Discovering blood in your urine, clinically known as hematuria, can be alarming. While in many instances, the cause might be benign, it’s crucial to understand that blood in urine can also indicate a more serious underlying health issue.
If you can visibly see blood in your urine, this is termed gross hematuria. Conversely, microscopic hematuria refers to blood that is not visible to the naked eye and can only be detected under a microscope during a urine test. Regardless of whether it’s gross or microscopic, identifying the reason for the presence of blood is essential for your health.
Treatment for hematuria is directly dependent on the underlying cause.
Symptoms of Hematuria
The appearance of blood in urine can vary, ranging from a pink or red hue to a darker, cola-colored appearance. This color change is due to the presence of red blood cells. It’s important to note that even a small amount of blood can significantly alter the color of urine.
Often, hematuria is painless. However, if blood clots are passed in the urine, it can cause discomfort or pain.
When to Seek Medical Advice
It is imperative to consult a healthcare provider any time you notice what appears to be blood in your urine.
It’s worth noting that red urine isn’t always indicative of blood. Certain medications, such as phenazopyridine used to alleviate urinary tract symptoms, can cause urine to turn red. Similarly, consuming foods like beets and rhubarb can also result in a reddish urine color.
Differentiating between blood and other causes of urine color change can be challenging. Therefore, seeking professional medical evaluation is always the safest course of action.
Causes of Blood in Urine
### Female urinary systemFemale urinary system diagram with kidneys, ureters, bladder, and urethra labeled
The urinary system, comprising the kidneys, ureters, bladder, and urethra, is responsible for removing waste from the body through urine. The kidneys, situated in the upper abdominal area towards the back, filter waste and excess fluid from the blood to produce urine. Urine then travels from the kidneys to the bladder via narrow tubes called ureters. The bladder stores urine until urination occurs, at which point urine exits the body through the urethra.
### Male urinary systemDiagram of the male urinary system showing kidneys, ureters, bladder, and urethra
Hematuria occurs when the kidneys or other parts of the urinary tract permit blood cells to leak into the urine. Several conditions can lead to this leakage, including:
- Urinary Tract Infections (UTIs): UTIs are a common cause, arising when bacteria enter the urethra and multiply in the bladder. These infections can cause bleeding, leading to pink, red, or brown urine. Symptoms often include a persistent urge to urinate, pain or burning during urination, and strong-smelling urine.
- Kidney Infections (Pyelonephritis): This type of UTI occurs when bacteria travel to the kidneys from the bloodstream or move up from the bladder through the ureters. Kidney infections share similar urinary symptoms with other UTIs but are more likely to cause fever and pain in the back, side, or groin.
- Bladder or Kidney Stones: Mineral crystals in urine can solidify into stones on the kidney or bladder walls. These stones can cause significant pain if they obstruct urine flow or pass through the urinary tract. They can also cause both visible and microscopic hematuria.
- Enlarged Prostate: The prostate gland, located beneath the bladder and surrounding the urethra, often enlarges with age. This enlargement can compress the urethra, obstructing urine flow and potentially causing blood in the urine. Symptoms may include difficulty urinating, urgency, and hematuria. Prostatitis, or prostate infection, can present similar symptoms.
- Kidney Disease (Glomerulonephritis): Microscopic hematuria is a common sign of glomerulonephritis, a kidney disease where the kidney’s filters (glomeruli) become inflamed. This condition can be associated with systemic diseases like diabetes or occur independently.
- Cancer: Gross hematuria can be a symptom of advanced kidney, bladder, or prostate cancer. These cancers may not exhibit noticeable symptoms in their early, more treatable stages.
- Inherited Diseases: Sickle cell anemia, a genetic condition affecting red blood cells, and Alport syndrome, which damages kidney blood vessels, can both cause hematuria, either visible or microscopic.
- Kidney Injury: Trauma to the kidneys from accidents or sports injuries can result in blood in the urine.
- Medications: Certain drugs, such as cyclophosphamide and penicillin, and anticoagulants like aspirin and heparin, are associated with hematuria.
- Strenuous Exercise: Intense physical activity, particularly contact sports and long-distance running, can cause blood in the urine. This may be due to bladder trauma or other exercise-related factors. Exercise-induced hematuria usually resolves within a week. However, it’s crucial to consult a doctor to rule out other causes.
In many cases, the exact cause of hematuria remains undetermined.
Risk Factors for Hematuria
While anyone can experience blood in their urine, certain factors increase the risk:
- Age: Middle-aged and older men are at higher risk due to the increased prevalence of enlarged prostate. The risk of cancers associated with hematuria also increases after age 50.
- Urinary Tract Infections (UTIs): UTIs are a leading cause of visible hematuria in children.
- Family History: A family history of kidney disease elevates the risk of hematuria.
- Certain Medications: Pain relievers, blood thinners, and some antibiotics can increase the risk.
- Strenuous Exercise: High-impact activities and endurance sports are known risk factors.
It’s important to remember that the presence of blood in your urine, regardless of visibility or pain, warrants a medical evaluation to determine the underlying cause and ensure appropriate management.
