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Toddler with urinary symptoms
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Toddler with urinary symptoms

My daughter is 2 and 1/2 years old and is not toilet trained.  Over the last couple of months I've noticed her diapers are not as wet as they usually were and she's been drinking the same as usual.  I didn't think too much of it until about two weeks ago she became very constipated.  Her urine also started having a very strong and foul odor.  I started making her drink more just in case she was a little dehydrated.  Soon after, in the middle of the night she came into my room and I woke because I could smell the urine; it was that strong!  She came into bed with us and complained that it "hurt down there".  I opened her diaper and looked and couldn't see anything unusual, no rash, redness, discharge, nothing.  She laid in our bed and began to take her fist and pound on her diaper and said again that it hurts.  She went to her pediatrician the next day who put her on Miralax for the constipation and instructed us to give her more fluids.  After a couple of days the constipation cleared, however her urine still had that horrible odor.  After a couple of more days she kept complaining that it "hurt in there" and would point to her diaper.  She would ask me to take off her diaper and look.  I still couldn't find anything.  I brought her back to  her pediatrician and he wanted to catheratize her to get a urine sample.  After two nurses and the pediatrician, himself, could not get the catheter in, her scheduled her for a renal ultrasound and a VCUG.  The physician performing the VCUG stated that there was no reflux and everything looked normal.  I don't have the results yet from the ultrasound yet.  Do you have any idea as to why her urine could smell so foul?  In the morning, I can smell her diaper from down the hall and two rooms away from hers.  She has not had a fever at all during this time, therefore her pediatrician did not feel it was a UTI.  Is there a connection between the constipation and the foul-smelling urine?  She is still on the Miralax and when I tried to stop it, the constipation came right back.  Her complaining about the pain has decreased, but like I said, her urine smells horrible.
Thank you for any information you can provide.
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22 Comments Post a Comment
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Avatar_dr_f_tn
Hi,

Constipation and decrease in urine output do point to dehydration. This must be the initial case with your daughter whose constipation improved after increased fluid intake.

When you say foul smelling urine, how would you describe the smell? Fishy, musky?

Was a urinalysis and urine culture done? The smell of urine is influenced by the balance of chemicals and substances present in it. This may be disrupted by the presence of infections .

For children, anatomical abnormalities have to be ruled out. A reflux has been ruled out by the VCUG. If the constipation persists and the urine's foul smell also persists after following your physician's advice, further examinations may be warranted.

Just stay calm and continue to reassure your daughter.Encourage her to talk about her symptoms.Give her plenty of fluids daily and maybe you can discuss with your physician the type of food you may give her to help with the constipation.
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Avatar_n_tn
Have you found any answers?  I ask because we are in the EXACT situation you are.  My daughter is also 2.5 yrs old, has constipation issues and lately has had major problems with very smelly urine.  Our ped.  thinks she's just dehydrated but I think it's something more.  I'm having trouble getting a urine sample though.  
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Avatar_n_tn
I just went into my almost 2 yrs old son's bedroom, cuz he'd been coughing on and off for a while, since he'd been in bed a few hours ago, and i went in to check on him, and there was this very strong, very foul smell in his room, i thought he'd pooped in his pull-ups...he only peed! the smell was disgusting, it's the 2nd or 3rd time this happens in the past week and a half, and now im getting a bit worried..did you find out what your daughter had? my son has not had any fever, nor constipation, only flu like symptoms (runny nose, and now a mild cough)
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Avatar_n_tn
Hi guys

It is very interesting that your stories sound exactly the same as our's!! My 3 year old daughter has had very smelly urine for a few months now. I can definitely relate to being woken up by the smell when she's sleeping in my room and when she comes through in the mornings. I thought it was from old urine trapped in her nappy(diaper!) but I've also noticed it when she wees in the toilet.

My daughter actually did have Urinirary Tract problems as a baby and infact had 2 ureters running from the one kidney to the bladder, causing major reflux. One of these ureters was removed at 10 months. Tests have shown that her collecting systems (kidneys, bladder etc) are operating fine now and she has not been ill at all so I don't actually think it would be a UTI or have anything to do with that. However I will definitely contact her Paed now since we are obvioiusly not imagining the foul unusual odour!!

Thanks for your messages - am interested to know if you've received any feedback.

Juliet.
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1239718_tn?1268168178
Has anyone had any success finding a cause for these symptoms? My daughter has the same problems; constipation and very foul smelling urine. She is now 18 months old and has had the constipation problem sense birth (literally) and has added the foul smelling urine symptom within the last 6 months.
She has been tested for a UTI and that came back negative. She has also been tested for a metabolic disorder and that too came back normal.
Just curious if anyone has gotten any answers with their child.

