2C2693%2C1781&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">One of the signature fragrances of spring comes after the consumption of asparagus.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/s7stem/5169230033">Anton G</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p>Along with many other delights, springtime brings the beginning of the asparagus growing season. Regardless of whether you prefer the green, purple or white variety, asparagus provides a rich source of vitamins and minerals, and its consumption as part of a healthy diet may <a href="https://doi.org/10.3390/nu8030156">reduce risk of cancer</a> and <a href="https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamins/vitamin-b/">cardiovascular-related diseases</a>.</p>
<p>Despite the nutritional benefits of asparagus, many are opposed to eating the vegetable due to its pungent aftereffects. As <a href="https://www.penguinrandomhouse.com/books/86757/fart-proudly-by-benjamin-franklin/9781583940792/">Benjamin Franklin wrote in 1781</a>, “A few stems of asparagus eaten, shall give our urine a disagreable odour.” This odor has become so well known that post-consumption urine is now often referred to as “asparagus pee.”</p>
<p>Scientists believe the odor in question is <a href="https://doi.org/10.1126/science.1162354">due to two chemicals</a>: methanethiol and S-methyl thioester. When enzymes in the human digestive tract break down the asparagusic acid that’s naturally present in the vegetable, these volatile compounds are created. When voided from the body, they become foul-smelling gas, wafting up from your asparagus pee.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/217342/original/file-20180502-153891-1nq8o8k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/217342/original/file-20180502-153891-1nq8o8k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/217342/original/file-20180502-153891-1nq8o8k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=896&fit=crop&dpr=1 600w, https://images.theconversation.com/files/217342/original/file-20180502-153891-1nq8o8k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=896&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/217342/original/file-20180502-153891-1nq8o8k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=896&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/217342/original/file-20180502-153891-1nq8o8k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1126&fit=crop&dpr=1 754w, https://images.theconversation.com/files/217342/original/file-20180502-153891-1nq8o8k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1126&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/217342/original/file-20180502-153891-1nq8o8k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1126&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Ready for harvest.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fresh-green-asparagus-growing-on-garden-12506143">DUSAN ZIDAR/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>And <a href="https://doi.org/10.1093/chemse/bjq081">just because you don’t smell it</a> <a href="https://doi.org/10.1136/bmj.281.6256.1676">doesn’t mean you’re not making it</a>. Two studies have shown that people who are unable to smell the odor in their own urine also don’t detect it in the urine of known producers. Yes, volunteers sniffed samples of other people’s asparagus pee. Though most everyone probably produces the scent to some degree, it seems <a href="https://doi.org/10.1136/bmj.281.6256.1676">not everyone’s noses pick up on it</a>.</p>
<p>In fact, a study my colleagues and I conducted in 2017 <a href="https://doi.org/10.1136/bmj.i6071">found that only 40 percent</a> of those surveyed reported detecting the odor in their urine. A lower proportion of women were able to detect the odor, compared to men, despite <a href="https://doi.org/10.1016/0028-3932(89)90055-9">women being thought to have</a> a <a href="https://doi.org/10.1016/0028-3932(85)90067-3">more keen sense of smell</a>.</p>
<p>We asked almost 7,000 participants from two large cohort studies to respond to the prompt “After eating asparagus, you notice a strong characteristic odor in your urine.” By linking the questionnaire data with genetic data, we were able to show that the ability to smell or not to smell depends on a person’s genetic makeup. Hundreds of variants in the DNA sequence across multiple genes involved in sense of smell are strongly associated with the ability to detect asparagus metabolites in urine.</p>
<p>Asparagus isn’t the only food that has genetically linked controversial smell or taste effects. Some people avoid eating cilantro because they claim it has a “soapy” aftertaste. A study using data from almost 30,000 users of 23andMe found <a href="https://doi.org/10.1186/2044-7248-1-22">genetic variants in olfactory receptors</a> linked to people’s perception of this adverse taste.</p>
<p>Maybe you can conduct your own survey at the next family meal that includes a platter of asparagus – or soon after.</p><img src="https://counter.theconversation.com/content/94696/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sarah Coseo Markt receives funding from the National Institutes of Health. </span></em></p>Perhaps you’ve noticed something unusual in the bathroom after you consume this healthy spring vegetable. A Speed Read explains there’s two parts to the stinky puzzle: production and perception.Sarah Coseo Markt, Research Scientist in Epidemiology, T.H. Chan School of Public Health, Harvard UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/860802017-11-16T11:57:45Z2017-11-16T11:57:45ZWhy we need to talk about incontinence<figure><img src="https://images.theconversation.com/files/191215/original/file-20171020-13936-1jy9u2x.JPG?ixlib=rb-1.1.0&rect=30%2C1056%2C3971%2C1913&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Claire Scott/Cranfield University</span>, <span class="license">Author provided</span></span></figcaption></figure><p>We rarely hear or speak about incontinence. But the <a href="https://www.ncbi.nlm.nih.gov/pubmed/20025020">condition</a> – the involuntary loss of urine or faecal matter – is frighteningly common. </p>
<p>Incontinence does not know wealth divides. It brings profound personal and socio-economic consequences across the income spectrum and around the world. <a href="https://www.ncbi.nlm.nih.gov/pubmed/19410574">Best estimates</a> reveal that about 8% of adults experience faecal incontinence, increasing to 15% for those over 70 years. Urinary incontinence is even more prevalent, affecting approximately <a href="https://www.ncbi.nlm.nih.gov/pubmed/14499979">24% of men and 53% of women</a> (the condition is more prevalent in women due to strong causative links with childbirth). It is <a href="https://www.ncbi.nlm.nih.gov/pubmed/20617303">equally prevalent in lower income countries</a>. </p>
<p>Incontinence is a symptom which can have <a href="http://www.ics.org/public/factsheets">many underlying causes</a>. It can result from a weakened pelvic floor (often resulting from childbirth), obstetric fistula, cancer, bladder or bowel dysfunction, emotional distress and many other conditions. And it can be traumatising regardless of where you call home. Many cultures consider incontinence to be a taboo topic, not to be spoken about in polite conversation:</p>
<blockquote>
<p>For the majority of my 34 years I’ve kept my daily accidents a secret. Even as a four year old I remember hiding my dirty underwear from my parents.</p>
</blockquote>
<p>This experience, recounted by a person experiencing faecal incontinence in the UK (to our colleagues in the <a href="http://impress-network.com/">IMPRESS Network</a>) is typical, and reveals that the condition affects all ages. Equally, a recent study in <a href="http://impress-network.com/wp-content/uploads/2017/10/Claire-Scott-Thesis-Incontinence-in-Zambia-1.pdf">Zambia</a>, conducted by a Cranfield University researcher, revealed that incontinence is sometimes considered a “curse”, particularly when it is not linked to an obvious causative “trauma” or illness. This results in the condition being more stigmatised for women (as childbirth is perceived as “natural” and not traumatic or an illness).</p>
<p>A similar study in Pakistan, conducted by the London School of Tropical Hygiene and Medicine (but not yet published) asked those experiencing incontinence to take photographs of people and objects that represented their experience. A common theme was photographs portraying the isolation they feel. Often they are excluded from their community, particularly if they are unable to bathe often enough to manage odour.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=420&fit=crop&dpr=1 600w, https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=420&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=420&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=528&fit=crop&dpr=1 754w, https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=528&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=528&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Incontinence can lead to ostracism and loneliness.</span>
<span class="attribution"><span class="source">De Visu/Shutterstock.com</span></span>
</figcaption>
</figure>
<h2>What is normal?</h2>
<p>In both low and high resource contexts, there is confusion around what is “normal” when it comes to continence-related conditions, particularly those caused by <a href="https://theconversation.com/pelvic-floor-training-in-pregnancy-could-help-prevent-the-need-for-barbaric-vaginal-mesh-surgery-76440">childbirth</a> and ageing. </p>
<p>People are often unaware, for example, that appropriate medical intervention could treat or better manage the condition. This can be compounded by non-specialist healthcare professionals dismissing the condition. One British patient we have worked with reported visiting several doctors over a 30-year period before undergoing surgery that has dramatically reduced her urinary incontinence symptoms. She told us: “It has really improved my quality of life.”</p>
