What is Purple Bag Syndrome, and How To Prevent It

This piece has been medically reviewed by Aleece Fosnight, MPAS, PA-C, CSC-S, CSE, NCMP, IF, Medical Advisor to Aeroflow Urology.

You look down at your urinary catheter bag, and you notice your urine is purple. Don’t panic! While rare, purple urine bag syndrome is easily preventable, and it is typically just a sign of a urinary tract infection (UTI).

What is Purple Urine Bag Syndrome?

Purple urine bag syndrome (PUBS) can occur in individuals with urinary tract infections (UTIs) that use urinary catheters long-term. When certain types of bacteria enter the urethra through the catheter, this can cause a urinary tract infection. This bacteria can react with the breakdown of tryptophan (the same chemical found in turkey and many other foods) in your digestive system. The resulting reaction causes the purple discoloration in the urine.

It should be noted that no research has been found that associates purple urine bag syndrome with the usage of a specific type of catheter or bag. Purple urine bag syndrome can occur with all catheters.

While the sight of purple urine may be alarming, there is no immediate cause to be worried or concerned. Typically, it is harmless and does not indicate a larger, more serious issue. Individuals that are more prone to purple urine bag syndrome occurring include women, those with alkaline urine (pH greater than 7), individuals with frequent constipation, and those with chronic renal failure. Although the color of the urine should not be a cause for alarm, the underlying urinary tract infection (UTI) should be discussed and treated by your healthcare provider.

Symptoms of Purple Urine Bag Syndrome

Aside from the purple discoloration of your urine and catheter bag, there are other symptoms that can arise with PUBS which are related to the underlying urinary tract infection (UTI). These signs may include:

  • Mild lower back pain
  • Body aches
  • Fatigue
  • Chills
  • Fever
  • Increased urge to urinate or increased need to catheterize
  • Blood in the urine
  • Headache
  • Cloudy or foul smelling urine

  • Preventing Purple Urine Bag Syndrome

    In order to prevent purple urine bag syndrome, it is important to regularly change and properly maintain your catheters and drainage bags to prevent the future growth of bacteria. It is important to also keep your insertion site clean using soap and water on a daily basis. Not only will proper sanitation and maintenance help prevent the build-up of bacteria, but it will also promote a healthier overall lifestyle.

    If you are not sure how often to change your catheter, speak with your healthcare provider or urologist to determine a set schedule. While it can be costly to keep a stock of catheters on hand, Aeroflow Urology can help. Aeroflow works directly with your insurance provider to help you to obtain high-quality, top brand catheters at no cost through your insurance benefits. Simply submit your information through the form below, and we’ll work with your doctor and insurance company to confirm your coverage. Each month we’ll ship your catheter and supplies directly to your home, all at no cost and no hassle to you.

    One of the best ways to prevent UTIs and PUBS is to drink enough water. Drinking at least 2000 to 3000mL (64oz - 100oz) of water daily can help to dilute the urine and flush away bacteria more easily in the urinary tract and catheter bag system. Avoiding or limiting beverages with sugar, caffeine, and alcohol have been shown to be beneficial, as well.

    Sometimes other symptoms, such as constipation, can follow purple urine bag syndrome and should be treated accordingly. Even though purple urine bag syndrome is a benign reaction to bacteria and tryptophan, it may be beneficial to inform your healthcare provider, so that they can check for any underlying concerns.

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    Dr. Aleece Fosnight

    Aleece Fosnight, MSPAS, PA-C, CSC-S, CSE, NCMP, IF is a Medical Advisor and Writer for Aeroflow Urology and a board-certified physician assistant specializing in sexual medicine, women’s health, and urology. In 2019, she opened up her own private practice, the Fosnight Center for Sexual Health, and implemented the sexual health grand rounds curriculum at her local hospital and residency program.

    Aleece is also the founder of the Fosnight Foundation, a non-profit organization dedicated to the education and training of professionals in the sexual health field and providing funding for access to healthcare services in her local community.

    Information provided on the Aeroflow Urology blog is not intended as a substitute to medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.