Blood in the urine is referred to as hematuria in more scientific terms. It may be a consequence of serious health problems that may prove life threatening and may also be reported in trivial conditions like after strenuous exercise or with the use of certain drugs. It can be of 2 types, gross hematuria in which frank bleeding is reported in the urine and the other variety is microscopic hematuria that is only visible under compound microscope or with chemical testing of urine. It is important to identify the actual cause of hematuria in order to initiate treatment as early as possible.
There are a number of causes that may lead to appearance of blood in urine. The color, amount, concentration and other factors may help in making the diagnosis. The color of urine usually varies according to the degree of bleeding and may range from red, pink or brown in color. Usually appearance of blood in urine is a painless condition, but at times it may become painful when the blood clot appears in the urine. Hematuria may also develop when we use laxatives like Ex-lax, foods like beetroot, berries and rhubarb etc. If the hematuria is caused by dietary agents or with some drugs, the symptoms may disappear upon the discontinuation of the inciting agents within few days. If it persists consult doctor immediately to identify the underlying cause.
The most common causes of blood in urine are:
It occurs when bacteria enters to the urinary system through urethra and multiply to cause various symptoms like flank pain, increased frequency in urination, pain and burning sensation while urinating. But in elderly the only sign of UTI is microscopic blood in the urine.
It is also called pyelonephritis and develops when bacteria enter the kidney through urethra or blood stream. The signs and symptoms are similar to that of UTI.
Kidney stone results due to precipitation of crystals (like minerals or pigments that are filtered by the kidney). Conditions like dehydration or inborn errors of metabolism may increase the risk of development of stones in the walls of the kidney or bladder. Usually the bleeding is painless; however, if the renal stone have sharp edges, it causes severe pain and bleeding when it passes through the ureter.
Enlargement of the prostate gland (that is mostly reported in the aging males) may increase the pressure on the blood vessels surrounding urinary bladder and urethra resulting in bleeding that may appear in urine. In addition, it may produce symptoms like difficulty in urinating, urgency, increased frequency and hematuria.
Strenuous exercise or activity found to cause hematuria but exact reason behind this is not known. This is commonly found in runners. Theories suggest that excessive physical activity may lead to myoglobin breakdown as a result of remodeling changes in the muscles, leading to red- colored urine.
Platelets are the important component of the blood which plays a major role in blood clotting. Thrombocytopenia is a condition characterized by low of platelet count which may leads to profuse bleeding.
Cancer of kidney, bladder and prostate can cause hematuria in males. In addition, malignant pathologies of female genital tract (cervix or vagina) may also produce bleeding in urine.
Vigorous sexual activity can cause blood in the urine. Usually it subsides within hours if no serious internal injury has occurred.
Inherited diseases like Alport syndrome and Sickle cell anemia (a hemoglobin defect in red blood cells) can also cause hematuria.
Anti -cancer drug cyclophosphamide (Cytoxan), the blood thinner heparin, aspirin, penicillin and laxative Ex-lax can cause hematuria.
The exact cause of hematuria should be identified before starting treatment to prevent further complications.
Test for hematuria include physical examination,urine analysis,imaging studies like x-ray, CT, MRI, and ultrasonography and cystoscopy.
Hematuria may be sign of underlying problem, so it is always advisable to consult a doctor to confirm diagnosis rather than taking self-treatment.
Blood in urine can be caused by various disease conditions. So the treatment depends on the underlying condition.
Before administering the medication causing hematuria health care provider should review the risks and benefits of the drug.
It is not always possible to prevent the hematuria but we can reduce the risk of some of the disease that may lead to blood in urine.