<p>But in locations where traditional healers are common, rural Zambia for example, those who experience incontinence (and recognise it as a health issue) may choose to visit such healers, who have not undergone medical training. If these healers are unable to address their concerns, people often simply “give up” on treating the condition at all, preferring to manage it privately and not visit a trained medical practitioner.</p>
<h2>Access is important</h2>
<p>In high income countries, primary treatment of incontinence includes pharmaceutical, surgical and lifestyle modifying interventions. Where the condition cannot be fully treated, management strategies are dominated by disposable products including catheters, colostomy bags and absorbent pads. This can have a severe impact on everyday life, bringing worries about where the nearest public toilet will be and making even short outings stressful, requiring extensive planning. This is exacerbated when those experiencing incontinence are also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3980491/">homeless</a>. </p>
<p>For those with internet access, Google Maps now allows users in some Indian cities to <a href="https://www.guidingtech.com/63154/google-maps-public-toilet-locator-india/">find their nearest public toilet</a>. Extending this facility worldwide would transform lives.</p>
<p>In low income contexts and in <a href="http://www.sphereproject.org/resources/sphere-essentials/">emergencies</a>, those with incontinence often cannot afford treatment or expensive management products (or appropriate infrastructure is not there to deliver it). The previously mentioned studies in <a href="http://impress-network.com/wp-content/uploads/2017/10/Claire-Scott-Thesis-Incontinence-in-Zambia-1.pdf">Zambia</a> and Pakistan both highlighted an affordability issue for those experiencing incontinence, but not necessarily of specialised incontinence aids such as catheters and colostomy bags. Rather, the primary issue was the unaffordability of the soap they required to wash themselves, their reusable pads and their surroundings. Disposable options are often not even a consideration due to their exorbitant cost.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=420&fit=crop&dpr=1 600w, https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=420&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=420&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=528&fit=crop&dpr=1 754w, https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=528&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=528&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Not being able to afford washing powder entrenches stigma around incontinence.</span>
<span class="attribution"><span class="source">Laboko/Shutterstock.com</span></span>
</figcaption>
</figure>
<h2>A complex issue</h2>
<p><a href="http://www.un.org/sustainabledevelopment/blog/2016/01/sanitation-becomes-separate-un-human-right-in-enhanced-fight-against-infection/">Sanitation is a human right</a>. How can we ensure that it is realised for everyone, including those experiencing incontinence? </p>
<p>Incontinence is treated and managed in a variety of ways around the world. But it is never as simple as installing a technology, selling a product or delivering an intervention. Even the most basic of management measures require supply chains, infrastructure and policies. Even where these are in place, affordability and a reluctance to seek medical help can result in many suffering quietly, often tagged with a stigma of being “smelly” or “cursed”.</p>
<p>So perhaps the heart of the challenge, and the solution to better tackling incontinence, lies in raising awareness and understanding. Through <a href="http://www.bladderandboweluk.co.uk/">education</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/26555779">public discussion</a>, <a href="http://www.telegraph.co.uk/health-fitness/body/kate-winslet-has-opened-the-floodgates-literally-how-to-cope-wit/">media coverage</a>, better <a href="http://www.bradforddistrictsccg.nhs.uk/news/lets-talk-about-incontinence/">recognition in healthcare</a> and even <a href="http://www.theguardian.com/healthcare-network/2017/aug/10/why-wrote-comedy-show-incontinence-edinburgh-fringe">comedy</a>, we can tackle stigma and reduce social barriers to appropriate healthcare. Furthermore, education can help transform the current burden of postpartum urinary incontinence through better awareness of preventative measures such as <a href="http://www.cochrane.org/CD007471/INCONT_pelvic-floor-muscle-training-for-prevention-and-treatment-of-urinary-and-faecal-incontinence-in-pregnant-women-and-women-who-have-recently-given-birth">pelvic floor training during pregnancy</a>.</p>
<p>We all urinate and defecate every day. <a href="https://data.unicef.org/topic/water-and-sanitation/sanitation/">Two thirds of us</a> have some basic sanitation system that we rely on to help us manage this, and don’t often think about what would happen if we didn’t have such access. But, undoubtedly, there have been instances where you, or someone you care for, has needed to “go” and hasn’t reached these facilities in time. Remembering the inconvenience, perhaps even embarrassment, of these experiences highlights why we need to be more open to discussing incontinence and developing management methods that allow everyone to live happy, productive and healthy lives.</p><img src="https://counter.theconversation.com/content/86080/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dani J Barrington is Editor-in-Chief of Engineers Without Borders, Australia's Journal of Humanitarian Engineering. This article grew out of conversations between Dani and Pete with Zara Ansari (Masters student, London School of Hygiene and Tropical Medicine), Claire Scott (Masters student, Cranfield University) and Sarah House (independent consultant) following a side event that they facilitated together at the WEDC 2017 Conference.
</span></em></p><p class="fine-print"><em><span>Pete Culmer receives funding from UK research councils – EPSRC and the UK National Institute of Health Research (NIHR). He is a member of the iMechE Biomedical Engineering Association.</span></em></p>Incontinence is frighteningly common.Dani Barrington, Lecturer in Water, Sanitation and Health, University of LeedsPete Culmer, Associate Professor in Surgical Technologies, University of LeedsLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/749902017-04-25T19:53:56Z2017-04-25T19:53:56ZHealth Check: what can your doctor tell from your urine?<figure><img src="https://images.theconversation.com/files/165472/original/image-20170417-25894-1s7cmo9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Doctors can tell a lot about your health from your urine sample, if you take it properly.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/561894202?src=PWq8M1UaGBg3mpXxI5Dv-Q-1-15&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>Doctors request a <a href="https://www.healthdirect.gov.au/urine-tests">urine test</a> to help diagnose and treat a range of conditions including <a href="http://kidney.org.au/health-professionals/detect/kidney-health-check">kidney disorders</a>, <a href="http://www.healthline.com/health/bilirubin-urine#overview1">liver problems</a>, <a href="http://www.diabetesqld.org.au/media/98723/diabetes_management.pdf">diabetes</a> and infections. Testing urine is also used to screen people for illicit <a href="https://www.nps.org.au/australian-prescriber/articles/urinary-drug-screening">drug use</a> and to test if a woman is <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-testing">pregnant</a>.</p>
<p>Urine can <a href="https://www.rcpa.edu.au/Library/Practising-Pathology/RCPA-Manual/Items/Pathology-Tests/U/Urinalysis">be tested</a> for particular proteins, sugars, hormones or other chemicals, certain bacteria and <a href="https://medlineplus.gov/ency/article/003583.htm">its acidity or alkalinity</a>.</p>
<p>Doctors can also tell a lot from how your urine <a href="https://theconversation.com/health-check-what-your-pee-and-poo-colour-says-about-your-health-59516">looks</a> and <a href="https://theconversation.com/from-the-sweet-taste-of-urine-to-mri-how-doctors-lost-their-senses-28905">smells</a>. For example dark urine could be a sign of dehydration; a cloudy appearance may suggest infection; if the urine is a reddish colour there may be blood in it; and a sweet smelling urine can be a sign of diabetes.</p>
<h2>Do I have an infection?</h2>
<p>The most common reason for analysing urine is to identify a bacterial infection in your urinary tract, your body’s drainage system for removing urine. Urinary tract infections are particularly common in women, affecting almost <a href="https://www.ncbi.nlm.nih.gov/pubmed/12601337">50%</a> in their lifetime.</p>
<p>Urine tests not only tell you if there’s an infection, they can identify the offending organism. That helps the doctor know how best to treat the infection, including prescribing the right type of antibiotic (one that particular microorganism is sensitive to).</p>
<p>At the GP, the first test uses a dipstick or strip test (sometimes called a rapid urine test). This involves dipping a specially treated plastic or paper strip into a urine sample collected in a sterile plastic pot. </p>
<p>The doctor compares the colour of the test strip with a chart of standard colours. If the strip test detects (is positive for) white blood cells (leucocytes), blood and/or chemicals called nitrites, infection is likely. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/165471/original/image-20170417-10077-1joicta.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/165471/original/image-20170417-10077-1joicta.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/165471/original/image-20170417-10077-1joicta.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/165471/original/image-20170417-10077-1joicta.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/165471/original/image-20170417-10077-1joicta.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/165471/original/image-20170417-10077-1joicta.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/165471/original/image-20170417-10077-1joicta.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/165471/original/image-20170417-10077-1joicta.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Your GP usually performs a quick dipstick test, where the colour of the test paper changes according to what the urine contains.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/438048715?src=PWq8M1UaGBg3mpXxI5Dv-Q-1-43&size=medium_jpg">from shutterstock.com</a></span>
