Seeing blood in your urine can be alarming. While in many instances the cause is harmless, be that as it may seem, blood in urine (hematuria) can indicate a serious disorder. Having blood in your urine (pee) can be a sign that something is wrong with your kidneys or another part of your urinary tract.
During routine visits to your doctor, you are often asked to give a urine sample for testing. Many tests are done routinely, like checking for sugar (diabetes), bacteria (infection) and blood. According to experts, hematuria is classified into two; blood in the urine that you do not see is called microscopic hematuria. This blood is only visible under a microscope. There are many causes and most are not serious, but may call for care by your doctor.
While the second is blood that you can see is called gross hematuria. Urinary blood that is visible only under a microscope (microscopic hematuria) is found when your doctor tests your urine. Either way, it’s important to determine the reason for the bleeding.
However, if you notice blood in your urine, do not ignore it. There are many possible causes of this condition, known as hematuria. While some are simply treated and not dangerous, others may need immediate medical attention.
Research shows that not all hematuria can be seen with the human eye. In fact, the most common type of hematuria called microscopic hematuria can only been seen by a health care expert under a microscope. In many cases, microscopic hematuria is spotted when a person has a urine test during a health exam.
When a person can see the blood in his or her urine, the condition is called gross hematuria. People with gross hematuria have urine that is pink, red or brown.
According to an Assistant Professor of Urology, Angela Smith, there’s a common misconception that if you see blood in your urine once and then it goes away that you are in the clear. “But it’s important to seek care the very first time you see blood in the urine, so your doctor can confirm that it is there and refer you to a urologist for an evaluation.”
Said she, “In most cases, people with either type of hematuria do not have pain or any other signs or symptoms. A change in urine color caused by drugs, food or exercise may go away within a few days. But you cannot automatically attribute red or bloody urine to medications or exercise; that is why it is best to see your doctor anytime you see blood in your urine.”
According to research, there are many reasons that you might have blood in your urine. Having blood in your urine does not necessarily mean you have kidney disease. Some common causes are: menstruation, strenuous (difficult) exercise, sexual activity, having a virus, injury and having an infection, such as a urinary tract infection (UTI).
Lending his voice, Professor in the Department of Surgery, Division of Urology at the Carolinas, Michael Kennelly said: “In many cases, kidney cancer and bladder cancer do not cause physical symptoms, so the tumor may continue to grow without a person being aware of it.
“By the time the tumour does cause symptoms, it may not be curable. That is why it is so important to seek medical attention if you see blood in your urine. It could be a warning sign for a potentially life-threatening illness. Fortunately, the majority of the time, blood in the urine is not a sign of a serious illness.”
The professor stated further that in hematuria, your kidneys or other parts of your urinary tract allow blood cells to leak into urine, while adding that a number of other problems can cause this leakage, including:
Kidney infections: Kidney infections (pyelonephritis) can occur when bacteria enter your kidneys from your bloodstream or move up from your ureters to your kidney(s). Signs and symptoms are often similar to bladder infections, though kidney infections are more likely to cause fever and flank pain.
A bladder or kidney stone: The minerals in concentrated urine sometimes precipitate out, forming crystals on the walls of your kidneys or bladder. Over time, the crystals can become small, hard stones. The stones are generally painless, and you probably won’t know you have them unless they cause a blockage or are being passed. Then there’s usually no mistaking the symptoms kidney stones, especially, can cause excruciating pain. Bladder or kidney stones can also cause both gross and microscopic bleeding.
Enlarged prostate: The prostate gland located just below the bladder and surrounding the top part of the urethra often begins growing as men approach middle age. When the gland enlarges, it compresses the urethra, partially blocking urine flow.
Signs and symptoms of an enlarged prostate (benign prostatic hyperplasia, or BPH) include difficulty urinating, an urgent or persistent need to urinate, and either visible or microscopic blood in the urine. Infection of the prostate (prostatitis) can cause the same signs and symptoms.
Kidney disease: Microscopic urinary bleeding is a common symptom of glomerulonephritis, which causes inflammation of the kidneys’ filtering system.
Glomerulonephritis may be part of a systemic disease, such as diabetes, or it can occur on its own. It can be triggered by viral or strep infections, blood vessel diseases (vasculitis), and immune problems such as IgA nephropathy, which affects the small capillaries that filter blood in the kidneys (glomeruli).
Cancer: Visible urinary bleeding may be a sign of advanced kidney, bladder or prostate cancer. Unfortunately, you may not have signs or symptoms in the early stages, when these cancers are more treatable.