Thanks!
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Avatar_n_tn
This is exactly what's going on with my 2.5 year old daughter! Constipation and foul smelling urine..like it's been sitting in the diaper for weeks!  She frequently complains that her "hiney hurts", which we attributed to possible rectal fissures.  Now that her urine is smelling terrible, she's started to complain that her "hole" hurts.  My initial thoughts are UTI.  She doesn't have any burning when she urinates, however.  Her urine isn't concentrated either, and her fluid intake is the same, so I don't think it's dehydration.  It's amazingly coincidental that we all have this issue, along with constipaion. I am hoping it's a UTI  and don't have to put her through test after test.  BTW, the urine is foul smelling whether or not she has taken miralax.
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Avatar_f_tn
Wow, I'm having the same issue with my 2.5 year old daughter.  She has had this happen once or twice before for a day but then it went away.  Now it has been a week of the smelly urine.  Took her to the doctor who took a urinalysis via cather no UTI was found, no diabetes, ph level good.  She sent out a sample of her urine to see if it grew any bacteria. Waiting on resoults.  She too has no other syptoms (symptoms) other than needing a drink at night, which she didn't so before.  It seems to be the strongest after napping or waking up in the morning. It has me worried.
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Avatar_m_tn
It seems all your children have the same conditiona s my own 2 kids.  It's TMA a condition in which the body cannot break down choline and as a result it sips through the sweat glands, like arm pits, mouth vaginal canal, etc.  The only remedy is to follw a special diet abstaining from foods such as eggs, FISH, liver, green vegetables etc.
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Avatar_f_tn
my 2/12 yrs old daughter have same conditions as u all said but she has horrible constipation her stool tests shows wbc but urine tests are clear can anyone tell me that whatwould be the remedy
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Avatar_f_tn
My duaghter is three.  We have had problems with her bowels since birth. We have had multiple episodes where she won't pee for a whole day and be drinking up to 64 oz. of fluid without using the bathroom. The doctors have taken urine samples and they all come back nagative. Her urine reeks if she pees the bad at night, which doesn't usually happen. But she has peed the bed two days in a row now and doesn't go for 8-10 hours or more. I don't know what else to do. I know she is not dehydrated. I'm trying to get an appointment with a urologist now. Please let me know if anyone gets any answers
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Avatar_f_tn
My 2 1/2 yr old daughter started with constipation, we did the usual;  prune juice, suppository and 1/2 exlax. Her bowel movements improved somewhat but only as a result of the above. When we stopped she was constipated again.  
2 days into constipation...she started screaming and crossing her legs in pain when she had to urinate(she's not toilet trained yet), I took off her diaper and "HOT urine suquirted out, it smelled "fishy" and was cloudy.
This happened 3 times before I took her the ER. To me it looked like a Urinary Tract Infection(UTI), howerver after being at ER for 8 hours (took that long to get an urine sample and wait for results)...Dr's gave her meds for constipation, test results showed nothing wrong with urine.
It's now been just over 2 weeks. We've been back to family dr...he gave her cream (thinking it may be a yeast infecion (infection))...that hasn't worked and today she's back to screaming in pain when she has to urinate and it's still really hot,murky and fishy.  I got a urine sample and will drop it off at lab monday(tdy is Saturday).  Like your kids...she's had no fever, always drinks alot of liquids though she has lost some of her appetite...but we have her on peadialyte with prune juice, still giving her constipation medicine and applying cream to her vagina.
I will post as soon as we confirm what it is.
To the first post....have you heard anything yet????
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Avatar_n_tn
I originally posted my daughter's issue when she was 2 & 1/2, she's now 5 & 1/2.  Her urine and pain issues were just from constipation. She dealt with constipation since she was born.  We had to put a teaspoon of corn syrup 1-2 times per day in her bottles.  She has been on Miralax since she was about 2 & 1/2, shortly after my first post.  She did have a UTI, but that is because she was holding her urnine due to the pain.  It has been a long road of finding the right dose of Miralax.  Sometimes, it's too much, other times she needs more.  She has not had a UTI since the constipation was under control.  Her pediatrician said she could be on Miralax for years and that her body will not become dependent on it.  She knows about the "powder" as we call it and she will tell me that her "poopies hurt" and then I know she needs more.  It helps that she's older and we've had many discussions about this, so she helps us to know when she needs more or less powder.
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Avatar_f_tn
Thank you for posting a solution CorieBell.  
My daughter is currently 2 1/2 and the Dr.'s have her on PMS-Lactulose....before bedtime.  It hasn't seemed to help with the constipation, she's still drinking prune juice.
But I'm happy to say, and hopefully not prematurely, that her urinating does not hurt her or come out hot anymore.
We find out about the the urine sample results tomorrow (fri) we took it in Monday.
I just pray that it doesn't come back whatever it was and hope that her bowel movements become regular soon....the past few weeks were very stressful for the whole family with screaming everytime she pee'd or poo'd.  Nice to see her running around again and eating lots.
Carol
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Avatar_f_tn
Received a call from my Dr. today....it turns out my daughter does have a UTI or e-coli.
I guess it didn't appear on the first test they did at the hospital....but they gave me antibiotics for that (TEVA-SULFAMETH/TRIMETH) twice a day. And I still have to give her the PMS Lactulose as she's still not back to her regular bowel movements and they're still a bit runny.