</figcaption>
</figure>
<p>Then, the doctor sends off a sample of the urine to the laboratory for further testing. There, a laboratory technician can view it under a microscope to look for bacteria and cells. If the white cell count is above a baseline level, or if organisms are identified (and the patient has symptoms), an infection is very likely. </p>
<p>Further testing in the laboratory involves culturing the bacteria from the urine (by growing it in a special medium) and testing different antibiotics on it to see which one is most effective.</p>
<p>How your urine sample is handled in hospital may be different. Larger hospitals have a laboratory on site and patients will usually wait in the emergency department for the results of the laboratory microscopic evaluation. Doctors then start treatment with this extra information. </p>
<p>Patients sent home from the emergency department will still need to visit their GP for the final laboratory results, such as the antibiotic sensitivities. If you are admitted to hospital, treatment will start and may be modified once these results are known.</p>
<h2>Sterile samples are vital</h2>
<p>For any of these tests to be valid, the urine sample needs to be sterile (without contamination). To obtain a sterile sample in hospital, that might involve inserting a catheter (a tube that collects urine from the bladder) or a needle into the bladder (suprapubic aspiration). </p>
<p>But the most common method is by asking for a mid-stream urine sample (also known as clean-catch urine sample). This is when you urinate the first part of the urine stream into the toilet, collect the middle part of the stream in a sterile container, then empty the rest of the bladder into the toilet.</p>
<p>The idea is that the first discarded urine flushes out any bacteria or skin cells from the penis or vagina leaving the mid-stream sample as a truly representative sample to test.</p>
<h2>Instructions are often vague</h2>
<p>But many patients will recall being asked to provide a urine sample without adequate explanation of how to do it. They are simply handed a sample container and given directions to the toilet.</p>
<p>Without instruction patients may not know how to prepare their external genitalia. For women this involves parting the labia or lips of the vagina, while for men, this involves retracting the foreskin. </p>
<p>Nor are patients clearly advised how to provide the sample. As a result, they can contaminate the container and its lid by not washing their hands, and their sample often contains the first rather than mid-stream urine. </p>
<p>In these cases, what actually gets into the sample are contaminants; cells and bacteria from hands; or cells and bacteria from the lower part of the urinary tract and genitalia. </p>
<p>Unfortunately for women, their anatomy is more likely to result in more of this latter contamination. They void urine from the urethra (the tube from the bladder) and through a part of the vagina, while men most often void directly into the container.</p>
<h2>Why is a contaminant-free sample important?</h2>
<p>If the sample is contaminated there are various consequences. The laboratory will report contamination and advise the doctor to take care in interpreting results. However, a contaminated sample can result in incorrect diagnosis and incorrect or unnecessary treatment. </p>
<p>A new sample will probably be needed. This causes delays in diagnosis and treatment, potential anxiety to the patient and additional costs.</p>
<p>In our hospital, where the emergency department collects more than 1,000 mid-stream samples each month, women’s samples are contaminated over 40% of the time. In a <a href="http://jcp.bmj.com/content/69/10/921">recent trial</a> visual instructions in the form of cartoons were provided on how to collect the samples. </p>
<p>We paid particular attention to hand washing and collection technique. The number of contaminated samples was reduced <a href="http://jcp.bmj.com/content/69/10/921">by 15%</a>. This potentially could save upwards of 150 repeat tests a month and those instructions are now provided to all patients in the emergency department. </p>
<p>If you are unsure how to take a sterile sample, ask your doctor or nurse for more information. It can save you the time, inconvenience and worry of coming back for another sample.</p>
<hr>
<p><em>This article has been updated to clarify a woman’s anatomy.</em></p><img src="https://counter.theconversation.com/content/74990/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rob Eley received funding from Emergency Medicine Foundation for the study. </span></em></p><p class="fine-print"><em><span>Michael Sinnott receives funding from Queensland Emergency Medicine Research Foundation
Affiliations - I am co-founder of Qlicksmart Pty Ltd and Smartstream Pty Ltd</span></em></p>If you’re not sure why you need a urine test or the right way to collect a sample, here’s what you need to know.Rob Eley, Academic Research Manager, Princess Alexandra Hospital Southside Clinical Unit, The University of QueenslandMichael Sinnott, Adjunct Associate Professor, Faculty of Medicine, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/739362017-03-03T10:14:15Z2017-03-03T10:14:15ZWhy that ‘clean swimming pool’ smell is actually bad for your health<figure><img src="https://images.theconversation.com/files/159265/original/image-20170303-16352-lve2r2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The busier the pool, the worse it is.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/some-students-swim-racing-indoor-pool-96243236?src=rL0vSDm5a41Y094aKPZfvA-1-18">Shutterstock</a></span></figcaption></figure><p>It’s recently been reported that scientists have managed to create a <a href="https://www.theguardian.com/science/2017/mar/01/how-much-pee-is-in-our-swimming-pools-new-urine-test-reveals-the-truth">test to measure how much urine</a> is in a swimming pool. It seems that peeing in the pool has become commonplace, and even <a href="http://www.dailymail.co.uk/news/article-2254037/Michael-Phelps-Ryan-Lochte-right-say-theres-wrong-peeing-pool-say-scientists.html">high-profile swimmers have admitted</a> to doing it during rigorous training sessions, arguing that the chlorine “kills it”. Not only is this untrue, but the chemical reaction that occurs between your pee and the chlorine creates a chemical that has <a href="http://erj.ersjournals.com/content/19/5/827">been linked to asthma</a> and other respiratory issues.</p>
<p>Nitrogen trichloride, also known as <a href="https://www.acs.org/content/acs/en/molecule-of-the-week/archive/t/trichloramine.html?cid=home_motw">trichloramine</a>, is made when the urea in your pee reacts with chlorine – the disinfectant widely used in swimming pool water. Nitrogen trichloride is largely made by accident in pools these days, but this compound was originally made for interest in <a href="https://h2oblogged.wordpress.com/charts-calculators-indexes/swimming-pool-water-tests/nitrogen-trichloride-ncl3-airborne-test/nitrogen-trichloride/">1812 by Pierre Louis DuLong</a>.</p>
<p>DuLong made the chemical by bubbling chlorine gas through a solution of ammonium chloride. But, despite his success, DuLong’s joy at having made it was probably short-lived – he hadn’t counted on the fact that it would be explosive – the chemical exploded without warning and <a href="http://www.sciencedirect.com/science/article/pii/S0950423000000115">cost him an eye and a finger</a>. It’s extremely sensitive and will explode even under gentle shock or when exposed to sunlight.</p>
<p>Scientists Sir Humphry Davy and Michael Faraday also fell victim to the substance when they repeated DuLong’s work shortly after. An explosion also caused Davy to lose the use of an eye temporarily and Faraday did permanent damage to his fingers.</p>
<p>Luckily for professional swimmers, only pure nitrogen trichloride is explosive, and so the fact that it is mixed with water and other substances in a swimming pool should be reassuring. However, research suggests that nitrogen trichloride, among other products formed when you pee in chlorinated water, such as chloramine and dichloramine, is linked to eye and upper airway irritation. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/159263/original/image-20170303-16372-h7929s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/159263/original/image-20170303-16372-h7929s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/159263/original/image-20170303-16372-h7929s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/159263/original/image-20170303-16372-h7929s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/159263/original/image-20170303-16372-h7929s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/159263/original/image-20170303-16372-h7929s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/159263/original/image-20170303-16372-h7929s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Michael Phelps pees in the pool.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/rio-de-janeiro-brazil-august-8-469770791?src=HlZsTJarb4hxq4F0O0SzRA-1-2">Shutterstock</a></span>
</figcaption>
</figure>
<p>It’s rather ironic that the chlorine that is used to kill bacteria and protect the health of swimmers, is linked to the creation of toxic chemicals. But also that the <a href="http://www.waterandhealth.org/swimming-shower/">aroma that people associate with a clean pool</a>, is actually the stench of nitrogen trichloride and an indicator of plenty of pee.</p>
<h2>Occupational health hazard</h2>
<p>It is a volatile chemical, meaning it easily turns into a gas and hangs around in the air around the pool. One study has shown that people who work in swimming pools or spend a lot of time around them, such as lifeguards, have a <a href="https://www.ncbi.nlm.nih.gov/pubmed/17107995">higher level of airway issue symptoms</a> in comparison with the general population – poolside workers showed more frequent work-related upper respiratory issues than administrative staff.</p>
