Sometimes it’s easy to tell the difference between relatively harmless bleeding, like a scratch or a nosebleed, from serious or life-threatening bleeding, such as rapid blood loss after a major injury.
That’s not the case for blood in the urine. It could be the result of an easily treated infection or a temporary consequence of intense exercise — but it also could be a sign of cancer, kidney disease or urinary stones. Or it might not be blood at all.
With such varied causes of blood in the urine, don’t rely on your own knowledge. Your health care team is best equipped to help you determine the source of the blood.
Noticing blood in your urine
When red blood cells get into the urine, it’s known as hematuria. There are many reasons why this can happen.
When you can see blood in your urine, it’s known as gross hematuria. It might look red, pink or brown. Some people say it looks like cola, rust or tea. The appearance of the urine and whether the blood shows up at the start, middle or end of the urine stream are important to note for your healthcare team. Your urine might contain blood clots, which can make urination difficult to start or even painful. When blood can’t be seen but is found with a lab test, it’s known as microscopic hematuria.
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What causes blood in the urine?
Blood in the urine may come from:
- Urinary tract infection (UTI) — Infection typically happens when bacteria enter the urinary tract, through the urethra, and then spread into the bladder or beyond. Kidney infections are a type of UTI known as pyelonephritis.
- Kidney or bladder stones — These stones, known as calculi, are hard deposits that form inside the kidneys or bladder.
- Glomerulonephritis — This type of kidney disease affects the glomeruli, which are tiny, waste-removing blood filters in the kidneys. They become inflamed and allow blood to get into the urine.
- Kidney, bladder or prostate cancers — Kidney and prostate cancers often don’t produce symptoms — like blood in the urine — until later in their course.
- Benign prostatic hyperplasia (BPH) — An enlarged prostate can cause urinary problems and sometimes blood in the urine.
Along with blood in the urine, these conditions also can cause:
- More frequent urination.
- A persistent urge to urinate.
- Cloudy urine.
- Pain or burning during urination.
To determine the cause of your hematuria, your healthcare team will likely perform a thorough history and physical exam, as well as lab tests on a sample of your urine. They may also order tests — often a CT urogram that evaluates the entire urinary system — and a procedure known as a cystoscopy. In a cystoscopy, a health professional threads a narrow tube with a tiny camera into your bladder to check for problems.
In addition to medical conditions, injury to the kidneys from an accident or contact sports may cause blood in the urine. Vigorous or long-distance exercise such as marathon running also can cause blood in the urine. These types of hematuria tend to get better on their own and often do not require treatment.
When it’s not blood in your urine
There are a few reasons your urine may look red or brown that don’t stem from a problem with your urinary system — and may not involve blood at all. These include:
- Menstruation or postmenopausal bleeding — It can be easy to confuse blood coming from the urethra and blood coming from the vagina. Let your healthcare team know if you’re experiencing any postmenopausal bleeding, because this can be a sign of a possible health concern.
- Eating beets or rhubarb — These foods can cause urine to turn red, a phenomenon known as beeturia. Other foods and edible dyes also can change the appearance of urine.
- Medication side effects — Drugs such as the urinary pain medication phenazopyridine (Pyridium), the antibiotic nitrofurantoin (Furadantin, Macrobid) and the antibacterial drug rifampin (Rifadin) can change the color of urine.
Don’t ignore blood in the urine
Though blood in the urine may turn out to be no big deal, it’s not something to ignore. Serious diseases such as bladder cancer may have no symptoms other than blood in the urine. Men are more likely to develop bladder cancer, but women have worse survival rates for this cancer than men. One possible reason may be that women sometimes think blood in the urine is due to another cause, like a UTI or vaginal spotting.
If you see blood in your urine, call your healthcare team. Rest assured that there are many nonserious causes of blood in the urine — and many treatments for more-serious causes.
This article originally appeared in the Mayo Clinic Health Letter.
The post Blood in the urine appeared first on Mayo Clinic Press.
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