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Explanation in layman terms for chyluria in an aged, precautions and treatment - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Average Posted in: Urinary and Bladder Problems
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2436 Questions
Doctor :   hi how can i help you?
Doctor :  
please proceed with your health query
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are you there?
User :   aged 70, having no BP, no sugar, no cholesterol having a problem of urine colour going murky white with no pain; She was diagnosed as having 'Chyluria' more than a year ago and an urologist have ruled nothing major; She has been advised not to have any food with high cholesterol; She develops the above problem of urine going thin white to thick white on & off; Just now she has developed some difficulty while passing urine & quantity also subdued; what could be her problem?
Doctor :  
are you there?
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ok
Doctor :  
please give me time to read through the history.
Doctor :  
i will help you in this
Doctor :  
chyluria is is urine containing chyle (emulsified fat) or pus
Doctor :  
it can also happen on having a high protien diet, and not necessarily fatty food.
Doctor :  
and also if there is slow ongoing infection in the bladder
Doctor :   are you there?

User :   yes, pl go ahead listening to you
Doctor :  
ok
Doctor :  
it can also happen in a parasitic infection due to filiriasis
Doctor :  
when was her last visit to the doctor?
Doctor :   what medications is she taking?
Doctor :  
other causes include urinary tract infec tions (UTI), pedal lymphangitis, edema, hypoproteinemia, cachexia, weight loss and malnutrition.
User :   Last visit was in Jul 09; Her urine inflow with full bladder was also checked & normal; She is having some problem since day-before with some irritation/difficulty in passing urine; She has given her urine sample for culture test & awaiting results; Regarding Chyluria, should we do any specific tests to identify the type of infection to the bladder in order to address them specifically?
Doctor :   diagnosis of chyluria can be confirmed by evaluating a sample of a postprandial urine for chylomicrons and triglycerides. The intermittent passage of milky cloudy urine should be differentiated from phos phaturia
Doctor :   if it is due to fatty food, the milky look will be lost on giving a fat free diet
Doctor :  
and post prandial urine fat measurement should be done, which will usually show 90% tryglycerides
Doctor :   wait for the culture results too
Doctor :  
such that if it is due to infection, it can be treated appropriately
Doctor :   is your mother on any medications now?