<p>It’s reported that one study found that a public swimming pool of <a href="https://www.theguardian.com/science/2017/mar/01/how-much-pee-is-in-our-swimming-pools-new-urine-test-reveals-the-truth">830,000 litres, can contain as much as 75 litres of urine</a> in the water at one time, which could react to form nitrogen trichloride. This may not sound like a lot, but the toxicity of chemicals is often in the dose and repeated exposure, so even low levels of nitrogen trichloride, will have damaging health effects. </p>
<p>But it <a href="https://www.acs.org/content/acs/en/pressroom/presspacs/2016/acs-presspac-august-3-2016/whats-really-in-your-swimming-pool.html">isn’t just pee that we should worry about</a> – the dirt on people’s bodies can consume up to 30% of the chlorine in the water on its own and in athletic swimmers, sweat – which also contains urea – can also contribute to the production of nitrogen trichloride. </p>
<p>So what can we do to combat it? Research which models the <a href="http://www.psep.ichemejournals.com/article/S0957-5820(14)00155-4/fulltext">amounts of nitrogen trichloride in a swimming pool</a> over time has led some researchers to suggest that lowering the levels of chlorine in a pool, while remaining above the legal lower limit, would reduce the amount of chlorine available to react to form the toxic chemical. However, this study was limited to a single pool, so more research is required to establish whether this could be a feasible solution.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/159264/original/image-20170303-16378-19nlb27.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/159264/original/image-20170303-16378-19nlb27.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/159264/original/image-20170303-16378-19nlb27.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/159264/original/image-20170303-16378-19nlb27.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/159264/original/image-20170303-16378-19nlb27.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/159264/original/image-20170303-16378-19nlb27.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/159264/original/image-20170303-16378-19nlb27.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Poolside workers are at risk.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/instructor-group-children-doing-exercises-near-405188230?src=h08PudiITt6GRQFMqUslkg-1-29">Shutterstock</a></span>
</figcaption>
</figure>
<h2>Don’t pee like a pro</h2>
<p>Swimming pools have long encouraged swimmers to take a <a href="http://www.waterandhealth.org/swimming-shower/">shower before they swim</a>, but the health implications of not showering are not emphasised enough. It’s not enough to recommend a shower to “reduce irritants” – swimmers need to know that these irritants can cause respiratory issues, and not just for them but also the pool staff. </p>
<p>Swimmers should also be encouraged to pee before they get into the pool, something that should extend to elite athletes too – <a href="http://uk.businessinsider.com/michael-phelps-everybody-pees-pool-2016-8?r=US&IR=T">Michael Phelps</a> might think it’s an accepted part of the sport, but it only gives licence to others if the professionals are doing it – they need to lead the way in pool hygiene. </p>
<p>Unfortunately, the “<a href="http://chemistry.about.com/od/waterchemistry/f/pool-urine-indicator.htm">swimming pool dye</a>” which changes colour on pee contact seems to be a mere myth in most countries and there do not appear to be any <a href="http://www.lims.hu/media/furdokonf/English/presentationsp/geradin_p.pdf">feasible alternatives to chlorine</a> which can disinfect a pool and not expose the staff to some harmful chemicals. So maybe it’s best to keep up the pretence if the prospect of embarrassment means people will actually go to the toilet.</p><img src="https://counter.theconversation.com/content/73936/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laura Finney is affiliated with The Conversation as an intern. </span></em></p><p class="fine-print"><em><span>Simon Cotton does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Nitrogen trichloride makes swimming pools smell and is a good indicator of plenty of pee.Simon Cotton, Senior Lecturer in Chemistry, University of BirminghamLaura Finney, PhD Candidate, University of NottinghamLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/595162016-07-25T04:07:09Z2016-07-25T04:07:09ZHealth Check: what your pee and poo colour says about your health<figure><img src="https://images.theconversation.com/files/131703/original/image-20160725-31162-khhpsr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Normal pee should be the colour of straw.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-232121512/stock-photo-white-toilet-bowl-in-a-bathroom.html?src=7Tc2rMTwXGHUu24B9g6akA-2-78">Devin_Pavel/Shutterstock</a></span></figcaption></figure><p>Out of the blue I passed bright red pee. I freaked, thinking it was a sign of terminal disease. Then I remembered the roasted beetroot tarts served at the party the night before – so delicious I’d eaten three! </p>
<p>Beetroot, artificial colours, vitamin supplements and medications can change the colour of your urine or bowel motions. Knowing which colour changes are due to food or medicines can save you worry, or provide an early alert to get to the doctor. </p>
<h2>Beeturia</h2>
<p>Beeturia is the term for passing red urine after eating beetroot. The red colour comes from a pigment called <a href="https://en.wikipedia.org/wiki/Betalain">betalain</a>, also in some flower petals, fruit, leaves, stems and roots. Concentrated beetroot extract, called Beet Red or additive number 162 on food labels, can be added to “pink” foods, such as ice-cream. </p>
<p>Whether betalain turns your pee red or not <a href="http://dmd.aspetjournals.org/content/29/4/539.full">depends on</a> the type of beetroot, amount eaten and how it’s prepared, because betalain is destroyed by heat, light and acid. </p>
<p>How much betalain enters your digestive tract depends on stomach acid and stomach emptying rate (people taking medications to reduce stomach acid may be prone to beeturia). Once in the blood stream, <a href="https://examine.com/supplements/betalains/">betalain pigments are filtered out by the kidneys</a>. Most is eliminated two to eight hours after eating. </p>
<p><a href="http://www.mayoclinic.org/diseases-conditions/urine-color/basics/symptoms/con-20032831">Persistent red urine can be due to</a> blood loss, infection, enlarged prostate, cancer, cysts, kidney stones or after a <a href="http://www.livestrong.com/article/383806-what-causes-blood-to-be-in-urine-after-exercising/">long-distance run</a>. If you see red and have not been eating beetroot, see your doctor.</p>
<h2>What should your pee look like?</h2>
<p>Normal pee should be the colour of straw. If your pee is so colourless that it looks like water, you probably drank more than you needed. </p>
<p>Very dark yellow pee usually means you are a bit dehydrated and need to drink more water. </p>
<p>Compare your pee colour to the <a href="https://health.clevelandclinic.org/2013/10/what-the-color-of-your-urine-says-about-you-infographic/">Cleveland Clinic’s</a> scale below.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1125&fit=crop&dpr=1 600w, https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1125&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1125&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1414&fit=crop&dpr=1 754w, https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1414&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1414&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">Courtesy Cleveland Clinic</span></span>
</figcaption>
</figure>
<h2>Strange pee colours due to food, drugs or disease</h2>
<p>Pee the colour of syrup or molasses <a href="https://www.nlm.nih.gov/medlineplus/ency/article/003139.htm">needs medical investigation</a>. While it could be due to extreme dehydration, it can be a sign of liver diseases such as hepatitis and cirrhosis, where a build up of <a href="https://en.wikipedia.org/wiki/Bilirubin">bilirubin</a> spills into your pee. Bilirubin is a breakdown product of red blood cells; it’s also responsible for poo’s normal brown colour. </p>
<p>Pee can turn <a href="https://www.nlm.nih.gov/medlineplus/ency/article/003139.htm">bright orange or yellow</a> when taking beta-carotene or vitamin B supplements, especially <a href="https://en.wikipedia.org/wiki/Riboflavin#Toxicity">large doses of riboflavin</a> (vitamin B2). These supplements are water soluble. What your body can’t use or store gets filtered out via your kidneys and into pee. </p>
<p>Medications including phenazopyridine (for urinary tract infections), rifampin (antibiotic for treating tuberculosis and Legionnaire’s disease), warfarin (blood thinner) and some laxatives can also change pee colour.</p>
<p>If you pass blue or green pee, it’s most likely due to food colouring or <a href="https://en.wikipedia.org/wiki/Methylene_blue">methylene blue</a> used in some diagnostic test procedures and some drugs. </p>
<p>But a range of medications can also trigger blue or green urine. These include <a href="http://onlinelibrary.wiley.com/enhanced/doi/10.1111/j.1445-5994.2005.00997.x">antihistamines, anti-inflammatories, antibacterials, antidepressants</a>, some nausea drugs or those for reducing stomach acid. </p>
<p>Rare genetic conditions <a href="https://en.wikipedia.org/wiki/Hartnup_disease">Hartnup disease</a> and <a href="https://en.wikipedia.org/wiki/Blue_diaper_syndrome">Blue diaper syndrome</a> cause blue-green urine. So see your doctor if it persists or it happens in an infant. </p>
<p>You should never see purple pee, but hospital staff might. “<a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894016/">Purple urine bag” syndrome</a> happens in patients with catheters and infections or complications. The catheter or bag turns purple due to a chemical reaction between protein breakdown products in urine and the plastic.</p>
