Blood in the urine (hematuria) - other symptoms, causes, therapies

Visible and invisible blood in the urine

Red-colored urine is often a shock for those affected and should never be taken lightly. Even if there is not always something bad behind it, red urine should always be clarified with a doctor. Although sometimes only the dye in the food fault, for example, as a result of eaten beetroot, and drugs that dilute the blood, for example, can lead to blood in the urine. But it can also be a serious disease behind it. Bloody urine is called in the jargon hematuria. This can have a variety of causes, ranging from a slight mucosal irritation in the genitourinary tract to cancer events.

contents

• Visible and invisible blood in the urine
• Blood in the urine - a short overview
• definition
• How does the blood get into the urine??
• Possible sources of bleeding
• Blood-like residues in the urine
• The kidneys as a cause
• Bladder and urinary tract as the cause
• Only causes occurring in men
• Only in women occurring cause (endometriosis)
• System and autoimmune diseases
• Medication as a cause of bleeding
• Going to the doctor unavoidable
• diagnosis
• therapy
• prevention
• Naturopathy with blood in the urine

Blood in the urine - a short overview

There are numerous causes that can be responsible for a bloody urine. The individual possible causes and further information on diagnosis, therapy, prevention and naturopathy will be explained in more detail below. Here is a short overview:

• definition: The technical term for blood in urine is hematuria. This refers to a morbid excretion of red blood cells (erythrocytes) with the urine.
• to form: Hematuria is further subdivided into macro- and microscopic hematuria. In case of gross hematuria, blood congestion is visible, whereas microhematuria can only be detected by laboratory tests.
• Possible causes: The cause is roughly divided into three areas. Thus, the source of bleeding may be behind the kidney (postrenal), in the kidney (renal) or outside the kidney area (prerenal). Numerous diseases can cause blood in the urine.
• diagnosis: Urine test, blood test, x-ray, cystoscopy, CT, MRI, ultrasound, prostate examination.
• therapy: The treatment depends strongly on the cause. More often antibiotics are used. Some causes also require special diets or diets.
• preventionPhysical exercise, healthy eating, relaxation exercises and stress reduction, do not smoke, drink a little alcohol, reduce excess weight, drink a lot of low-sugar liquid.
• Naturopathy in support: Own blood therapy, homeopathy, phytotherapy, acupuncture, foot reflexology.

definition

Hematuria (blood in the urine) is the pathological secretion of red blood cells (erythrocytes) with urine. Since a small amount of blood can also be found in the urine of healthy people, hematuria does not occur until there are more than five to ten red blood cells per microliter of urine. Bloody urine may or may not be associated with other symptoms such as pain and discomfort when urinating. Depending on the amount of blood contained, the hematuria is classified into macro- and microhematuria.

gross hematuria

In case of gross hematuria, the blood is immediately recognizable, which shocks many patients quite severely. However, even this is not immediately an indication of a specific disease, but must be clarified. Gross hematuria is caused, for example, by:

• Kidney stones,
• Tumors of the urinary tract or kidneys,
• Tuberculosis of the urogenital tract,
• polycystic kidney disease,
• bladder infections,
• haemorrhagic diathesis (increased bleeding tendency),
• Trauma (for example, by catheterization),
• Endometriosis (disease of the endometrium).

Blood in the urine must be checked by a doctor. (Image: angellodeco / fotolia.com)

microhematuria

In a microhematuria, the blood in the urine is not visible to the naked eye, but is detected by a microscopic examination or with the aid of a test strip. This may well be a chance finding, in which the affected do not feel any symptoms. Microhematuria can occur in all the causes of macrohematuria mentioned above and in addition to:

• Pyelonephritis (pyelonephritis),
• Interstitial nephritis (inflammation of the kidneys involving the urinary canals and the surrounding connective tissue),
• mechanical load (or overload),
• Glomerulonephritis (inflammation of the renal corpuscles).

How does the blood get into the urine??

By filtering off the blood, urine is produced in the kidneys. This is concentrated via the ureter to the bladder and discharged from there via the urethra to the outside. This fluid does not normally contain any blood components, but various diseases can cause blood to be released from the urine. However, a reddish discoloration of the urine does not necessarily have to be caused by blood. Some foods, such as beetroot or blueberry, may temporarily leave traces of paint in the urine. In this case, the problem should be solved after a few toilets. Is actually blood in the urine can be based on a sometimes serious illness, which should urgently be clarified by a doctor. Possible causes are explained below.

