Help, there’s blood in my pee!

Although you may not be able to see the blood in your urine, its presence, when detected through a test, should be checked out in case it is a symptom of a serious problem. — AFP

I recently went for a urine test because I had to do a health check-up in order to qualify for insurance coverage. The lab told me I had blood in my urine. Now I am worried. The insurance agent asked me to get it investigated further before they would cover me. Is having blood in my urine ­common?

Blood in your urine is called haematuria (“haema” means blood and “uria” means urine).

It is fairly common, but you may not always notice it because there may not be enough red blood cells to turn your urine red.

When you can actually see your urine turn red, it is called gross haematuria.

You can sometimes see it after you pee in the toilet, and it can turn the toilet water a pale pink or a bright red, depending on how much blood there is.

When you cannot see red in your urine, but it is picked up on a diagnostic test – such as a urine dipstick test – it is called microscopic haematuria.

Apparently, more than one in five people have some blood in their urine.

Microscopic haematuria can affect up to 30% of all people.

It is far commoner than gross haematuria.

The blood in my urine was ­confirmed by a dipstick test. Is that considered microscopic haematuria?

Actually, there is such a term as dipstick haematuria.

It occurs when the dipstick is not stored properly and is exposed to oxygen.

This can cause a colour change unrelated to blood in the urine.

Urine dipstick tests have high false positive rates.

So you may not necessarily have blood in your pee even if the dipstick tells you that you do.

The lab needs to confirm your dipstick diagnosis with a proper microscopic urine analysis.

OK. The lab has now confirmed that I do indeed have blood in my urine. But I don’t have any other symptoms. I don’t, for instance, have any pain when I pee. Should I be worried anyway?

Many times, you can have blood in your urine without any other symptoms; you would be considered asymptomatic.

Some people can have associated symptoms that may point to the cause of the haematuria.

That is why you need to see a doctor after this lab diagnosis.

The associated symptoms can include:

• Frequent urination

  This is usually referred to as “frequency”, which means you are peeing more than usual.

• A strong urge to urinate

  This is termed “urgency”.

  It is a feeling, usually in your bladder area, that you need to pee right now.

  People who have this usually go to the toilet very often, but it doesn’t necessarily mean that you actually need to pee.

• Pain or burning sensation while peeing

  This is known as dysuria.

It is also possible to have other symptoms like fever, abdominal pain, and lower back or flank pain, among others.

Some people might have no other symptoms at all.

It is important to understand that even if you have blood in your urine, it does not mean that you have some sort of health problem.

But it is still important to get it checked out.

What causes blood in the urine?

There are many causes, including:

> Urinary tract stones

These can appear anywhere in your urinary tract, i.e. your bladder, kidney or ureter.

The constant rubbing of these stones on the surfaces of your urinary tract can cause bleeding.

There is sometimes pain if the stone is passing through, especially in your ureter, which is the tract that connects your kidney to your bladder.

But many of these stones may only be noticed when they appear on an X-ray or ultrasound as part of a check-up.

> Urinary tract infections

These can occur in either the kidneys or the bladder.

> Urinary tract cancers

This is the condition most ­people are worried about.

Cancers can appear in any part of the urinary tract.

It’s important for men to note that prostate cancer can also cause haematuria.

> Benign prostatic hypertrophy

This very common condition in older men can also lead to haematuria.

> Menstruation

Some women may confuse having blood in their urine due to this.

That is why urine diagnostic tests are done when you are not menstruating.

> Injuries to your urinary tract

These can be caused by falls, accidents or stabbing wounds, for example.

> Chronic kidney disease

This can be any long-term condition that affects your kidneys – like kidney failure, for example.

I was worried, so I went for a thorough investigation with a doctor. But I have none of the above conditions. Can it be anything else? Or am I ­completely healthy and I just happen to have haematuria?

Yes, you can be completely healthy but still experience ­haematuria.

If you have ruled out all of the diseases above, then it is ­plausible that you may be at higher risk of haematuria due to one of the following factors:

• Age 50 years or above
• Not drinking enough water and being frequently dehydrated
• Smoking
• A family history of conditions that affect the urinary tract
• Certain medications like blood thinners, painkillers (including non-steroidal anti-inflammatory agents, or NSAIDs) and some antibiotics.
• Undetected injuries from ­contact sports like football or boxing
• Long-distance running (this is called exercise haematuria)
• Frequent exposure to metals, fumes, rubber or dyes
• Vigorous sex!

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, ­computers and entertainment. For further information, email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal ­medical advice. Neither The Star nor the author gives any ­warranty on accuracy, ­completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or ­indirectly from reliance on such information.