Most people may think of the presence of kidney stones when they think about red or brown urine. Maybe you’re asking yourself, “Is it a UTI?” or “Is it an emergency?” Maybe you have some other thoughts about why this is happening to you.
One of the most common reasons to see a urologist is the presence of blood in the urine, or hematuria. There are many causes of hematuria. In some cases, hematuria can be the first sign of a more serious condition that is never benign. It’s also possible that hematuria is blood that is only discovered in the lab and is undetectable in the urine (microscopic hematuria).
There are many possible causes of hematuria, including the closed urinary tract system and the renal system and the bladder. Dehydration and vigorous exercise are examples of some benign causes of hematuria. When you decide to not treat hematuria, you have to carefully think about what the possible causes of hematuria are and the potential consequences of your decision.
Hematuria can also be caused by injuries to the closed system of the urinary system that are infected. Such injuries can cause the urine to be colored and cloudy.
Hematuria is understandably concerning to many individuals. Although there are limited instances when hematuria is truly concerning to practitioners, blood is usually present in very small amounts. From a volume perspective, practitioners are not truly concerned when a few red blood cells are present in urine, as urine can be colored for a variety of reasons.
Typically, there is gross hematuria or micro hematuria. The systems that have been proposed to classify hematuria are:
Hematuria Type Gross Hematuria Microscopic Hematuria
Is defined as Blood is colored to the extent that it is visible without any other tests or imaging. Is defined as Blood is only visible when coloring is seen with the aid of other tests.
When a closed system urinary tract injury is infected, it may be easier to assess the injury if the system is able to allow for a color change greater than that of blood. Of all the instances of hematuria, the most common is microscopic hematuria. Most individuals learn that they have hematuria through routine or annual physical examinations.
The most significant obstacle that is encountered with hematuria is that it is almost always discovered incidentally. While hematuria is frequently considered asymptomatic, in instances where the individual is describing pain or burning while urinating, it is appropriate to consider hematuria symptomatic. Additional symptoms should be evaluated when blood is found in the urine.
How Common Is Hematuria?
Hematuria is very common and is very concerning. NIDDK reports that hematuria comprises 20% of all referrals to urology.
Apart from sex, age shows variety in certain conditions. For instance, in men aged 50 and above, blood in urine may be attributed to urinary obstruction arising from enlargement of the prostate. In the women, it may be due to a UTI in the bladder. In children, blood in urine may be attributed to a kidney condition that they may have inherited. Infections, strenuous exercises or even a sportif activity can cause it too.
Strenuous exercise can cause blood in urine too, especially in athletes. Additionally, blood thinners and some antibiotics can cause blood in urine too.
It is also important to note that hematuria is not a disease in itself. It is a sign that further evaluation is required such as a condition in a vehicle for instance. Inherited kidney diseases and urinary infections may explain hematuria.
Main Causes of Blood in Urine
Urinary Tract Infections (UTIs)
A urinary tract infection occurs when infection of bacteria in the bladder irritates it and causes almost an inflating effect in the bladder that causes it to bleed and produces a pink or red urine.
There, in a UTI, are several symptoms. These include:
- •A burning sensation during urination.
- •Persistent urge to urinate.
- •Urine has a foul oder.
- •Pelvic Pain.
- •Fever.
While urinary tract infections may occur in all females and in all, though rare, males, a UTI may be described as a sandpaper effect in the bladder that causes irritation and bleeding.
According to the Mayo Clinic, blood in the urine of women and children is usually due to a UTI.
Blood in the urine due to kidney stones
Kidney Stones and Hematuria
Kidney stones all but guarantee that there will be blood in the urine.
Inflammation in the urinary system may also be caused by the stones and can also lead to bleeding.
Any size of stone may guarantee blood in the urine.
Severe pain may be experienced in the back and may also be felt in the groin.
The pain caused by kidney stones has been compared to the sensation of having broken glass in the urinary tract. Users report that hematuria occurs before the pain in the urinary tract. There are a number of posts on Reddit stating that blood in the urine may be an indicator of a kidney stone.
