Blood in urine (haematuria)Peshab mein khoon (haematuria)

Peshab mein khoon kya hai

Peshab mein khoon ko haematuria kehte hain. Kabhi khoon nazar aata hai: peshab gulabi, laal, bhura, ya chai ya cola ke rang ka lagta hai. Kabhi khoon itna kam hota hai ke nazar nahi aata aur kisi aur wajah se kiye gaye peshab ke test mein pakra jata hai. Dono qisam ahem hain.

Yeh aik baar aa kar ruk sakta hai, aata jata reh sakta hai, ya musalsal rehta hai. Is mein dard ho bhi sakta hai aur nahi bhi. Har soorat mein yeh normal nahi, aur is ki wajah maloom karna zaroori hai.

Har laal peshab khoon nahi hota. Chukandar, kuch khaane aur rang, kuch dawaiyan, aur paani kam peena peshab ka rang badal sakte hain, aur kisi aur jagah ka khoon, maslan mahwari ya pakhane ki nali ka khoon, peshab mein mil sakta hai. Sirf peshab ka test hi bata sakta hai, is liye meherbani karke khud faisla na karein.

Meherbani karke is ka ilaaj jari bootiyon ya desi nuskhon se, ya bohat zyada paani peene se khud karne ki koshish na karein. Yeh wajah maloom nahi karte, aur us jaanch mein der ho sakti hai jo asal mein ahem hai.

Aam wajohat

Khoon peshab ke nizam ke kisi bhi hisse se aa sakta hai: kidneys, wo nalian jo kidneys se peshab bladder tak le jati hain (ureters), bladder, aur peshab ki nali (urethra). Mardon mein prostate se bhi aa sakta hai. Aam wajohat yeh hain:

• Peshab ka infection, aksar jalan, baar baar peshab aane ya jaldi peshab aane ke saath (dekhein urine infection guide).
• Pathri kidney, ureter ya bladder mein, aksar dard ke saath (dekhein kidney stones guide aur bladder stones guide).
• Barha hua prostate mardon mein, jahan gland ki satah se khoon aa sakta hai (dekhein enlarged prostate guide).
• Cancer bladder, kidney ya prostate ka. Peshab mein khoon pehli nishani ho sakta hai, aur kabhi kabhi wahid nishani (dekhein bladder cancer, kidney cancer aur prostate cancer guides).
• Chot, haal hi ka operation ya procedure, ya catheter.
• Kidney ki bimari, jis mein kidney ke chhote filters se khoon leak hota hai. Yeh aam tor par khoon aur peshab ke tests se pakri jati hai, aur soojan ya high blood pressure ke saath ho sakti hai.
• Khoon patla karne wali dawaiyan ya khoon behne ki koi bimari. In se khoon behna aasaan ho sakta hai, lekin yeh akeli is ki wajah nahi batatin. Phir bhi jaanch zaroori hai.

Kuch logon mein mukammal tests ke baad bhi koi wajah nahi milti. Yeh nateeja sirf tab tasalli-bakhsh hai jab tests ho chuke hon, aur kuch logon ko follow-up ke liye dobara bulaya jata hai.

Aik wajah mil jana, maslan infection ya pathri, ka matlab hamesha yeh nahi ke wahi akeli wajah hai. Isi liye urologists aksar bladder ke andar camera se dekhne ka mashwara dete hain, chahe scan par koi mumkina wajah nazar aa jaye.

Dard ke baghair khoon kyun sab se zyada ahem hai

Bladder aur kidney ke cancer shuru mein aam tor par dard nahi dete, is liye dard ke baghair khoon wo soorat hai jo sab se zyada cancer se jura hota hai. Infection ya pathri ka khoon zyada tar dard ya jalan ke saath aata hai. Lekin dard ka hona cancer ko radd nahi karta, aur dard ka na hona khoon ko be-zarar nahi banata.

Khoon aksar khud ruk jata hai. Yeh jhoothi tasalli ho sakti hai: wajah abhi bhi mojood hoti hai aur khoon haftaon ya mahinon baad dobara aa sakta hai. Meherbani karke doosri baar ka intezar na karein. Nazar aane wale khoon ka aik episode bhi kaafi wajah hai.