Inherited disorders: Sickle cell anemia a hereditary defect of hemoglobin in red blood cells can be the cause of blood in urine, both visible and microscopic hematuria. So can Alport syndrome, which affects the filtering membranes in the glomeruli of the kidneys.
Kidney injury: A blow or other injury to your kidneys from an accident or contact sports can cause blood in your urine that you can see.
Medications: The anti-cancer drug cyclophosphamide (Cytoxan) and penicillin can cause urinary bleeding. Visible urinary blood sometimes occurs if you take an anticoagulant, such as aspirin and the blood thinner heparin, and you also have a condition that causes your bladder to bleed.
Signs and symptoms
On symptoms, Smith said, the visible sign of hematuria is pink, red or cola-colored urine due to the presence of red blood cells. It takes little blood to produce red urine, and the bleeding usually is not painful.
“Passing blood clots in your urine, however, can be painful. Bloody urine often occurs without other signs or symptoms. It is possible to have blood in your urine that is visible only under a microscope (microscopic hematuria) as mentioned earlier,” she added.
“If your doctor thinks you may have hematuria, you will have a repeat urine test to make sure the first test was right,” says Smith.
“Your doctor will ask you about your health history, including infections, kidney stones, smoking, menstruation and recent injuries. He or she will also ask about medications you are taking.
“Your doctor will perform a physical exam to check for pain or tenderness in the bladder or kidney area. Men may be given a digital rectal exam to look for prostate problems. Women may have a pelvic exam to look for the source of red blood cells in the urine.”
“Sometimes, the cause of urinary bleeding may not be found. In that case, your doctor may recommend regular follow-up tests, especially if you have risk factors for bladder cancer, such as smoking, exposure to environmental toxins or a history of radiation therapy.”
Experts say hematuria has no specific treatment. Instead, your doctor will focus on treating the underlying condition. This might include, for instance, taking antibiotics to clear a urinary tract infection, trying a prescription medication to shrink an enlarged prostate, or for kidney stones treatment can include waiting for the stone to pass by itself, medication or surgery.
Kennelly continued: “If you are found to have kidney or bladder cancer, your doctor may refer you to an oncologist or urologic surgeon. If the tumour is found early, the cancer often can be cured. “There are a number of options for kidney and bladder cancer treatment, including surgery, chemotherapy and radiation. If the doctor rules out any medical problem causing hematuria, you will not need treatment.
“If you find blood in your urine, or your doctor tells you that you have microscopic hematuria, don’t panic,” Kennelly says.
“The good news is that with proper evaluation, your doctor can find out the cause and if needed, make sure you get the correct treatment right away.”
Prevention and home remedies
It is generally not possible to prevent hematuria, though there are steps you can take to reduce your risk of some of the diseases that cause it. Prevention strategies include:
Urinary tract infections: To reduce your risk of urinary tract infections, try drinking plenty of fluids, urinating when you feel the urge and after intercourse, and wiping from front to back after urination (for women). Avoid feminine hygiene products that may irritate your genitals.
Kidney stones: To help lower the likelihood of kidney stones, drink plenty of fluids and limit salt, protein and oxalate-containing foods, such as spinach and rhubarb.
Bladder cancer: Stopping smoking, avoiding exposure to chemicals and drinking plenty of fluids can cut your risk of bladder cancer.
Kidney cancer: To help prevent kidney cancer, stop smoking, maintain a healthy weight, eat a healthy diet, stay active and avoid exposure to toxic chemicals.
Almost anyone including children and teens can have red blood cells in the urine. Factors according experts that make this more likely include:
Age: Many men older than 50 have occasional hematuria due to an enlarged prostate gland.
Your sex: More than half of all women will have a urinary tract infection at least once in their lives, possibly with some urinary bleeding. Younger men are more likely to have kidney stones or Alport syndrome, a form of hereditary nephritis that can cause blood in the urine.
A recent infection: Kidney inflammation after a viral or bacterial infection (post-infectious glomerulonephritis) is one of the leading causes of visible urinary blood in children.
Family history: You may be more prone to urinary bleeding if you have a family history of kidney disease or kidney stones.
Certain medications: Aspirin, nonsteroidal anti-inflammatory pain relievers and antibiotics such as penicillin are known to increase the risk of urinary bleeding.
Strenuous exercise: Long-distance runners are especially prone to exercise-induced urinary bleeding. In fact, the condition is sometimes called jogger’s hematuria. But anyone who works out strenuously can develop symptoms.