Bladder Infections
A bladder infection is a type of urinary tract infection that occurs when a person is infected in the bladder. Generally, bladder infections happen to women more than men. This is due to the anatomical arrangement of the female urethra, which is much shorter than the male urethra.
An individual infected in the bladder usually has an increased urge to urinate, an abdomen that is tender and/or painful, cloudy urine, a burning pain during urination, and blood in the urine.
Although bladder infections can resolve on their own, occasionally they can travel to your kidneys and become more serious.
Enlarged Prostate
An enlarged prostate can lead to more severe urinary problems including hematuria. Because the prostate surrounds the urethra, it can obstruct urinary flow.
Men exhibiting these symptoms often experience:
- A weaker urinary stream
- More difficulty starting the urinary stream
- More frequent urination, especially at night
- Urine containing blood
Men can expect the symptoms of an interrupted urinary stream, especially at night around the age of 50. It is therefore crucial to assess an enlarged prostate, including the case of renal or bladder cancer, as it otherwise is not of clinical significance.
Kidney Disease
As kidneys become more aggressive or more diseased, more extensive glomeruli injury becomes irreversible and hematuria becomes more obvious. Symptoms include:
- Swelling of the arms or legs
- High blood pressure
- Increased fatigue
- Urine containing a foam
- Proteinuria
Diabetes may be linked to renal disease and/or hematuria, especially if glomerulonephritis is present, but may also be of a more direct path.
Cancer
Hematuria may be due to malignancy of the bladder, kidney, or urinary tract especially prostate cancer.
It is warranted to evaluate hematuria for possible malignancy among those who are older than 50, especially if they smoke. Hematuria can often be the first and only sign of those diseases.
Exercise-Induced Hematuria
It is not unreasonable to think that a full bladder can be worked against the wall and stretched to decrease blood flow from the kidneys, leaving blood in the bladder.
Normally, hematuria will resolve in 24 to 72 hours. If this does not happen, seek the attention of a medical professional.
Medication Side Effects
There are many drugs that can be the reason why someone may present with hematuria. Anticoagulants, aspirin, penicillin, and cyclophosphamide can affect the color of the urine, leading to a false positive for hematuria, and a medical workup will be necessary.
Besides hematuria, there are many other presentations. It can be a one time event, or as severe as a chronic, painful condition, and may present with fever. It may also present with trace blood, or pink urine.
Blood in Urine Symptoms to Watch For
Some of the other presentations and symptoms that may be seen along with hematuria include:
Red, brown, black, or even pink urine, increased urgency to urinate, and frequent or even decreased urination, as well as painful urination, back pain, chills and/or fever, and even fatigue and abdominal pressure. Also, the presence of urine clots.
With all of the symptoms listed above, it is very important to seek medical attention, especially an emergency room.
What Do Different Urine Colors Indicate?
Light pink urine may be caused by small amounts of blood in urine.
If there is bleeding from body fluids, then there may be bright red urine.
Brownish, or cola colored urine, may suggest a kidney problem, and also may be old blood or oxidized blood in urine.
Red or orange urine may also have blood, and may also be caused by many different substances or food.
The color of urine may be changed by foods such as beets or blackberries and may also make you think you have blood in your urine, which is a false case of hematuria.
Hematuria may be possible due to many different causes:
Also, smoking makes people at risk for developing bladder cancer, and smoky urine may be developing bladder cancer, and if a smoker has hematuria, they may be in a very serious condition.
What are possible ways to diagnose hematuria?
Hematuria may be diagnosed by many different methods including urine or blood testing, and imaging or tests for hematuria, or may even include the doctor changing the order in which procedures are done.
What is the purpose of urinalysis and urine culture?
Urinalysis and urine culture may be used for the identification of hematuria and may be used for the identification of the following:
Red blood cells, Proteins, Crystals, or Bacteria. If urine cultures are done, then it may also be done as a part of an infectious work up, and may guide management through the use of a specific antibiotic.
What are some diagnostic imaging examples?
Some tests or imaging that may be done include, but are not limited to:
Ultrasound, CT, or MRI.
