Discovering blood when wiping after urination, medically termed hematuria, means blood is present in the urine. It can be visually apparent, appearing pink, red, or brown, or microscopic and only detectable through laboratory tests. This article explores various reasons for this occurrence, from common issues to those requiring medical evaluation.
Common Reasons for Blood
Minor irritation of the urethral or vaginal area can lead to visible blood when wiping. This can occur from vigorous wiping, especially with dry or rough toilet paper, or from general dryness. Such irritation typically results in a small amount of bright red blood.
Hemorrhoids, swollen veins in the rectum or anus, are another frequent cause. If they bleed, especially after a bowel movement, blood may be noticed when wiping after urination due to proximity. This blood is usually distinct from urine and appears on the toilet paper.
Menstrual spotting or the end of a menstrual period can also be a source of perceived blood. Small amounts of residual menstrual blood might mix with urine or be present on the external genital area when wiping. This is a common occurrence for individuals who menstruate.
Urinary Tract Infections (UTIs) are a common cause of blood in urine, particularly in women. Bacteria entering the urethra and ascending into the bladder can cause inflammation, leading to visible blood. Other symptoms include a burning sensation during urination, frequent urges, and cloudy or foul-smelling urine. UTIs are more common in women due to their shorter urethra, which provides bacteria easier access to the bladder.
Less Frequent Causes
Kidney stones can cause blood to appear in the urine as they move through the urinary tract, irritating the lining of the kidneys or ureters. This irritation can lead to visible blood and intense pain, often described as severe cramping.
Severe bladder infections, or infections that have spread to the kidneys (pyelonephritis), can cause more significant bleeding. These infections often present with systemic symptoms like fever, chills, and back or flank pain.
Certain Sexually Transmitted Infections (STIs), such as chlamydia and gonorrhea, can cause inflammation and bleeding in the genital or urinary tract. These infections might present with symptoms like unusual discharge, pain during urination, or abnormal vaginal bleeding.
Some medications can increase the likelihood of bleeding in the urinary tract. Blood thinners, such as anticoagulants and antiplatelet drugs, can make the urinary system more prone to bleeding. Other medications, including certain antibiotics and chemotherapy drugs, have also been linked to blood in the urine.
In rare instances, more serious underlying conditions, such as bladder or kidney cancer, can cause blood in the urine. This possibility underscores the importance of medical evaluation for persistent or unexplained bleeding.
When to Consult a Doctor
Seeking medical attention is important whenever blood is noticed when wiping after peeing, even if the amount is small or it appears to resolve. Any visible blood in the urine warrants evaluation.
It is important to consult a doctor if bleeding is heavy or persistent, or if it is accompanied by other symptoms. These include pain in the lower back or abdomen, fever, chills, or difficulty urinating. Recurrent episodes, or any instance of blood in urine during pregnancy, in children, or in men, should also prompt a medical visit.
Consult a doctor if blood clots are present in the urine or if there is an inability to urinate. Blood in the urine should not be ignored, even if it seems to go away, as it can sometimes be the only symptom of a serious condition.
What to Expect at the Doctor’s Office
Your doctor will discuss your symptoms and medical history. This includes questions about the blood’s appearance, when it occurs, and any associated symptoms. They will also inquire about your overall health, medications, and relevant family history.
Diagnostic tests typically involve a urine analysis, where your urine is examined for blood cells, signs of infection, or other abnormalities. A urine culture may also be performed to identify specific bacteria if an infection is suspected. Blood tests might be ordered to assess kidney function or look for other systemic issues.
Depending on initial findings and risk factors, further investigations may be recommended. Imaging tests, such as an ultrasound or CT scan of the kidneys and bladder, can provide detailed views of the urinary tract. In some cases, a cystoscopy may be performed, involving a thin tube with a camera to visualize the bladder and urethra. Treatment will be tailored to the specific diagnosis, ranging from antibiotics for infections to other interventions as needed.