<p>Occasionally, <a href="http://www.md-health.com/Foamy-Urine.html">pee can be frothy</a>. It’s a normal reaction if protein intake is high and pee comes out fast. It is more likely if you consume protein powders or protein supplements. Excess protein can’t be stored in the body so the nitrogen component (responsible for the froth) gets removed and the kidneys excrete it as urea. </p>
<p>See your doctor if the frothiness doesn’t go away or gets worse, as protein can leak into pee if you have kidney disease. </p>
<h2>Poo colours of the rainbow</h2>
<p>Normal <a href="http://www.mayoclinic.org/stool-color/expert-answers/faq-20058080">poo colour ranges</a> from light yellow to brown to black. The colour is due to a mix of <a href="https://en.wikipedia.org/wiki/Bile">bile</a>, which starts off green in the gall bladder, and <a href="https://en.wikipedia.org/wiki/Bilirubin">bilirubin</a> a yellow breakdown product from red blood cells. </p>
<p>Poo can <a href="http://www.mayoclinic.org/stool-color/expert-answers/faq-20058080">turn green</a> after consuming food and drink containing blue or green food colouring, or if food travels too fast through the gut and some bile is still present. </p>
<p>Poo that is yellow, greasy and smells really bad signals food malabsorption. If this colour is associated with weight loss in an adult or poor growth in a child, see a doctor to rule out gut infections such as <a href="http://www.mayoclinic.org/diseases-conditions/giardia-infection/basics/definition/con-20024686">giardia</a> or medical conditions like <a href="http://www.coeliac.org.au/coeliac-disease/">coeliac disease</a>. </p>
<p>Very <a href="http://www.mayoclinic.org/stool-color/expert-answers/faq-20058080">pale or clay-coloured poo</a> can happen when taking some anti-diarrhoeal medications, or when digestive problems affect the liver, gut, pancreas or gall bladder. </p>
<p>At the other extreme of the colour spectrum, black poo could be a serious medical issue due to <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bowel-motions">bleeding in the stomach</a> or upper gut. Or it could be a harmless side-effect from <a href="https://www.nlm.nih.gov/medlineplus/ency/article/007478.htm">taking iron supplements</a>, or eating lots of licorice. </p>
<p>Red poo can also be a serious medical issue due to bleeding in the lower gut, or from haemorrhoids, or harmless after having large amounts of red food colouring.</p>
<p>If you don’t know what colour your pee or poo is, take a look. If you see a colour that’s out of the ordinary and you haven’t eaten anything unusual, take a picture and make an appointment to show your GP.</p><img src="https://counter.theconversation.com/content/59516/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Collins is affiliated with the Priority Research Centre in Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research fellow. She created the online Healthy Eating Quiz and the Australian Eating Survey. She has received funding from a range of research grants including NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia. She has consulted to SHINE Australia and Novo Nordisk. Clare Collins is a spokesperson for the Dietitians Association of Australia on specific nutrition issues, including Australia's Healthy Weight Week. </span></em></p><p class="fine-print"><em><span>Kristine Pezdirc is affiliated with the Priority Research Centre in Physical Activity and Nutrition, the University of Newcastle, NSW. She has received funding from Hunter Medical Research Institute. She is a member of the Nutrition Society of Australia, </span></em></p><p class="fine-print"><em><span>Megan Rollo has received research funding from a number of bodies including the Hunter Medical Research Institute, the New South Wales Government (TechVoucher) and Novo Nordisk. She is affiliated with the Priority Research Centre in Physical Activity and Nutrition at the University of Newcastle and a member of professional organisations including the Dietitians Association of Australia. </span></em></p>Beetroot, artificial colours, vitamin supplements, medications and illnesses can change the colour of your urine or bowel motions.Clare Collins, Professor in Nutrition and Dietetics, University of NewcastleKristine Pezdirc, Research Associate | Post-doctoral Researcher, University of NewcastleMegan Rollo, Postdoctoral Research Fellow, Nutrition & Dietetics, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/507002015-11-19T11:18:51Z2015-11-19T11:18:51ZGender equality comes one toilet at a time<figure><img src="https://images.theconversation.com/files/102404/original/image-20151118-14191-kxt2hv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Newly built toilets at Harper transit site in Liberia.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/oxfam/5621438439/in/photolist-9yKkNp-2dstet-hgFCnM-cGmus5-7tKRr1-7wcRns-7w94wR-8SivKf-5s6iBM-kY2M6X-kY2Me2-kY3iwK-kY4aEb-kY2Lwv-kY4b1G-kY4aNC-kY49jW-kY49Yw-kY4bbG-kY2LiV-kY4aij-kY3j3K-kY3ieF-kY3jQr-kY3jkP-cAkpq1-pSh5nU-oVmrGw-e9EwNc-5G6dYH-bmCVYQ-cqNXLC-9eAkXo-hiZScc-21f82Q-dWadw7-hye3Ww-7kpFo3-7kkMur-dQxiUB-7S4jdR-e2Cd7w-dW4BHF-dW4BGc-dWaduy-dWadwS-dW4BHP-9Y2De9-hydRok-e2wBg8">Oxfam International/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>Across the world, <a href="http://www.unicef.org/publications/files/Progress_on_Sanitation_and_Drinking_Water_2015_Update_.pdf">2.4 billion people</a> do not have access to proper sanitation, including toilets and latrines, with nearly <a href="http://www.unicef.org/publications/files/Progress_on_Sanitation_and_Drinking_Water_2015_Update_.pdf">one billion people</a> left to defecate in the open. </p>
<p>It’s remarkable that today so many people still do not have access to a simple, private place to go to manage their bodily functions in dignity and comfort, putting them at increased risk of disease. And while everyone needs access to proper sanitation to be healthy, for girls and women this is also an issue of safety and equal participation in society. </p>
<p>In fact, one of the United Nations’ new <a href="https://sustainabledevelopment.un.org/?menu=1300">Sustainable Development Goals</a> focuses on ensuring availability and sustainable management of water and sanitation for all “paying special attention to the needs of women and girls.” </p>
<p>Yet research highlighting the effect poor sanitation has on women’s health, safety and equality is nascent, and some issues, including sanitation in workplaces, remain uninvestigated. Here is what we know so far.</p>
<h2>Sanitation and safety</h2>
<p>In countries across Africa, Asia and other low-income regions of the world (and even among the homeless or <a href="https://www.researchgate.net/profile/Joe_Brown7/publication/257781005_Limited_Access_to_Safe_Drinking_Water_and_Sanitation_in_Alabamas_Black_Belt_A_Cross-Sectional_Case_Study/links/54763ff00cf29afed6142001.pdf">rural poor</a> here in the United States), many people don’t have easy access to toilets or latrines.</p>
<p>Even for those who do have access to a toilet, there is no guarantee that it’s clean, private, easy to get to or even safe. A household’s latrine may be located a significant distance from the house, <a href="http://washinschoolsmapping.com/projects/mongolia.html">making access challenging</a> during the nighttime hours or in harsh weather such as monsoon rains or heavy snowfall. This makes girls and women more vulnerable to harm. </p>
<p>Seeking privacy, women might opt to go the toilet in the early morning hours or after dark. If women are forced to manage their needs in the open, such as by the roadside after dark or in a field at dawn, they are at <a href="http://www.susana.org/en/resources/library/details/2098">high risk</a> of <a href="http://eau.sagepub.com/content/27/1/105.full.pdf">violence</a>, including <a href="http://www.bbc.com/news/world-asia-india-22460871">rape</a>. </p>
<p>It’s no surprise, then, that recent evidence from India <a href="http://www.sciencedirect.com/science/article/pii/S0277953615300010">suggests</a> that the significant challenge of finding safe, clean and private places to urinate, defecate and manage their menstruation near the household greatly increases women’s levels of stress. This becomes an even greater challenge when someone has an upset stomach, is experiencing incontinence or is pregnant and needs to urinate more frequently.</p>
<p>Overall, the impact of poor sanitation on women’s and girls’ health remains underinvestigated. While there is recent research linking <a href="http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001851">poor sanitation to preterm birth in India</a>, women’s health hasn’t historically been the focus of sanitation-related research.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/102417/original/image-20151118-14183-13ft0cc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/102417/original/image-20151118-14183-13ft0cc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/102417/original/image-20151118-14183-13ft0cc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/102417/original/image-20151118-14183-13ft0cc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/102417/original/image-20151118-14183-13ft0cc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/102417/original/image-20151118-14183-13ft0cc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/102417/original/image-20151118-14183-13ft0cc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Girls need adequate sanitation facilities to manage menstruation.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/gtzecosan/5570897330/in/photolist-9u1Fzj-9tZ6qh-bW7gFE-b9HuSt-9uhiFY-7iiPYP-7Df4TU-6a77Mm-9tYEs9-9oDGD4-9tYAPt-8ADJcS-ba9P94-9QRzRG-7Df53E-9ugNrW-a9UA3v-9udMaR-cersU1-8PP7j6-cerhpb-9tVF4k-8vLWiR-9ugNxb-9tVF1K-baanB2-8AADMH-8JJNb3-7ALh5H-8ADHJQ-9u3g1C-7DbgVR-baardH-9RZ4M2-9QRxpN-8AADog-7o2eWd-7nXkiT-7nXkgk-7nXkhr-8wFioy-7inLyE-7nXkb2-7o2eGs-7nXk7K-7nXkrR-7nXk9B-7o2eV1-7o2eS5-8ADHyC/">SuSanA Secretariat/Peter Morgan</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<h2>Students around the world don’t have access to adequate sanitation</h2>
<p>Research about sanitation in schools is more established. UNICEF (United Nations Children’s Fund) estimates that <a href="http://www.unicef.org/wash/schools/washinschools_53108.html">almost 50% of primary schools</a> in the least- and less-developed countries do not have adequate sanitation (or water) on school grounds. </p>