Possible sources of bleeding

Bloody urine, in the form of so-called coagula (special form of blood clots), sometimes occurs when the source of bleeding is behind the kidney (medically: postrenal). An example of this would be the bladder as a postrenal source. If the cause is in the kidney itself, it is called renal hematuria. Other sources may also be outside the urological-nephrological area. These underlying causes are referred to medically as prerenal hematuria. This is the case with gynecological herpes or with an increased bleeding tendency.

If blood is present in the urine, this is a shock for many people affected. However, the causes are often treatable. Nevertheless, a visit to the doctor should not be postponed. (Image: demphoto / fotolia.com)

Blood-like residues in the urine

Whether there is really blood in the urine can not necessarily be clarified with the naked eye. It may also be, for example, a so-called hemoglobinuria. It is not the erythrocytes (red blood cells) in the urine but hemoglobin (red blood pigment). This may be the case with certain forms of anemia or autoimmune diseases.

March hemoglobinuria

A special form of hemoglobinuria is march hemoglobinuria. This is a condition that primarily affects people who exercise massively. The hemoglobin is literally "squeezed" out of the blood cells and therefore ends up in the urine. Normally, this is harmless, but should be clarified with a doctor.

Porphyria and myoglobinuria

A red-colored urine can also arise in a so-called porphyria. This is a metabolic disorder that interferes with the production of the red blood pigment. A myoglobinuria can also stain the urine red. The myoglobin is the oxygen-binding muscle dye. In case of muscle injuries it can get into the bloodstream and eventually into the urine and give it a reddish color. This is possible, for example, in competitive sports or by the sinking or dying of muscles during a myocardial infarction.

The kidneys as a cause

As mentioned above, renal hematuria is the cause of bleeding in the kidney itself. Some kidney disorders may be responsible for blood in the urine. These include:

• Pyelonephritis,
• Kidney stones,
• nephritis,
• renal tuberculosis,
• Renal vein thrombosis,
• renal infarction,
• polycystic kidney disease,
• Injuries to the kidneys,
• kidney tumors,
• Nierenpapillennekrose.

Not infrequently, kidney diseases are the cause of bloody urine. (Image: benschonewille / fotolia.com)

Pyelonephritis

Kidney pelvic inflammation (medically pyelonephritis) is one of the most common kidney diseases. Most of these are caused by ascending bacteria from the bladder. Symptoms include fever, chills, nausea, vomiting, kidney pain, back pain, flank pain, and hematuria.

Kidney stones

Certain ingredients of the urine may, if too many of them are present, crystallize out and make stones out of them. In addition, other components such as drinking volume and pH of the urine play a role. Bacteria promote the development of kidney stones. The associated symptoms, when acute renal colic occurs, are massive spasmodic pain that can radiate into the back and genital area. There are also dysuria (problems and / or pain when urinating), blood in the urine, nausea and vomiting.

nephritis

In case of nephritis the so-called glomeruli is inflamed. This is a vascular bundle in the renal cortex, which is involved in the blood filtering. Here the first stage of the urine is formed. Renal inflammation is triggered for example by bacterial infections or inflammatory processes due to autoimmune diseases such as lupus nephritis. In addition, allergic reactions may be responsible for inflammation of the urinary tract, including the surrounding tissue. Signs of nephritis are:

• Rising or decreasing urine levels,
• flank pain,
• fatigue,
• a headache,
• body aches,
• high blood pressure.

kidney tumor

A benign kidney tumor is rare. Most of these are determined by chance, because they cause little to no discomfort. Large blood vessel tumors of the kidney, which are at risk of bleeding, are surgically removed. Even the malignant renal cell carcinoma is often symptom-free for those affected for a long time. This unfortunately has the consequence that the tumor is often recognized only at an advanced stage. Classic symptoms include microhemorrhage or gross hematuria, which are initially painless and have kidney or flank pain.

The picture shows the anatomy of the kidneys and the different stages of a kidney tumor. (Image: bilderzwerg / fotolia.com)

renal tuberculosis

Tuberculosis can not only affect the lungs but also affect other organs such as the kidney. This so-called extrapulmonary tuberculosis is spreading not only in the kidney but mostly throughout the genitourinary tract. The sufferers usually do not suffer excessively from the disease. Elevated temperatures (37.1 ° C to 37.9 ° C, temperatures just below the fever limit), dysuria and hematuria are potential symptoms. However, the tuberculosis pathogens can survive even after a healed disease for years in the body and provide for another outbreak.

