Frank’s yelling woke us up. He was obviously alarmed to see his urine turn red with streaks of blood. We immediately called our doctor, who scheduled an urgent clinic appointment. We just hope it’s nothing serious .  

Presence of blood in the urine will alarm anyone and raise suspicion of serious health problems. Blood in the urine is described in two ways: microscopic, in which blood is seen only under a microscope, or gross, in which the urine appears visibly red with blood.  

Blood in the urine is caused by a range of medical conditions, from mild to severe, and each episode needs to be evaluated by a doctor.  

What causes blood in urine? 

Typically, blood does not leak into the urine. Some of the conditions that can cause this include:  

1. Urinary tract infections: Urinary tract infections (UTIs) occur when a bug enters the urinary tract. UTIs cause pain on urination, frequent urge to urinate, and strong-smelling urine. The infection can affect the bladder, the kidneys, or both. 
2. Large Prostate: The prostate lies below the bladder in men. In certain conditions, including prostate cancer and benign prostatic hypertrophy (BPH), the prostate enlarges and could damage adjacent blood vessels, causing blood to leak into the urine.  
3. Kidney Disease: Some diseases that affect the whole body such as lupus can affect the kidneys and cause blood to leak into the urine. There are many types of kidney diseases that can also cause bleeding. Examples include cancer and kidney inflammation called nephritis.  
4. Kidney Stones: Kidney stones are a product of crystals forming on the walls of the kidneys or bladder. These crystals may build up to obstruct the flow of urine from the kidneys and damage blood vessels along the urinary tract. Other symptoms of kidney stones include loin pain that may be excruciating or dull.  
5. Medications: If you use blood-thinning medicines, such as heparin or warfarin, you may have bleeding into your urine if the medication causes your blood to become too thin.

How is bloody urine treated?  

The treatment for bloody urine depends on the cause. Your doctor will typically order certain laboratory investigations to identify what may be causing the symptom. Common investigations needed to evaluate bloody urine include: 

Complete blood count 

Urine analysis 

• Urine culture test to look for bugs 

For men older than 40, your doctor may examine the prostate with one gloved finger passed through the anus to evaluate the size and texture of the prostate. Your doctor may also order a PSA blood test to screen for prostate cancer. Imaging investigations such as ultrasound or CT scan can be done to examine the kidneys, bladder, and other internal organs  

Treatment depends on the identified cause. Treatment may include:  

• Antibiotics if kidney infection or UTI is diagnosed 
• Medicines to shrink the prostate or surgery to remove a part or the entire prostate in certain situations.  
• Treatment or surgical removal of kidney stones  

Bloody urine would alarm anyone. While it may not always be caused by a dangerous disease, it is worth seeing your doctor for proper evaluation and treatment.