<p>However, the true number of schools and children affected globally is unknown because many countries do not have robust systems for monitoring school water and sanitation facilities. Even if governments do know that schools lack facilities, constructing them may not be prioritized when budgets are tight. </p>
<p>Moreover, schools that do have facilities <a href="http://water.care2share.wikispaces.net/file/view/Sustaining+School+Hand+Washing+and+Water+Treatments+Programmes.pdf/501019752/Sustaining+School+Hand+Washing+and+Water+Treatments+Programmes.pdf">struggle to maintain</a> them due to recurrent costs for soap or the need to make repairs. </p>
<p>A growing body of evidence <a href="http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301374">indicates</a> that many girls and female teachers are uncomfortable in school environments during their monthly menstruation. If toilets do exist, they might not have locks or be separate from the boys’ toilets. They might not be clean, or have means for disposal of used sanitary materials. Water, if available on school grounds, may be located at some distance from the toilets, making it difficult to discreetly wash blood off hands or clothing. </p>
<p><a href="http://www.unicef.org/wash/schools/files/Bolivia_MHM_Booklet_DM_15_Nov_single_0940_Bolivia.pdf">Research has found</a> that girls may skip class, leave school early or be distracted while in the classroom due to fears of having a menstrual leak. Even if a student has affordable good cloth or sanitary pads for managing her menstruation, with the absence of adequate toilets in school, she has no place to privately and comfortably <a href="http://washdev.iwaponline.com/content/3/4/612">change these materials</a> during the school day.</p>
<h2>Participation in the workplace</h2>
<p>Given the growing role of women in informal and formal work environments, one can extrapolate the potential impacts of inadequate workplace sanitation on their productivity and overall health and well-being. But not much research has been done on how much the absence of proper sanitation can affect working women. </p>
<p>But we do know that inadequate sanitation comes at a price; the <a href="http://water.worldbank.org/news/inadequate-sanitation-costs-india-equivalent-64-percent-gdp">World Bank</a> calculates that poor sanitation costs India <a href="http://womensenews.org/story/reproductive-health/150415/world-bankers-please-study-menstruation-costs">US$53.8 billion per year</a> thanks to increased disease, as well as “losses in education, productivity, time and tourism.” </p>
<h2>Making World Toilet Day a thing of the past</h2>
<p>The first step to improving sanitation access is to overcoming taboos in countries struggling with the issue. For instance, in Nepal, taboos may restrict a girl’s participation in household life because menstruating girls and women are perceived as unclean or polluting. In response to these prohibitions, one Nepali girl wrote <a href="http://www.npr.org/sections/goatsandsoda/2015/10/17/449176709/horrible-things-happen-to-nepali-girls-when-they-menstruate-15girls">a novel</a> that describes a world where menstruation gives girls superpowers. </p>
<p>In India, Prime Minister Narendra Modi and other political leaders have called for the <a href="http://www.economist.com/news/asia/21607837-fixing-dreadful-sanitation-india-requires-not-just-building-lavatories-also-changing">construction of more toilets</a>, but local cultural beliefs and taboos around sanitation practices are hard to change. This may include beliefs encouraging defecation far away from home to avoid impurity, or relegating waste management to certain castes in society.</p>
<p>Solving this problem isn’t as simple as building more toilets and latrines. They must be culturally appropriate, environmentally sound, accessible at all times and attentive to <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)61497-0/fulltext">gender</a>. To achieve this, local <a href="https://www.humanitarianresponse.info/en/system/files/documents/files/Sustainable%20sanitation%20alliance.pdf">community members</a>, including girls and women, <a href="https://www.humanitarianresponse.info/en/system/files/documents/files/Sustainable%20sanitation%20alliance.pdf">must be consulted</a> on the location and design of toilets and latrines, to make sure that they will actually be used. </p>
<p>This highlights another reason that women should be involved in discussions about sanitation. According to the United Nations, women play a key role in <a href="http://www.unwater.org/downloads/EGM_report.pdf">promoting sanitation</a>. Very often women have the primary responsibility for health, hygiene and sanitation for their family. Lack of access to sanitation (and water) impacts not only a woman’s health, but that of her whole family.</p>
<p>As low- and middle-income countries rapidly urbanize, the <a href="https://www.ucl.ac.uk/sustainable-cities/smallgrants/small-grants-2014-15/gcsc-2014-15/belur">need for privacy and safety</a> for toileting become ever more urgent.</p>
<p>If we were to assure that all girls and women (and boys and men) had access to toilets that were safe, accessible and comfortable, we expect that the world would see improvements in health, in educational outcomes and productivity. Not to mention we would achieve every human’s basic human right to sanitation.</p><img src="https://counter.theconversation.com/content/50700/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>While everyone needs access to proper sanitation to stay healthy, for girls and women it is also an issue of safety and equal participation in society.Marni Sommer, Associate Professor of Sociomedical Sciences, Columbia UniversityBethany Caruso, Assistant Professor, Hubert Department of Global Health, Rollins School of Public Health, Emory UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/495682015-11-03T11:08:30Z2015-11-03T11:08:30ZEleven body fluids we couldn’t live without<figure><img src="https://images.theconversation.com/files/99266/original/image-20151022-15414-1nhuve6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Blood is just one of the body fluids we need to survive. </span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-193429070/stock-photo-blood-donor-at-donation-with-a-bouncy-ball-holding-in-hand.html?src=57IVDqZZgssJrc82KtPa8A-1-23">Blood bag via www.shutterstock.com.</a></span></figcaption></figure><p>How is a human being like a fish? </p>
<p>Just as a fish never stops to think about the water in which it spends its entire life, so do many human beings rarely pause to consider the body fluids that make our lives possible. </p>
<p>Though not always fit for polite conversation, even the less pleasant among them play a crucial role in maintaining health. By learning a bit more about 11 of these body fluids, we can develop a deeper appreciation for the beauty and complexity of our own biology. What exactly are these fluids, and what often unheralded contributions do they make?</p>
<h2>1. Bile</h2>
<p>Bile is a brown to dark green fluid that is produced by the liver, stored in the gallbladder (a synonym for bile is gall), and released into the intestines when we eat. It is partly responsible for the color of vomitus and stool. Its most important ingredient is bile salts, which function like soap to break down dietary fats, enabling them and fat-soluble vitamins such as A, D and E to be absorbed. They also help to prevent the cholesterol-containing bile in the gallbladder from forming gallstones.</p>
<p>Curiously, about 15 grams of bile salts are excreted into the intestine each day, yet the human body contains only about five grams in total. How is this possible? The answer is that bile salts are recycled, being reabsorbed into the blood through the small intestine and then secreted again by the liver. </p>
<p>Some intestinal diseases, such as Crohn’s disease, can damage the part of the small bowel where bile salts are reabsorbed, predisposing patients to gallstones.</p>
<h2>2. Blood</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/99263/original/image-20151022-15421-la6k9h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/99263/original/image-20151022-15421-la6k9h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/99263/original/image-20151022-15421-la6k9h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/99263/original/image-20151022-15421-la6k9h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/99263/original/image-20151022-15421-la6k9h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/99263/original/image-20151022-15421-la6k9h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/99263/original/image-20151022-15421-la6k9h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/99263/original/image-20151022-15421-la6k9h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Give a little.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-193429070/stock-photo-blood-donor-at-donation-with-a-bouncy-ball-holding-in-hand.html?src=57IVDqZZgssJrc82KtPa8A-1-23">Blood donation via www.shutterstock.com.</a></span>
</figcaption>
</figure>
<p>Perhaps the most important body fluid of all is blood. The average adult contains about six liters of blood, which functions to transport oxygen to cells, carry metabolic waste products such as carbon dioxide away from cells and transport infection-fighting white blood cells, glucose, hormones and other essential substances throughout the body. Blood also contains cell fragments called platelets and clotting factors that help to seal leaks that may develop in blood vessels.</p>
<p>An adult’s body contains about 25 trillion red blood cells – about one-third of all the body’s cells. Red blood cells survive on average about 120 days, which means that every second of every day, an adult human produces about two million red blood cells. If lined up end to end, the tiny blood vessels in which gas is actually exchanged, the capillaries, would reach a length of about 60,000 miles, long enough to encircle the earth more than twice.</p>
<h2>3. Menstrual fluid</h2>