Renal vein thrombosis

If a blood clot forms in the renal vein that is large enough to obstruct the bloodstream, there is a renal vein thrombosis. Inflammation, diabetes, tumors and injuries can promote the formation of such clots. Not infrequently, renal vein thrombosis remains symptom-free for a long time. Sometimes it can cause pain in the flanks, fever and hematuria.

renal infarction

In renal infarction, a blood clot clogs the renal artery. The affected kidney tissue is underserved and dies. Depending on the extent, this disease is asymptomatic or causes massive pain in the abdomen and flanks, defensive tension, blood in the urine, fever and anuria (the excretion amount of urine is less than 100ml / day). The causes of such an infarction can be of different nature. Often a blood clot dissolves from a blood clot in the heart and is flushed through the bloodstream into the kidney, where it gets stuck and the artery is added. Atherosclerosis (vascular calcification), injuries, surgery or vascular inflammation are considered risk factors.

polycystic kidney disease

A simple cyst in the kidney usually means no problem. In the presence of a so-called cystic kidney, which in contrast to the simple cyst is hereditary, these fluid-filled encapsulated tumors can severely limit the function of the kidneys. The cysts are more numerous and reach diameters of several centimeters. They are common sites of inflammation and increasingly displace healthy kidney tissue. This can lead to complete kidney failure. Cystic kidney causes symptoms such as:

• one-sided or bilateral flank pain,
• hematuria,
• high blood pressure,
• chronic fatigue,
• progressive kidney failure.

Kidney injuries

The effect of blunt force does not necessarily mean that there is blood in the urine. However, kidney traumas are associated with sometimes massive pain, a defense tension and possible shock symptoms.

Kidney and bladder are closely linked, so kidney disease is often noticeable through changes in the urine. (Image: Adiano / fotolia.com)

Nierenpapillennekrose

In the kidneys, the renal medulla is formed by ducts. This is where filtering the urine takes place. The corridors converge in so-called papillae, which in turn end up in the renal pelvis. Inflammation can cause the papillae to die or necrotize. Diabetes mellitus, anemia in the form of sickle cell anemia or even analgesic abuse can lead to the inflammatory processes. In this disease sufferers suffer from pain in the flanks, fever and blood in the urine.

Bladder and urinary tract as the cause

Often, the urinary tract or urinary bladder is the source of bleeding. Various diseases in this area may be responsible for the blood in the urine. These include, for example:

• bladder infections,
• bladder stones,
• ureteral stones,
• diverticulum,
• Bladder schistosomiasis,
• bladder tumors.

bladder infection

A quite common cause is the cystitis (cystitis) or the so-called urinary tract infection. From the intestine, pathogens through the urethra can reach the bladder. Women are affected much more often because the intestine and urethra opening are not far apart and the female urethra is still quite short. Supported is the development of cystitis by drainage disorders, in women by frequent sexual intercourse and also by the laying of a catheter. Other triggers are wetness, cold, menstruation and the hormonal change during menopause.

Symptoms of a urinary tract infection

Symptoms of a urinary tract infection are frequent urinary frequency (pollakiuria), urinary symptoms (dysuria) and constant painful urgency (tenesmus). Also, blood in the urine can be added. If fever and a bad general condition are observed, the upper urinary tract is usually affected.

Bladder and ureteral stones

Bladder stones and ureteral stones can also lead to residues of blood in the urine. The stones are formed by precipitating and crystallizing mineral salts, which are normally dissolved in the urine. The reasons for this are outflow obstacles, such as an enlarged prostate or a too tight urethra. Inflammation additionally promotes the development of bladder or urinary stones. Residual urination and protuberances in the bladder wall and the presence of diabetes mellitus and gout can lead to the formation of urinary and bladder stones. In those affected show hematuria, urinary frequency and so-called urinary stuttering (the urination occurs intermittently).