But I'm finally glad I have answers!

Hope this helps some of you and thanks for starting this Corriebell...it really helped ME!
Carol
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Avatar_f_tn
When my daughter was 2.5 this same thing has happened.  The doctor did the same testing as yours plus took a urine sample via cath.  She didn't have the normal symptoms of a UTI, no fever, etc.  But sure enough when the culture came back it showed that she had a bacteria infection.  Matter of fact the doctor said the numbers were so high she didn't know how she wasn't showing any signs especially the fever.  She belied that my duaghters constipation allowed this to happen by the fact of the bowel being back-up putting pressure on the bladder causing a blockage in the flow of the urine.  She said that my daughter needed to have a bowel movement every day and if she wasn't then she wasn't getting enough fiber.  so I make sure that she has fruits, vegetables, and whole grains every day so that she can achieve movement of her bowels and so she doesn't have to rely on medicine.
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Avatar_n_tn
It has been alot of years since my daughter had some of these problems. When she was 1 1/2 she had blood in her urine which really freaked me out. After that she had constant UTI. She went to the urologist and was put on a sulfa medication. After about 3 years of this treatment I asked him how long she would be on it and he said probably years. She also had the base of the bladder streched because of urine retention. I didn't think this was the right answer since the problems persisted.

I saw an article in Readers Digest about allergies and UTI so I took her to the allergist and lo and behold she was allergic to a number of things. After 2 years of allergy shots the problems disappered. She is now 46 and has had very few UTI.

I would suggest if the problems persists to look into allergies. It sure worked for her.

Good Luck.
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Avatar_f_tn
I am having the same issues with my almost 3 year old daughter...it started with a few days of the very strong smelling urine it would wake me up it was so bad but only in the morning and then came the constipation ... My daughter to is pounding saying ow on her pull up I have tried laxatives safe for children and it clears up for a bit then returns and now the strong urine is not only in the morning but also at least once during the day
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Avatar_m_tn
My daughter is 9 and has had the same problems since she was a baby.  She just got diagnosed with VU reflex. An abnormality in the valve or the ureters that allows urine to flow backwards.
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Avatar_f_tn
Omg..my 2 1/2 year old daughter is having the same issue. Constipation and a strong fishy smell in her diaper/urine. She is urinating frequently though. I had been giving her Miralax (sp) for the constipation (for two days now) and am about to make an appt to get some answers. I was thinking it is bacterial vaginosis bc she complains that it hurts but I don't see a rash, redness or discharge (nothing) just the fishy smell.
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Avatar_n_tn
my daughter has these sames issues,  We have tried everything.  It has caused her to pee in her pants through out today,  She has has ultrasound and vcug and the came back ok.  Just show she has thick bladder and she retains fluid.  Xrays and ultrasound show that she has been constipated a lot to.  NOw she is complaining of back and lower tummy hurting.. very frustrated we cant get answers :( She is four now and we have been fighting this for like a year now
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Avatar_f_tn
I had the same problems with foul smelling urine and constipation with my 7 year old. My husband and I were at out wits end. Her father drinks green tea all the time and one night decided to give her half a cup. She pee pee'd immediately. From that point on we've given it to her every night about 1 hour before bedtime and it cleared up the problem.
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Avatar_m_tn
You all should check out this website: www.specialneedsnutrition.com
Don't let the name fool you; it's geared towards autism spectrum disorder, ADD, ADHD, etc, but it can help anyone. These children may have specific food allergies that are causing their GI tract problems and Faye Elahi is amazing and has helped many people (children and adults). If your child is taking medication for long periods of time for constipation there is probably something bothering his/her digestive tract. My 4 year old son is a "normally developed" child but has been taking asthma medications (steroids) for the past couple of years. Now I know it's not asthma, but a food intolerance. Hope the website helps!
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