<p>The average woman menstruates every 28 days over 42 years of her life, for a total of about 520 menstrual periods. The average volume of menstrual fluid is approximately 40 milliliters, or about 2.5 tablespoons in total. The fluid itself is about one-half blood, and also contains tissue from the inner lining of the uterus, mucus and secretions from the vagina. If the amount of bleeding is abnormally high, it can result in anemia, a deficit of red blood cells.</p>
<p>Along with blood and semen, menstrual fluid is one of the body fluids with the strongest psychological and cultural overtones. Traditionally, the onset of menstruation is associated with the transition from childhood to adulthood, and the onset of each menstrual cycle has long provided the best evidence that a woman is not pregnant. Some societies and faith traditions have sequestered menstruating women, although menstrual fluid is no more biologically hazardous than blood.</p>
<h2>4. Mucus</h2>
<p>Mucus sounds unpleasant, but none of us would be here without it. A slippery, clear liquid produced by mucous glands, it lines the cells of the bronchi in the lungs, the stomach and intestines, the urinary and reproductive tracts, and the eyes and ears. Mucus contains a variety of important substances, including antiseptic enzymes, antibodies and mucins that give mucus its gel-like properties. The average adult produces about one liter of mucus per day.</p>
<p>Mucus keeps the lining of the respiratory system from drying out and also filters out dust and infectious agents in the air we breathe. Microscopic hair-like projections from the cells lining the lung’s air passages help to propel the mucus back up toward the mouth at a speed of about one millimeter per minute, where it can be swallowed or expectorated. </p>
<p>Patients with cystic fibrosis have a genetic mutation that makes their mucus too thick, undermining this important defense against infection.</p>
<h2>5. Pus</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/99253/original/image-20151021-15426-22wldr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/99253/original/image-20151021-15426-22wldr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/99253/original/image-20151021-15426-22wldr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=787&fit=crop&dpr=1 600w, https://images.theconversation.com/files/99253/original/image-20151021-15426-22wldr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=787&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/99253/original/image-20151021-15426-22wldr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=787&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/99253/original/image-20151021-15426-22wldr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=989&fit=crop&dpr=1 754w, https://images.theconversation.com/files/99253/original/image-20151021-15426-22wldr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=989&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/99253/original/image-20151021-15426-22wldr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=989&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Any pus? Watercolour by J. Cats, 1787, after B. Maton.</span>
<span class="attribution"><span class="source">Wellcome Library, London</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Pus sounds even more disagreeable but serves as a sign that the immune system is working. A white, yellow or brown viscous fluid that accumulates at sites of infection, pus usually consists of bacteria, white blood cells, and other proteins and cell debris. Pus under the skin is often found in a pimple, but deeper in the body a larger collection is known as an abscess. Pimples and abscesses represent the body’s attempt to contain the spread of an infection.</p>
<p>For many centuries, one of the dictums of the barber-surgeon was, “Where there is pus, evacuate it,” thereby purging the infection from the body. Until several decades ago, drainage required a surgical procedure. Today, however, many abscesses are drained using just a needle and catheter, with ultrasound or CT imaging for guidance. This less invasive approach reduces the need for anesthesia, recovery time and cost.</p>
<h2>6. Semen</h2>
<p>Semen, the fluid released by males at ejaculation, generally contains spermatozoa, the gametes that fertilize the female egg, though this is not the case for males who have undergone the most common sterilization procedure, vasectomy. </p>
<p>In addition to providing a medium through which sperm can “swim,” semen also contains fructose, a sugar that nourishes the sperm, as well as alkaline secretions that help to neutralize the normally acidic environment of the vagina.</p>
<p>Females are born with all the eggs they will ever have, but males continuously produce gametes from puberty onward, and the average healthy male’s ejaculate of about five milliliters contains approximately 300 million spermatozoa. </p>
<p>Why such large quantities are produced when only one sperm can fertilize an egg is a bit of a puzzle, but one explanation may be that the competition between sperm helps to select for the fittest.</p>
<h2>7. Saliva</h2>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/99269/original/image-20151022-15426-1r7lqcw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/99269/original/image-20151022-15426-1r7lqcw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=750&fit=crop&dpr=1 600w, https://images.theconversation.com/files/99269/original/image-20151022-15426-1r7lqcw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=750&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/99269/original/image-20151022-15426-1r7lqcw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=750&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/99269/original/image-20151022-15426-1r7lqcw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=943&fit=crop&dpr=1 754w, https://images.theconversation.com/files/99269/original/image-20151022-15426-1r7lqcw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=943&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/99269/original/image-20151022-15426-1r7lqcw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=943&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Drool, baby, drool.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-3227780/stock-photo-cute-baby-drooling.html?src=G0E1zC4Cs22yU0iEkGYcTw-1-0">Baby via www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>Saliva is secreted by salivary glands in and around the mouth. The average adult produces about a liter of saliva per day, with peak secretion at meals. Like mucus, saliva contains antibacterial enzymes and antibodies, as well as mucus itself. Saliva helps to moisten food, which is important to lubricate chewing and swallowing. It also enhances taste, because if the chemicals in food were not in a liquid medium, they could not be detected by taste receptors. </p>
<p>Some of the enzymes in saliva also begin to break down substances in food, such as starches, which are broken down by amylase. Because such enzymes are generally neutralized within seconds after reaching the highly acidic secretions in the stomach, they probably function mainly to break down food particles trapped between teeth, helping to prevent cavities. </p>
<p>Patients who lack sufficient saliva have much higher rates of tooth decay and gum disease.</p>
<h2>8. Sweat</h2>
<p>Sweat, like saliva, consists almost entirely of water, though it also contains minerals that account for its salty taste. Sweat production can vary widely between one-tenth of a liter and eight liters per day, and during intense exercise, an adult may produce two liters per hour or more. The body’s three million sweat glands come in two types. Eccrine glands are found all over the body, with the highest density in palms and souls. Apocrine glands are located most prominently in the armpits.</p>
<p>Sweat’s most important role is thermoregulation, helping to cool the body when it begins to overheat. By comparison, dogs, which lack sweat glands, must pant to dissipate heat through evaporation. The brain stimulates sweating through nerves, and the rate is increased in response not just to heat but also emotional states. In contrast to heat-based sweating, the emotional type is associated with perspiration in only the palms, soles and armpits.</p>
<h2>9. Tears</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/99257/original/image-20151021-15414-j4e9eq.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/99257/original/image-20151021-15414-j4e9eq.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/99257/original/image-20151021-15414-j4e9eq.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=638&fit=crop&dpr=1 600w, https://images.theconversation.com/files/99257/original/image-20151021-15414-j4e9eq.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=638&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/99257/original/image-20151021-15414-j4e9eq.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=638&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/99257/original/image-20151021-15414-j4e9eq.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=801&fit=crop&dpr=1 754w, https://images.theconversation.com/files/99257/original/image-20151021-15414-j4e9eq.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=801&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/99257/original/image-20151021-15414-j4e9eq.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=801&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Engraving of the lacrimal gland.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Gray896.png">Henry Vandyke Carter, via Wikimedia Commons</a></span>
</figcaption>
</figure>
<p>Tears are produced by the lacrimal glands above and lateral to the eye, and are spread over the eye’s surface by blinking. They are drained into the nasal cavity, which explains why people often get a runny nose when they cry. Tears serve three functions: to lubricate the eye, to remove irritants such as smoke (and a sulfuric acid-producing chemical from cut onions) and in association with emotional states such as sorrow and joy.</p>