Cystoscopy
Cystoscopy may also be a way of viewing the bladder and the entire urinary tract, and may help identify the cause of bleeding, as well as bladder stones or tumors.
What is the treatment for hematuria?
If the cause of hematuria is unknown, then there may not be a treatment.
Antibiotics
Hematuria may be caused by an infection of the bladder and urinary tract, and may resolve after a course of antibiotics and increased fluid intake.
Pain Management
Increased fluid intake and pain management may help with the passing of small kidney stones. Larger kidney stones may require the following management:
- Surgery
- Laser
- Shock Wave
- Therapy
Lifestyle Management
Given that the formation of kidney stones may recur, the prevention of formation is may be accomplished through the following may decrease the risk of recurrence.
- Increase water intake
- Decrease salt intake
- Quit smoking
- Improve hygiene
- Reduce urinary retention
If the urinary tract is not hydrated, it will remain concentrated and will lead to a urinary tract infection and the formation of stones.
When is Blood in Urine an Emergency?
The following symptoms could mean there is an obstructing stone in the kidney, the beginning of a serious infection, or internal bleeding.
- Inability to pass urine
- Vomiting
- Extreme weakness
- Severe pain
- Large clots
What Causes Blood in Urine?
Blood in urine may be a result of bad habits. Blood in urine may be resolved if these bad habits are replaced with good habits.
Some of the good habits include:
- Drinking adequate amounts of water
- Urinating after intercourse
- Being smoke free
- Controlling infections (if present)
- Keeping sodium in the blood low
More good habits include lower blood pressure and proper sports protective gear.
When you understand how the urinary system works, you may think of it like a river. The easier it flows, the clearer it is, and the less problems there will be. The opposite will be true with infections and inflammation.
Conclusion
Finding blood in urine is unusual and causes both alarm and uncertainty. A more mild version is discovering a urinary tract infection, which is similar but not significantly more serious. Kidney infections, bladder infections, and kidney stones are all problematic as well. The modern world is a blessing in that we are discovering more and more of these issues with urine tests and other analyses. Hematuria is a far more fascinating research question than blood in urine. For all of these reasons, you need to see a doctor to evaluate you — this is probably the only time you ever want to see blood in your urine.
The presence of hematuria is a sign that your body is in trouble, and this sign should never be ignored.
FAQs
What causes blood in urine?
Blood in the urine has many causes, but the most common is a urinary tract infection. Blood in the urine can be from other infections, such as a bladder infection, kidney stones, an enlarged prostate, strenuous activity, and can be caused by some medication.
Is blood in your urine serious?
Blood in your urine should always be taken seriously, and there is never a case in which blood in your urine is an appropriate condition to not go to the doctor. If the blood in the urine is only an isolated event and there are no other symptoms or concerning signs, you may be less worried about it.
What is the cause for blood in your urine?
There are many causes for blood in urine and it is not a rare condition. There may be an infection in the lower urinary tract, an inflammation response or perhaps kidney disease. Rare conditions may be the cause of blood in the urine and there may be a cancer diagnosis. A urine sample is just the tip of the many tests to be answered for your multiple symptoms where blood may be present in the urine.
What are the treatment options when blood is found in the urine?
There is a large spectrum for the treatment of blood in the urine and it entirely depends on the case. A UTI may be the cause for blood in the urine and a common treatment for this case may be antibiotics. A common treatment for kidney stones may yet be another cause for blood in the urine and the treatment entirely depends on that case.
What are some causes that are not medical that can lead to blood in the urine?
Symptoms for blood in the urine may be caused by the formation of kidney stones or dehydration which may irritate the urinary tract. Irritation of the urinary tract may also cause blood to be present in the urine. Blood may also be present in the urine while stones are in the formation. The consumption of water may both help prevent the formation of stones and the symptom for blood in the urine.
Is it common for everyone to feel urinary tract pain during hematuria?
It isn’t. In some instances of bladder cancer or kidney dysfunction, hematuria can be painless if it is only detected microscopically during laboratory analysis.