Doctor :  
if it is due to infection, it has to treated
Doctor :  
if due to filariasis, specific drugs need to be given
Doctor :  
and if it is due to lymph channel damage, then it may require surgery.
Doctor :  
are yiu there?
Doctor :  
are you there?
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have you followed what i have said?
User :   pl go ahead
Doctor :  
have you followed what i have said?
Doctor :  
so i will suggest a reexamination for your mother and repeat tests, may at another clinic to get the current picture of what is happening to her
Doctor :  
Is there any thing else I can help you with?
Doctor :   are you there?
User :   let me read your reply once again; Kindly wait
Doctor :  
ok
User :   what is post prandial urine test?; Because all sorts of tests on her kidney - ultrasonic, blood tests, urine tests have been done in Jul 09 & nothing was identified;Will the culture test identify all of what you have said?
Doctor :   postprandial urine test is done after two hours of food
Doctor :  
culture test will identify the infections if any in the urine
Doctor :  
filariasis can be detected
User :   will the culture test also identify the lymph channel damage, filariasis? Is there any other tests for the latter?
Doctor :  
by doing this test membrane filterations method, ultrasound, immunology tests and lymphoscintigraphy
Doctor :  
Is there any thing else I can help you with?
Doctor :   Please fill the feedback form say done when done.
User :   urologist also said, if there is no pain, there is no need to worry about the milky white discharge; Should we bother only when she undergoes some sort of difficulty/pain while urinating or otherwise?
Doctor :   you told me that she is having problem since the day before
Doctor :  
so it is advisable to get a check done for her
Doctor :  
as chyluria can be asymptomatic and symptomatic both
User :   yes, for the 1st time since diagnosed as chyluria, she is having problem only now; Otherwise whenever she had such a white discharge, she never experienced problem otherwise;
Doctor :  
ok
User :   what is lumph channel discharge? how serious it is?
Doctor :  
Chyluria is not a life threatening disease, but it may be associated with severe weight loss and the painful voiding episodes are due to the passage of chylus clots. hence the urologist has said not to worry
User :   sorry meant lymph channel damage, since you mentioned surgery?
Doctor :  
but if there is a lymph channel that is affected, then it may turn serious
User :   Chylus clots?
Doctor :  
yes
Doctor :  
clots that are made up of chyle
User :   what is chylus clots?
User :   In addition, whe is also having bowel problem - leading to uncontrollable loose motion; she is having it for the past 10 years plus; Once once she got admitted in a hospital to control her loose motion; Again nothing specific is diagnosed;She is not on any specific medication - possible causes or suggestions please?
Doctor :  
you should tell the entire history at the beginning to give a clear picture of the patient to the doctor. please explain what problems she is having with bowel movements.
Doctor :  
for chyluria i have already explained the most important possible causes. and teh necessary treatments for each
Doctor :  
however if you want me to tell again, i will repeat
User :   Sorry Doctor; She has loose motion, that she is not able to control; She goes to toilet around 3 times a day - sometimes more, sometimes less; What is more worrying is her historic problem of loose motion; She does 'enemia' through naturopathy (water) herself & is also taking some home remedies that she claims makes her motion a bit controlled;
Doctor :  
if she is taking the naturopathic enema, then she is bound to have loose motions.
Doctor :   and since she is having this for a very long period of time, the possibility of coilitis and/or irritable bowel syndrome should be confirmed/ruled out.
User :   Is her loose motion problem connected with chyluria?She takes water enema only for the past 3 months plus, but her loose motion problem exists for very long! Is there a specialist doctor for the loose motion problem or a general doctor?
Doctor :  
yes
Doctor :  
she should get a gastroenterologist opinion for loose motion
Doctor :  
and this may not be related
Doctor :  
unless the cause for both is known
Doctor :  
then any relation can be established.
Doctor :  
have you gone through the entire chat? do you want me to repeat the causes and treatments for the various reasons for chyluria?
User :   Yes doctor please go ahead!
Doctor :  
you mother will need a abdominal ultrasound again and a colonoscopy to confirm/rule out colitis or irritable bowel syndrome.
Doctor :   chyluria is is urine containing chyle (emulsified fat) or pus
Doctor :   it can also happen on having a high protien diet, and not necessarily fatty food.

Doctor :  
and also with slow ongoing infection in the bladder
Doctor :  
the various other causes include urinary tract infections (UTI), pedal lymphangitis, edema, hypoproteinemia, cachexia, weight loss and malnutrition.
Doctor :   diagnosis of chyluria can be confirmed by evaluating a sample of a postprandial urine for chylomicrons and triglycerides.
Doctor :  
The intermittent passage of milky cloudy urine should be differentiated from phosphaturia which will also give similar appearance to urine

User :   you said phos phaturia - what is it?
Doctor :  
it is passage of phosphates in urine
Doctor :  
so if it is due to fatty food, the milky look will be lost on giving a fat free diet and in this the post prandial urine fat measurement should be done, which will usually show 90% tryglycerides

User :   OK Doctor; You have been very kind to repeat the message & very useful;
User :   Thank you very much
Doctor :  
since you said earlier that culture reports are awaited, when you will get the report?
User :   Culture testes are awaited today;
Doctor :   ok
User :   I am done Doctor; Good bye
Doctor :  
so see if any infection is picked up and go ahead with the rest of folow up
Doctor :  
both for chyluria and loose motions
Doctor :  

Is there any thing else I can help you with?
Doctor :  
Please fill the feedback form once again and say done when done
User :   Nothing Doctor; thanks a lot;
Doctor :  
Can you please share your mobile number and e-mail id so that we may update our records. This information will be useful to us in case we need to send you additional information through mail or sms.
Doctor :   are you there?
Doctor :  
Can you please share your mobile number and e-mail id so that we may update our records.
Doctor :   This information will be useful to us in case we need to send you additional information through mail or sms.
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please chat with our doctors 24/7 for medical queries.
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