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Blood in the urine (Hematuria)

Blood in urine

Table of Contents

Summary

Blood in the urine (also called hematuria) occurs when we can see an unusual colour of the urine stream that can be pink, red, or brown (gross hematuria). Sometimes, blood is microscopic. In this case, we can not see it with the naked eye. This micro-hematuria can be detected only in urine analysis

Sometimes the bleeding goes away on its own. Empiric treatments, like antibiotics or homemade remedies, can only casually be effective. However, ignoring an episode of hematuria is not recommended. The underlying diseases might be severe. Anyone who sees blood in the urine should see a doctor at the earliest.

What causes blood in urine?

In some cases, particularly in women, the blood coming from rectal or vaginal bleeding can mix up with urine (false hematuria). Occasionally, false hematuria can also result from the reddish colouring given to the urine by some foods (beetroot). Some drugs can also discolour urine and give an impression of gross hematuria.

Intense exercise can also cause blood to show up in the urine.

Blood in urine occurs when leakage of blood arises from any part of the urinary tract, from the kidneys to the urethra. There are many possible causes of hematuria:

Infection

Infection is one of the most common causes of blood in the urine. The bacteria can enter the urinary tract through the urethra that is the tube that carries urine out of the bladder (causing urethritis). The infection can move up into the bladder or the prostate, causing cystitis or prostatitis or up to the kidney, causing pyelonephritis. These infections can be the source of blood leakage, and the hematuria comes with symptoms like painful urination, frequent urination, perineal or flank pain.

Stones

With kidney and ureteral stones, the urine might be dark red or brown. When the stone obstructs the urinary tract, renal colic usually accompanies hematuria. With bladder stones, the blood in urine is associated with painful urination, frequent urination, or urgent urination.

Enlarged prostate

A possible cause of blood in urine after the 50s is prostate enlargement. The prostate enlargement can compress the blood vessels in the bladder neck, causing varicosities that can leak. Also, infections are a common reason for bleeding in enlarged prostate patients. Hematuria in enlarged prostate patients is usually associated with frequent urination and nocturia.

Kidney disease

A less common reason for seeing blood in the urine is kidney disease. A diseased or inflamed kidney can cause hematuria. This disease can occur on its own or as part of another illness, such as diabetes.

In children ages, 6 to 10 years, post-streptococcal glomerulonephritis (a kidney inflammation) may cause hematuria. This disorder can develop one to two weeks after an untreated strep infection. It’s rare today because antibiotics can quickly treat strep infections.

Cancer

Hematuria is the most common first and solitary symptom of bladder cancer. Renal and prostate cancers usually bleed only in advanced stages.

Medications

Some medications cause hematuria:

  • aspirin;
  • blood thinners like heparin and warfarin (Coumadin);
  • penicillin;
  • cyclophosphamide, which is a drug used as a chemotherapic for cancer.

Less common causes

There are some other causes of hematuria that are not so frequent:

  • blood disorders such as sickle cell anaemia;
  • Alport syndrome;
  • haemophilia can cause blood in the urine.

When to see the doctor

In all cases of blood in the urine, seeing a doctor is highly recommended. Hematuria, as a single sign, without any other symptom, might be caused by cancer.

External resources

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