Seedhi baat yeh hai: peshab mein khoon wale bohat se logon ko cancer nahi hota, lekin cancer wo wajah hai jo chhootni nahi chahiye, aur jaldi pakray jane wale cancer ka ilaaj aasaan hota hai. Maloom karne ka sirf aik tareeqa hai: jaanch.

Agar aap kisi bhi shakal mein tambaaku istemal karte hain to meherbani karke khud ko qasoorwar na thehrayen. Tamam tambaaku chhor dena aap ke bladder aur kidneys ke liye sab se mufeed kaamon mein se hai, aur chhorne mein kabhi der nahi hoti.

Jaanch aam tor par kaise hoti hai

Aap ke doctor poochhenge ke khoon kab aata hai (peshab ke shuru mein, aakhir mein, ya poore dauran), kya lothray, dard, jalan, bukhar ya wazan ki kami hai, aap kaun si dawaiyan lete hain, kya aap tambaaku istemal karte hain, aur aap ke kaam aur khandaan ki history. Phir muaina karenge. Aam tests yeh hain:

• Peshab ka test aur culture, khoon ki tasdeeq aur infection dekhne ke liye.
• Khoon ke tests, yeh dekhne ke liye ke kidneys kitni theek kaam kar rahi hain aur khoon ki kami (anaemia) to nahi.
• Kidneys aur bladder ka ultrasound: pathri, soojan aur gilti dekhne ke liye dard ke baghair pehli nazar.
• Peshab ke nizam ka CT scan: kidneys aur nalion ki tafseeli tasaweer, aksar dye ke injection ke saath. Aap ki team dekhegi ke yeh aap ke liye mehfooz hai.
• Flexible cystoscopy: patla, mudne wala camera peshab ki nali se bladder tak jata hai taake bladder ki andar ki parat dekhi ja sake. Aam tor par jaagte hue hoti hai aur sirf chand minute leti hai.

Aksar aik se zyada tests ki zaroorat hoti hai, kyunke har test aik alag hisse ko dekhta hai. Normal ultrasound tasalli-bakhsh hai, lekin yeh bladder ki poori andar ki parat nahi dikha sakta, is liye phir bhi camera se dekhne ka mashwara ho sakta hai. Kaun se tests dastiyab hain, yeh is par munhasir hai ke aap ka ilaaj kahan ho raha hai, aur aap ke urologist batayenge ke aap ke liye kya behtar hai.

Ab kya karein

• Jitni jaldi ho sake urologist ko dikhayein, ya aise doctor ko jo aap ko refer kar sake, chahe khoon ruk chuka ho.
• Apne kaghazat saath le jayein: pehle ke peshab ke reports, scans aur khoon ke tests, aur har dawai ki list jo aap lete hain, jis mein khoon patla karne wali aur jari booti wali cheezein bhi shamil hain.
• Chand notes bana lein: khoon kab nazar aata hai (shuru, aakhir ya poore dauran), lothray ya dard hai ya nahi, aur kitni baar hota hai. Peshab ki phone se li hui tasveer doctor ki madad kar sakti hai.
• Likhi hui dawaiyan band na karein us doctor se poochhe baghair jis ne likhi hain.
• Aam tarah paani peeyein. Zabardasti bohat zyada paani peena wajah ka ilaaj nahi karta.
• Tamam tambaaku chhor dein.
• Tests ke baad poochhein ke nateejon ka kya matlab hai aur kya follow-up chahiye. Yeh bhi poochhein ke agar khoon dobara aaye to kya karein.

Aam sawalaat

What blood in the urine is

Blood in the urine is called haematuria. Sometimes you can see it: the urine looks pink, red, brown, or the colour of tea or cola. Sometimes there is too little to see, and it is found only on a urine test done for another reason. Both kinds matter.

It may happen once and stop, come and go, or stay. It may be painless or painful. Either way it is not normal, and a reason always needs to be found.

