Blood in urine (often described by many as peeing blood) is medically known as hematuria. It is a situation that could really seem alarming but shouldn’t be. It’s not usually a life-threatening occurrence.
However, blood in urine can still be a sign of serious medical condition. This makes it important to seek medical attention for evaluation purposes. Hematuria is a symptom and not a particular disease. Therefore, the treatment of blood in urine is geared towards the underlying cause.
Blood in urine may originate from the kidneys and other parts of the urinary tract. The blood may appear bright red or brown in color. It can also be in very small amounts not visible to the naked eye. Visible hematuria is called ‘macroscopic’ while hematuria only detectable with laboratory testing is called ‘microscopic’.
Causes of Blood in Urine (Peeing Blood)
The most common causes of blood in urine (peeing blood) are detailed below. For confirmation and ruling out of potential causes, consult a doctor.
1. Urinary Tract Infection (UTI)
It is a common cause of microscopic hematuria. Infection in the urine either stems from the bladder or kidneys considering that the urine should be normally sterile and does not contain any bacteria. It happens when bacteria enter the body through the urethra and eventually grow in the bladder. In some people, the only indicator is microscopic blood in urine. Other symptoms include pain and burning with urination, persistent urge to urinate and strong urine odor. The usual treatment for urinary tract infections is the use of antibiotics for both simple and complicated stages of the disease.
2. Kidney Infections
It is a medical condition called pyelonephritis where bacteria enter the kidneys coming from the blood stream or the ureter. Symptoms include elevated body temperature and pain in the side of the abdomen (flank pain). The first line of treatment for kidney infections is the use of antibiotics.
- Paula F. Orlandi, Naohiko Fujii, Jason Roy, Hsiang-Yu Chen, L. Lee Hamm, James H. Sondheimer, Jiang He, Michael J. Fischer, Hernan Rincon-Choles, Geetha Krishnan, Raymond Townsend, Tariq Shafi, Chi-yuan Hsu, John W. Kusek, John T. Daugirdas, & Harold I. Feldman. (2018). Hematuria as a risk factor for progression of chronic kidney disease and death: findings from the Chronic Renal Insufficiency Cohort (CRIC) Study.
3. Bladder or Kidney Stones
It is another common reason behind blood in urine where crystals form from urine minerals. This usually develop on the walls of the bladder or kidneys. The stones can become hard with time. It may be a condition that is particularly painless but could lead to blocking of tubes (due to large stones) that comes from the kidneys which could cause severe abdominal pain. Abrasion and irritation of the urinary tract leads to the presence of blood in urine. Management for the development small kidney stones may basically involve the use of pain relievers, drinking of water and medical therapy with alpha blocker.
4. Kidney Disease
Kidney disease and inflammation can lead to blood in urine or peeing blood. It can be a disease that develops on its own or secondary to another underlying disease. Glomerulonephritis which causes the inflammation of kidney’s filtering system can be the reason behind microscopic blood in urine. The medical condition can be initiated by bacterial or viral infections, immune problems, blood vessel diseases, affecting the small capillaries filtering blood in the kidneys (glomeruli). Large stones may need surgery, use of scopes, or sound waves.
5. Enlarged Prostate
A common occurrence in older males but is not associated with prostate cancer. The prostate is located beneath the bladder and close to the urethra. The enlargement of the prostate gland can cause pressure against the bladder which could lead to difficulty and frequency of urination. When it compresses the urethra, it can lead to the blocking of urine flow and the display of blood in urine. The three main treatment options for enlarged prostate includes medication, lifestyle changes and surgery.
6. Inherited Disorders
There are hereditary disorders that can also cause blood in urine. Sickle cell anemia is a hereditary disease that affects the hemoglobin in red blood cells. The presence of blood in urine can either be macroscopic or microscopic. Medications involved in the treatment of sickle cell anemia includes pain relievers, antibiotics and hydroxyurea. Another medical condition is the Alport syndrome affecting the filtering membranes in the glomeruli of kidneys. The goals of treatment for Alport syndrome is the control of the disease and its symptoms.
7. Kidney, Bladder or Prostate Cancer
The development of cancer of the kidney, bladder or prostate can also display the presence of blood in urine (peeing blood). However, it is an occurrence that usually only takes place at an advanced stage. Treatment may include surgery, targeted therapy, radiation therapy, immunotherapy and chemotherapy.
Kidney cancer is usually observed in people aged 50 and above. The medical condition can lead to the formation of a lump in the affected site and persistent pain below the ribs.
Bladder cancer also usually affects individuals aged 50 and above. Symptoms include frequent but with a feeling of more need to urinate. Pain during urination can be present.
Prostate cancer is a medical condition in men which is another form of cancer common in aged 50 and above. Progress of the condition is usually slow. Symptoms include frequent and urgent need to urinate and difficulty of bladder emptying.
8. Kidney Injury
Trauma to the kidneys is another obvious possible cause for blood in urine or peeing urine. Injury to the kidneys can either be due to accident or contact sports that can eventually result to the impairment in renal function.
- Federico Coccolini, Ernest E. Moore, Yoram Kluger, Walter Biffl, Ari Leppaniemi, Yosuke Matsumura, Fernando Kim, Andrew B. Peitzman, Gustavo P. Fraga, Massimo Sartelli, Luca Ansaloni, Goran Augustin, Andrew Kirkpatrick, Fikri Abu-Zidan, Imitiaz Wani, Dieter Weber, Emmanouil Pikoulis, Martha Larrea, Catherine Arvieux, Vassil Manchev, Viktor Reva, Raul Coimbra, Vladimir Khokha, Alain Chichom Mefire, Carlos Ordonez, Massimo Chiarugi, Fernando Machado, Boris Sakakushev, Junichi Matsumoto, Ron Maier, Isidoro di Carlo, & Fausto Catena (2019). Kidney and uro-trauma: WSES-AAST guidelines.
There are particular medications that can also cause blood in urine. Some of these include blood thinners like warfarin and heparin, penicillin, cyclophosphamide and aspirin. The typical description for intake of anticoagulants as the causative factor for blood in urine is mainly being visible or macroscopic.
10. Strenuous Exercise
Strenuous exercise can also cause blood in urine. It’s a rare occurrence that happens usually due to trauma to the bladder or breakdown of red blood cells that can happen with persistent aerobic exercise. Many cases of athletes display macroscopic blood in urine after an intense workout. It’s been a known occurrence with runners.
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