Ever heard of Purple Urine Bag Syndrome? Have you ever looked down at your urine drainage collection bag only to see that it has turned purple? You know that you were using a transparent urine drainage bag, but why did it turn purple?
Although extremely rare, Purple Urine Bag Syndrome (PUBS) is not something to panic about. It can be prevented and quickly treated. PUBS is usually a sign of a urinary tract infection (UTI) with constipation.
What is Purple Urine Bag Syndrome?
PUBS happens when there is a mixture of indole and indoxyl that comes into contact with alkaline urine and interacts with the plastic material of the urine drainage bag. We will help break it down in terms that can be more familiar.
First, tryptophan is an essential amino acid found in many foods we consume, like chicken, turkey, eggs, and cheese. Tryptophan is digested and metabolized by gut bacteria to produce indole, which is then converted into indoxyl sulfate by the liver. Chronic constipation is commonly associated with an overgrowth of bacteria in the colon. This bacterial overgrowth increases the conversion of tryptophan to indole.
Next, using long-term urinary catheters like Foley catheters can allow bacteria to enter the urethra and increase one’s chances of a UTI. Catheter-associated urinary tract infections increase the conversion of indoxyl sulfate into indoxyl.
Finally, the increased indoxyl sulfate levels in the urine cause it to become alkalized. The alkaline urine comes into contact with indoxyl and enters the urine drainage bag. This combination interacts with the plastic material of the urine collection bag producing a deep purple color of urine. PUBS is most often seen in elderly female patients with chronic constipation and an indwelling catheter.
What are the Symptoms of Purple Urine Bag Syndrome?
Similar to the symptoms of a UTI, aside from the purple-colored urine, Purple Urine Bag Syndrome symptoms can include:
- Urinary leakage
- Catheterizing more frequently
- Fever or chills
- Nausea
- Increased bladder spasms
- Blood in the urine
- Cloudy urine
- Foul-smelling urine
- Mild lower back pain
- Headaches
How is Purple Urine Bag Syndrome Treated?
A medical doctor can treat PUBS by prescribing an antibiotic and addressing the underlying chronic constipation. Ensuring good catheter care practice is often discussed with patients as well.
How is Purple Urine Bag Syndrome Prevented?
Drink plenty of fluids
It is essential to drink at least 8 to 12 glasses of water a day to help avoid UTIs. Avoiding caffeine, sugar, and alcoholic beverages is best as they may cause bladder irritation that contributes to UTIs. Dehydration is associated with PUBS, and if your bladder and kidneys aren’t able to flush out waste products, the chances of a UTI increase.
Practice good catheter hygiene
If you are using an indwelling catheter, it is recommended to change it every month. If you notice crystals or sediment in your urine, you may need to change your Foley catheter more frequently. Make sure to speak to your doctor about what schedule is right for you.
Keep your catheter insertion site clean
If you use a Foley catheter, keeping the insertion site clean will help prevent UTIs. Try maintaining a routine to clean this area and the catheter with warm, soapy water every morning and night. BZK Antiseptic Towelettes are an excellent cleansing wipe to disinfect this area using a powerful antimicrobial Benzalkonium Chloride USP solution.
Establish a bowel routine
You can do several things to get into a good bowel program. Emptying your bowels around the same time each day can help promote overall bowel health.
- If you are taking prescribed medications to manage your constipation, take them at the same time each day.
- If you are using a suppository, use it at the same time each day.
- Include up to 35 grams of fiber in your daily diet.
- Make sure to drink 8 to 12 glasses of water each day.
- Avoid caffeine, alcohol, and any foods that may upset your stomach.
- Exercise daily to move food through the GI tract and aid your daily bowel movements.
So there you have it! Don’t get distressed if you are a Foley catheter user and develop Purple Urine Bag Syndrome. It is temporary, is treatable, and can be prevented. Practicing good catheter hygiene and keeping a good relationship with your doctor is vital. If you have any of the symptoms mentioned above, make sure to consult with your doctor immediately.
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