Not all red urine is blood. Beetroot, some foods and colourings, some medicines and not drinking enough can change the colour of urine, and blood from somewhere else, for example a period or the back passage, can mix with the urine. A urine test is the only way to tell, so please do not decide for yourself.

Please do not try to treat this yourself with herbal or desi remedies, or by drinking large amounts of fluid. These do not find the cause, and they can delay the check that matters.

Common causes

Blood can come from any part of the urinary system: the kidneys, the tubes that carry urine from the kidneys (the ureters), the bladder, and the urine tube (the urethra). In men it can also come from the prostate. Common causes are:

• Urine infection, often with burning, frequent passing of urine or urgency (see the urine infection guide).
• Stones in the kidney, ureter or bladder, often with pain (see the kidney stones guide and the bladder stones guide).
• Enlarged prostate in men, where the surface of the gland can bleed (see the enlarged prostate guide).
• Cancer of the bladder, kidney or prostate. Blood in the urine can be the first sign, and sometimes the only sign (see the bladder cancer, kidney cancer and prostate cancer guides).
• Injury, a recent operation or procedure, or a catheter.
• Kidney disease, where the tiny filters of the kidney leak blood. This is usually found on blood and urine tests and may come with swelling or high blood pressure.
• Blood-thinning medicines or a bleeding problem. These can make bleeding more likely, but they do not explain it on their own. A check is still needed.

In some people no cause is found even after full tests. That result is only reassuring once the tests are done, and some people are asked to come back for follow-up.

Finding one cause, such as an infection or a stone, does not always mean it is the only one. This is why urologists often advise a camera look inside the bladder even when a scan shows a likely cause.

Why painless blood matters most

Cancers of the bladder and kidney usually do not hurt in the early stages, so painless blood is the pattern most often linked to cancer. Blood from an infection or a stone is more likely to come with pain or burning. But pain does not rule cancer out, and a lack of pain does not make bleeding harmless.

Bleeding often stops by itself. That can be falsely reassuring: the cause is still there and the bleeding can return weeks or months later. Please do not wait for a second episode before seeing a doctor. One episode of visible blood is reason enough.

To be direct: many people with blood in the urine do not have cancer, but cancer is the cause that must not be missed, and cancers found early are easier to treat. The only way to know is to be checked.

If you use any form of tobacco, please do not blame yourself. Stopping all tobacco is one of the most useful things you can do for your bladder and kidneys, and it is never too late to stop.

How it is usually investigated

Your doctor will ask when the blood appears (at the start, at the end or all the way through), whether there are clots, pain, burning, fever or weight loss, which medicines you take, whether you use tobacco, and about your work and family history. Then they will examine you. Usual tests are:

• Urine test and culture, to confirm blood and look for infection.
• Blood tests, to check how well the kidneys are working and whether you are anaemic.
• Ultrasound of the kidneys and bladder: a painless first look for stones, swelling and lumps.
• CT scan of the urinary tract: detailed pictures of the kidneys and the tubes, often with an injection of dye. Your team will check that it is safe for you.
• Flexible cystoscopy: a thin, bendable camera is passed up the urine tube to look at the lining of the bladder. It is usually done awake and takes only a few minutes.

More than one test is often needed, because each looks at a different part. A normal ultrasound is reassuring, but it cannot show the whole lining of the bladder, so a camera look may still be advised. Which tests are available depends on where you are treated, and your urologist will tell you what is best for you.

What to do next

• See a urologist, or a doctor who can refer you, as soon as you can, even if the bleeding has stopped.
• Take your papers: earlier urine reports, scans and blood tests, and a list of every medicine you take, including blood thinners and herbal products.
• Make a few notes: when you see the blood (start, end or throughout), whether there are clots or pain, and how often it happens. A photo of the urine on your phone can help the doctor.
• Do not stop prescribed medicines without asking the doctor who prescribed them.
• Drink normally. Forcing large amounts of water does not treat the cause.
• Stop all tobacco.
• After the tests, ask what the results mean and whether you need follow-up. Ask what to do if the bleeding comes back.

Common questions