Dr Maxwell Adeyemi

Hematuria, meaning blood in urine can be alarming. While in many instances the cause is harmless, blood in urine can indicate a serious disorder.

Blood that you can see is called gross hematuria. Urinary blood that's visible only under a microscope (microscopic hematuria) is found when you test your urine. Either way, it's important to determine the reason for the bleeding.

Symptoms

Gross hematuria produces pink, red or cola-coloured urine owing to the presence of red blood cells. It takes little blood to produce red urine, and the bleeding usually isn't painful. Passing blood clots in your urine, however, can be painful.

Bloody urine often occurs without other signs or symptoms.

Some medications, such as the laxative Ex-lax, and certain foods, including beets, and berries, can cause your urine to turn red. A change in urine color caused by drugs, food or exercise might go away within a few days.

Causes

In hematuria, your kidneys or other parts of your urinary tract allow blood cells to leak into urine. Various problems can cause this leakage, including:

•

Urinary tract infections. These occur when bacteria enter your body through the urethra and multiply in your bladder. Symptoms can include a persistent urge to urinate, pain and burning with urination, and extremely strong-smelling urine. For some people, especially older adults, the only sign of illness might be microscopic blood in the urine.

•

Kidney infections (pyelonephritis). These can occur when bacteria enter the kidneys from the bloodstream or move from the bladder to the kidney(s). Signs and symptoms are often similar to bladder infections, though kidney infections are more likely to cause a fever and flank pain.

• A bladder or kidney stone. The minerals in concentrated urine sometimes form crystals on the walls of the kidneys or bladder. Over time, the crystals can become small, hard stones.

The stones are generally painless, but kidney stones, especially, can cause excruciating pain. Bladder or kidney stones can also cause both gross and microscopic bleeding.

•

Enlarged prostate. The prostate gland – which is just below the bladder and surrounding the top part of the urethra – often enlarges as men approach middle age. It then compresses the urethra, partially blocking urine flow. Signs and symptoms of an enlarged prostate (benign prostatic hyperplasia, or BPH) include difficulty urinating, an urgent or persistent need to urinate, and either visible or microscopic blood in the urine. Infection of the prostate (prostatitis) can cause the same signs and symptoms.

•

Kidney disease. Microscopic urinary bleeding is a common symptom of glomerulonephritis, an inflammation of the kidneys' filtering system. Glomerulonephritis may be part of a systemic disease, such as diabetes, or it can occur on its own. Viral or streptococcus infections, blood vessel diseases (vasculitis), and immune problems such as IgA nephropathy, which affects the small capillaries that filter blood in the kidneys (glomeruli), can trigger