<p>Dry eye syndrome, the most common eye disease, affects as many as one-third of elderly people, though it can occur at any time in life. The most common cause is decreased tear production, which in most patients occurs for no known reason, though it is associated with a variety of diseases and medications. The most common treatment involves, naturally enough, the use of eye drops.</p>
<h2>10. Urine</h2>
<p>The average adult produces about 1.5 liters of urine per day. Produced by the kidneys and stored by the bladder, urine contains many substances that must be removed from the body to maintain a state of health. These include the breakdown products of protein metabolism, which would become toxic if they were allowed to accumulate in the blood. Urine also serves as the principal means for removing excess salt and water from the body. </p>
<p>A common diagnostic procedure in medicine is urinalysis. Finding glucose in urine could indicate that a patient is suffering from diabetes mellitus, a disease that got its name in part from the fact that the urine of diabetic patients tastes sweet. Likewise, finding bacteria suggests that the patient is suffering from a urinary tract infection. Interestingly, most of the amniotic fluid that cushions a fetus in utero is made up of urine produced by the fetus’ kidneys.</p>
<h2>11. Vomitus</h2>
<p>Vomitus differs from the other body fluids discussed here because it is not produced under everyday circumstances. Everyone vomits at some point in their life in response to one of several types of stimuli. The balance center of the inner ear can induce vomiting, as in motion sickness. Another cause is irritation of the gastrointestinal tract by infections and poisons.</p>
<p>In some cases, vomiting purges the body of toxins, but in other cases vomitus contains only food. In either case, the fluid is usually highly acidic, because of the acids normally secreted by the stomach. In individuals who vomit frequently, such as patients with bulimia, this acid can erode the surface of the teeth and cause dangerous changes in the pH balance of the blood. The presence of blood in vomitus is generally a sign of bleeding from the esophagus or stomach.</p>
<p>This list of bodily fluids only scratches the surface. For every fluid that is regularly visible to the eye, there is another that, at least in health, we see only rarely. These include amniotic fluid, cerebrospinal fluid and the fluids that lubricate the surface of the heart and lungs, the abdominal organs and the joints, among many others. To get to know these fluids better is to gain deep insights into the biology of the human body in both health and disease.</p><img src="https://counter.theconversation.com/content/49568/count.gif" alt="The Conversation" width="1" height="1" />
By learning a bit more about these body fluids, we can develop a deeper appreciation for the beauty and complexity of our own biology.Richard Gunderman, Chancellor's Professor of Medicine, Liberal Arts, and Philanthropy, Indiana UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/485142015-10-05T05:29:36Z2015-10-05T05:29:36ZWhy does asparagus make some people’s pee smell but not others?<figure><img src="https://images.theconversation.com/files/97079/original/image-20151002-23109-90vok0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Have you eaten asparagus and noticed that it can alter how your urine smells? Perhaps you’ve heard about the phenomenon but wondered why it doesn’t seem to affect you. Or maybe you’ve eaten beetroot and then been worried there appeared to be blood in your water. Why do certain foods change our urine and does it make a difference to our health?</p>
<p>Observations of how what we eat can affect our pee can be traced back through history, from the ancient Greeks including <a href="http://dmd.aspetjournals.org/content/29/4/539.full">Antiphon and Theophrastes</a> to an early edition of the medical journal <a href="http://bit.ly/1N8s3b8">The Lancet in 1836</a>. But asparagus’s potential to affect urine was not formally described <a href="http://ota.ox.ac.uk/text/5174.html">until 1735</a>. This happened to coincide with the British agrarian revolution when fertilisers containing sulphur were first used on crops, although there is no real evidence to say if this effect is causal.</p>
<p>There have been different theories put forward over the years explaining why only some people notice a smell in their urine after eating asparagus. It was first thought that some people broke down the vegetable in a way that released a smelly chemical in the urine. In the UK, <a href="http://dmd.aspetjournals.org/content/29/4/539.full">data suggested</a> about half of the population were so-called “excretors” in this way. This led to a theory that the characteristic was carried by a dominant gene that only needed to be inherited from one parent.</p>
<p>Interestingly there have also been reports that women who are “non-excretors” can produce the odorous urine <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2125.1989.tb03432.x/pdf">when pregnant</a>. This suggested that any asparagus compound responsible for the smell could pass through the placenta and be converted to the smelly compound by the foetus that inherited the gene from their father.</p>
<h2>Odour or smell?</h2>
<p>The problem with the idea of a genetic ability to produce smelly urine is that there is not just one compound that always appears in urine after eating asparagus. Up to 29 different compounds from the vegetable are potential odourants, although methanethiol or methyl–mercaptin is the most predominant. The number of potential smelly molecules has given rise to an alternative theory, not that certain people don’t produce the chemicals but that some people lack the genetic ability to detect the smell.</p>
<p>One <a href="http://chemse.oxfordjournals.org/content/early/2010/09/27/chemse.bjq081.full">small study</a> asked 38 people to eat asparagus and then sniff their own and each other’s urine samples to see if they could detect unusual odours, and around 8% of participants did not produce detectable odourants. A further 6% reported not being able to smell the asparagus odour in any of the samples they were asked to sniff.</p>
<p>When looking at possible genetic causes, the researchers not find any particular genes associated with production of odorants. They did however, find that the ability to detect the smell was linked to a specific DNA sequence that varied between different people. This means a single molecule change in the genes responsible for smell may be linked to the inability to smell asparagus odour in urine.</p>
<p>The problem is that there aren’t actually that many studies of this phenomenon and most of those that have been carried out are small so evidence is limited. This means it’s hard to say whether “asparagus pee” is an ability to produce the compounds or smell them, or a bit of both.</p>
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<img alt="" src="https://images.theconversation.com/files/97080/original/image-20151002-23072-1m3ezr3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/97080/original/image-20151002-23072-1m3ezr3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/97080/original/image-20151002-23072-1m3ezr3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/97080/original/image-20151002-23072-1m3ezr3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/97080/original/image-20151002-23072-1m3ezr3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/97080/original/image-20151002-23072-1m3ezr3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/97080/original/image-20151002-23072-1m3ezr3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Blood red.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
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<p>Asparagus has also been reported to change the colour of urine, giving it a greenish tinge, something that is also associated with beetroot. In some individuals, the potentially disturbing effect can be pink or red urine. This can lead to the false impression of blood appearing in the urine (haematuria).</p>
<p>Known as beeturia, the cause is not thought to be a genetic characteristic, but related to the physical state of the person who experiences it. The beetroot’s red pigments only appear in the urine if they are not damaged by the digestive process and are then absorbed and re-excreted by the kidneys. It is thought that <a href="http://chemse.oxfordjournals.org/content/early/2010/09/27/chemse.bjq081.abstract">this can happen</a> if the stomach is not acidic enough, or if the beetroot itself has high levels vitamin C in the beetroot itself. So, some people can produce beetroot-red urine some but not necessarily all of the time.</p>
<h2>Other foods</h2>
<p>Although asparagus and beetroot are the most commonly mentioned examples, it is actually likely that many foods have an effect on the chemicals that appear in urine. This allows doctors to use urine to assess a person’s <a href="http://ajcn.nutrition.org/content/93/2/314.short">dietary intake</a> by analysing the different chemicals it contains.</p>
<p>However, most changes aren’t usually noticeable even if they are associated with colour or smell changes. For example, coffee isn’t usually thought of as something that strongly effects urine but a recent study has shown that drinking two cups can be enough to lead to the presence of compounds such as vanillin which are often associated with a vanilla-like sweet smell.</p>
<p>Perhaps next time you visit the bathroom, you may be able to see or smell a chemical marker of what you have recently ate or drank. It is usually normal for metabolites from food to appear in urine, and should not be anything to be worried about. If however, you think there is blood or a distinct change you should always seek a medical opinion.</p><img src="https://counter.theconversation.com/content/48514/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Duane Mellor does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The question of whether your reaction to asparagus is down to your stomach or your nose is a 300-year-old mystery.Duane Mellor, Assistant Professor in Dietetics, University of NottinghamLicensed as Creative Commons – attribution, no derivatives.