Bladder and ureteral stones can also be the cause of blood in the urine. (Image: bilderzwerg / fotolia.com)

diverticulum

Bladder diverticula are baggy bulges on the bladder wall or the inner wall of the urethra. These are partly hereditary, but may also be due to a bladder emptying disorder, narrowed urethra or enlarged prostate. The diverticula often causes pain when urinating, increased urination and sometimes to bloody urine.

Bladder schistosomiasis

Bladder schistosomiasis (schistosomiasis) is an infectious disease caused by sucking worms. The Saugwurm larvae are in waters, predominantly in tropical areas. But even in this country, they are occasionally found in swimming lakes. If they get into the human organism, they settle down in the bladder wall. It can cause symptoms such as itchy rash, diarrhea, fever, cough, painful urination and blood in the urine. In addition, growths of the bladder mucosa are possible, from which a so-called precancerosis can develop.

bladder tumors

Whether benign or malignant, in both bladder tumors a painless hematuria is the guiding symptom. The bladder papilloma is a benign tumor associated with a low risk of degeneration. On the other hand, bladder cancer is one of the most common carcinomas of the urinary tract. Men are more concerned than women. In the case of bladder papillomas (benign tumors of the bladder mucosa), those affected may suffer from recurrent bladder infections in addition to hematuria. Blood in the urine and symptoms similar to those in cystitis accompany the bladder carcinoma. Later, flank pain and lymphatic stasis of the lower extremities are added (see Thick Legs).

Only causes occurring in men

The following diseases, which may be responsible for bloody urine, affect the male genital organs and thus can only occur in men. These include, for example:

• Prostate Cancer,
• prostatitis,
• seeds cystitis,
• Prostatavarizenblutung.

A prostate carcinoma often remains undetected for a long time. Often, blood in the urine is the only indication of this malignant tumor. (Image: PATTARAWIT / fotolia.com)

Prostate Cancer

This malignant tumor is difficult to detect, as it develops over a long period of time and those affected are free of symptoms for the time being. Since early detection is very important for successful treatment, men should take early warnings for prostate cancer seriously. Blood in urine is considered an early warning sign of prostate cancer. Furthermore, changes in urination may occur, such as more frequent use of the toilet, a sudden urge to empty the bladder or difficulty in urinating. Later symptoms include blood in the semen, pelvic pain and erectile dysfunction.

Prostate and seminal vesicitis

A so-called prostatitis is a chronic or acute inflammation of the prostate. This happens, for example, when pathogens spread through the urinary tract and thus reach the prostate. Younger men with frequent sexual contacts are considered as a risk group. Fever, urinary symptoms, discharge from the penis and possibly also blood in the urine are signs of prostate infection. As a result of such inflammation, it can also lead to a seminal vascular inflammation, which can come in addition to symptoms such as pain after sex, abdominal pain and blood in the semen.

Prostatavarizenblutung

Varices are varicose veins that can also form from prostate veins if they expand morbidly. Such varices can cause hematuria without further pain or urinary tract discomfort.

Prostate diseases can be responsible for blood in the urine. (Picture: Henrie / fotolia.com)

Only in women occurring cause (endometriosis)

Blood debris can enter the urine in women during a normal menstrual period. When urinating the rule blood is partially detected by the urine flow and washed away, causing the urine may discolor. But there is also a condition that may be responsible for blood in urine, especially in women. In endometriosis, the uterine lining proliferates in places in the body where it should not actually be, such as in the bladder. As a result, it can cause discomfort

• severe and painful menstrual bleeding,
• Blood in the urine,
• Blood on the anus,
• Abdominal pains,
• and intermenstrual bleeding come.

System and autoimmune diseases

In systemic diseases, several organs or body regions are involved in a disease process. In autoimmune diseases, the body is attacked by its own defense mechanisms. Many of these processes are still considered insufficiently understood. Hematuria can occur as a result of many systemic and autoimmune diseases. For example:

• Panarteritis nodosa,
• lupus nephritis,
• Purpura Henoch-Schonlein,
• Granulomatosis with polyangiitis,
• Goodpasture's syndrome.

Panarteritis nodosa

In this rare vascular disease, arteries of various organs, including the surrounding tissue, are inflamed. If the kidneys are affected, it can lead to blood in the urine, high blood pressure and swollen legs.

lupus nephritis

In this autoimmune disease, the body's own defenses attack the skin and several internal organs. Characteristic of the disease are the noticeable rashes on the face. If the kidneys are attacked by this autoimmune disease, it can also cause blood in the urine, swelling, flank pain and changes in urination.

