Q: I have been having blood in my urine this week. What are the possible causes?
A: Blood in the urine is medically referred to as hematuria. There are two types – that which is visible to the naked eye such as in a toilet bowl or on tissue referred to as gross hematuria and that which isn’t visible and can only be detected by examination under a microscope. The microscopic form may not present with any symptoms, while gross hematuria will reveal abnormally colored urine – pink, brown, or red because of the presence of red blood cells. Before panic sets in, ask yourself if you recently consumed beets, blackberries or rhubarb or if you used a laxative containing senna, or the antibiotic Rifampin, all of which can color your urine.
Causes of blood in the urine can result from taking aspirin, infection of the urinary tract), inflammation of the kidney/ bladder/or prostate (in men), a clotting disorder, polycystic kidney disease, performing strenuous exercise, cancer, and more. Infection occurs when bacteria enter the body through the urethra. Symptoms can include pain, burning and a strong urge to urinate plus urine that has a strong odor. Kidney infection occurs when bacteria enter the kidneys from the bloodstream or move from the ureters to the kidneys. Symptoms resemble those of having a bladder infection and may include flank pain and fever. Bladder infections and stones are crystals on the walls of the kidney that may present with extreme pain. An enlarged prostate can place pressure on the urethra and block the flow of urine. Problems urinating and an annoying urge to urinate are common. Clotting disorders such as sickle cell anemia will cause both visible and microscopic hematuria. Polycystic kidney disease is an inherited disorder that can cause cysts to develop in the liver and other areas of the body. Hypertension and kidney failure are common. On the upside, some of the complications are preventable with medication and changes in lifestyle.
Diagnosis is accomplished through testing of urine collected in a sterile manner, blood analysis that may reveal the presence of high levels of creatinine (a waste product from normal muscle breakdown), kidney biopsy with examination under a microscope, cystoscopy that allows a physician to examine the inside of the bladder and urethra, or even a CT or MRI. Despite the various tests available, there are instances in which the true cause simply isn’t found and a physician or urologist may consider a course of antibiotics or other means to reduce or eliminate symptoms.
If you cannot readily pinpoint recent trauma, a period of stressful exercise or another possible cause, I recommend you make an appointment with your primary care physician who may, in turn, refer you to a urologist to help get to the underlying cause of your hematuria. In the interim, drink more fluids, add 100% cranberry juice to your daily regimen, wipe from front to back during voiding, reduce your salt intake, eat less spinach, and be sure to follow-up with a health care professional if the situation continues.
Other readers who are interested in learning more can order Dr. Gott’s Health Report “Kidney Disorders” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.
