What Will a Doctor Ask if you Have Blood in Your Urine?

In the normal course, blood has no reason to appear in the urine, but if that happens, one should not hesitate to seek specialist medical opinion. Blood may appear in urine owing to simple infections in the urinary and genital systems, or it could be a result of some serious ailment that is simmering in the background.

Blood in urine or Hematuria as the doctors call it results due to the presence of RBC, only hemoglobin, betanin (from beet) or Myoglobin cells in the urine. The color of the urine is rendered to pink or a dark reddish hue from the normal straw color. When the blood is visible in the urine it is known as Macroscopic or Gross hematuria.

The symptoms which can further occur with this condition are Painful urination, passing blood clots in urine and Microscopic hematuria (Urine containing microscopic traces of blood). The comprehensive list of causes include –

Common causes –

• Robust exercise regime
• Traumatic event or injury
• UTI (Urinary Tract Infection) due to any bacteria species or E.coli (common)
• Nephrolithiasis (Stone formation in the ureter, bladder or kidneys)
• Cancerous growths in the kidneys, ureter or the bladder

Rare causes include –

• Any kidney ailment
• Urethritis
• Sickle cell anemia
• Alport syndrome
• Schistosomiasis
• Arteriovenous Malformation of the kidney (can be diagnosed with scans like a renal cell carcinoma)
• Alllergens (mostly in children)
• Congenital Defects such as UPJ (Ureter Pelvic Junction obstruction)
• Any previous surgery involving the Urinary tract

Depending on the degree of seriousness marking the symptoms other than blood in urine, you will be referred to an array of specialists. Specialists like Urologists, Urinary Surgeons, Nephrologists (kidney doctors) and Oncologists (cancer doctors) will be eager to pepper you with questions to diagnose your distress. These are some of the questions you may need to prepare yourself for. This is one of the most crucial steps to an in-depth diagnosis and hence ensuring a speedy recovery.

Do you experience any discomfort or pain while urinating?

Common urinary infections cause a burning sensation and irritation while peeing. Fever and pain if any in the abdomen may accompany the bloody discharge.

How frequent is the passage of blood in Urine? Does urine have an odor?

You need to explain whether blood loss in urine is occasional or frequent and whether it is faint or voluminous. You may be required to describe whether the odor is normal or something more pungent. This question is well answered when the patient has already been engaged in tracking the episodes he/she has had. If not then the doctor would recommend you to keep a note of the frequency and character of your urine for a day.

Is the bloody discharge visible at the beginning of urination or at the end?

What the doctor would like to know is whether the discharge is intermittent and broken or continuous and streaming.

Do you notice clots or stones in urine? If yes, can you tell whether they are hard?

Certain genetic disorders disturb the body’s clotting mechanism. Proteins that are essential for clotting and healing wounds may be weakened. This loosens up clots of blood that may be discharged through the urine. The answer to this question will determine the seriousness of the bloody discharge.

Are you being treated for any other ailment? If you are, can you describe the medicines you are taking?

Certain cancer-fighting drugs, and also Aspirin and Heparin are known to lead to loss of blood through the urine. The doctor may have to administer new medicines to counteract the blood thinning tendencies of meds you are already taking.

Are you a smoker, and if you are, do you smoke occasionally or full time?

According to specialists, smoking is considered as one of the most potent risk factors appearing to trigger cancer, particularly cancer of the bladder. A cancerous growth in the kidney, ureter or urinary bladder can assume life-threatening proportions.

Does your job or vocation expose you to toxic chemicals or radiation?

Air, water, and soil pollution push contaminants into our system creating conditions ripe for cancerous growths. The risk is doubled if the factory job exposes one to hazardous agents that are potentially cancerous. Tumors may release toxins that provoke internal bleeding leading to loss of blood through urine.

Have you suffered any abdominal blow or injury, and did you undergo corrective surgery?

Blood in urine is quite common among sportspersons and fitness freaks that overexert their bodies or suffer hidden internal injuries. Sometimes the site of a surgical scar might reopen and create septic and inflammatory conditions. Athletic nephritis is a condition which can be a cause of passing blood in urine in athletes or persons carrying out an extreme workout routine for a long time.

Can you describe your daily dietary pattern? Have you consumed any foods laced with beets or berries?

This is a very simple question that rules out a common error (mistakenly assuming plant pigments to be blood). Vegetables and fruits with high pigmentation sometimes color the urine, and you may be mistaking the rusty brown discoloration for blood. The same holds true of artificially colored junk foods. Usually, this is caused by an excessive consumption of beetroot (which contains Betanin), a pigment which can render the urine red.

Are you a cancer patient, and have you undergone chemotherapy or radiation?

A history of cancer, especially cancer of the bladder predisposes the person to blood loss through urine. This happens because as a side effect of cancer-fighting meds.

How to prepare for such questions?

Do remember to take your medical history and a list of your triggers and symptoms. The doctor may ask you several questions in addition to the aforementioned ones, so it is better to keep an observation copy of your condition beforehand.

To ask questions such as – if the condition is temporary, the exact cause of the issue, the treatment options available and how to manage any underlying issue, is equally important. Any query that pops up in your mind should be put forward during the consultation as the doctor may assure you better than any other source.