Many autoimmune and systemic diseases such as panarteritis nodosa, lupus nephritis, purpura-schoenlein-enoch, granulomatosis with polyangiitis or the Goodpasture syndrome can be the cause of bloody urine. (Image: Zerbor / fotolia.com)

Purpura Henoch-Schonlein

This vascular disease is characterized by discomfort on many small vessels in different parts of the body. In the course of the disease, the kidneys may also be affected. This can be manifested by blood in the stool, blood in the urine, hypertension and abdominal pain.

Granulomatosis with polyangiitis

Granulomatosis with polyangiitis was formerly known as Wegener's granulomatosis and is one of the inflammatory rheumatic diseases. Initially, the disease is characterized by repeated runny nose, sinusitis, earache, hearing loss, and headache. When kidney tissue changes occur during the course of the disease, edema, hematuria and flank pain are common.

Goodpasture's syndrome

Chronic haematopoietic disease is characteristic of this autoimmune disease, which primarily affects the lungs and kidneys. Blood in the urine, coughing with bloody sputum and shortness of breath are signs of such a syndrome.

Medication as a cause of bleeding

In addition to the diseases described, medicines are also considered as triggers of blood residues in the urine, especially if they are taken in high doses and / or over a long period of time. These include, for example

• anticoagulants,
• Antibiotics such as penicillins, cefalosporins, aminoglycosides or gyrase inhibitors,
• Painkillers like acetaminophen,
• other nonsteroidal anti-inflammatory drugs.

Sickle cell anemia

Sickle cell anemia causes erythrocyte destruction leading to hemolytic anemia. Due to the occlusion of small arteries suffer the sufferers of circulatory disorders with severe pain in multiple areas of the organ. Likewise, a gross hematuria is possible.

The urologist will usually perform a urine test after the patient interview and a physical examination. (Image: Lothar Drechsel / fotolia.com)

Going to the doctor unavoidable

Much of the underlying causes of bloody urine are well treatable. Patients should therefore keep calm and see a doctor if they notice appropriate discoloration. Maybe a specialist in urology will be called in. After a detailed history in which patients report how much the urine is stained and what additional symptoms are present, further research will follow.

diagnosis

After a detailed consultation with the patient, a number of diagnostic options are available to the physician. In most cases, first a physical examination and a urine and possibly a blood test are performed. Other diagnostic options include X-ray, cystoscopy, CT and MRI. Urologists often use ultrasound techniques to examine the kidneys and bladder. In men, the prostate is often examined.

therapy

The particular cause of the bloody urine determines significantly, which therapies are used. The treatments depend on the disease. For example, an antibiotic is often used in cystitis. Patients are advised to drink enough to flush out any pathogens. Special bladder kidney tea blends are suitable here. Sometimes certain diets and diets may be required during or after therapy.

prevention

Kidney diseases can be the cause. Diabetics tend to develop kidney disease. A healthy lifestyle is preventively important here. These include physical exercise, relaxation exercises and a healthy diet. Smoking and alcohol are absolutely counterproductive, both should be avoided. Also, possibly existing overweight or obesity should be reduced.

These preventive measures can help prevent hematuria from occurring. Naturopathic support can also help prevent and cure many underlying diseases. (Photo: prockopenko / fotolia.com / heilpraxis.de)

Drink a lot and regularly

In general, the intake of fluids is important so that any germs do not even settle, but are immediately transported to the outside. Cold in the abdomen and cold feet should be avoided. Both can promote inflammation in the genitourinary tract. If there is a heart condition, the amount of drinking should be discussed with the doctor.

Naturopathy with blood in the urine

A patient with blood in the urine, as already mentioned, necessarily belongs in a doctor's office. However, in uncritical, harmless inflammations in the urinary tract - in addition to conventional medical treatment - naturopathy can promote recovery. Especially if those affected tend to recurrent infections, for example, with the help of naturopathic therapies, the defense can be strengthened. This is the purpose of the self-blood therapy, special diversion methods, classical homeopathy and phytotherapy approaches that strengthen the immune system. In order to strengthen the bladder and kidney, therapies such as acupuncture and foot reflexology are also used in naturopathic practice. Suitable herbs, properly administered, complete the holistic treatment. (sw, vb updated on 04.08.2018)