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Blood in urine

For the past nine months I have had intermittent bouts of excruciating pain in my left flank associated with visible blood in my urine.  I have had at least five episodes that required trips to the ER or doctor's office.  I've had 3 CTs (the last one was with and without contrast), 2 ultrasounds, and a cystoscopy which have all been negative.  The last two episodes have revealed a UTI with a positive culture for e coli--the other episodes did not show signs of infection.  The only thing the doctors have said is to drink plenty of fluids (I'm drinking at least 5 20 oz bottles of water already).  

Any other suggestions?  Also, is it possible that I could have kidney or bladder stones that do not show up on CT?
3 Responses
Avatar universal
MEDICAL PROFESSIONAL
Hi,

"There are multiple causes of blood in urine. Some are serious, including cancers, trauma, stones, infections, and obstructions of the urinary tract. Others are less important, and may require no treatment. These may include viral infections, nonspecific inflammations of the kidney, medications which thin the blood's clotting ability, and benign prostate enlargement"
www.medicinenet.com/blood_in_urine/article.htm

Have you noticed at what stage of urination the blood appears in the urine? Does it appear at the beginning, at the end, or is present throughout the time you pass urine?

How old are you?
A UTI can cause blood to appear in the urine as it results in an infection of the bladder or other structures above the bladder.

Flank pain can be associated with renal stones as you are describing it appears in bouts.

It is possible that you pass small stones at intervals which cause a lot of pain as they are passing through the tract, abrade the tract while they are passing through, and cause the bleeding while predisposing you to infection.

Small stones which pass through the tract do not show up on investigation  usually.
An infection with E.Coli can, and needs to, be treated with antibiotics.

Do you have any family history of kidney stones?

In addition to drinking plenty of water, you can do the following:
  Take natural sources of vitamin C, such as citrus juices.
  Try to avoid oxalate rich food.
  Increase your intake of natural sources of  calcium, such as milk and yoghurt.
  If you are female, wipe from front to back while in the restroom.
  
You need to be on antibiotics that the cultured E. Coli is sensitive to. So talk to your physician about it.

Do keep us posted on your doubts and progress.
regards
Avatar universal
Thanks for the info.  I am a 30 year old female, and I do have extensive history of kidney stones in my family (although I don't know what type of stones they were).  I have been straining my urine during these episodes and I've yet to find a stone.  I have had sediment with particles that look like sand along with what looks like skin/tissue fragments.  I haven't noticed at what time the blood appears but I have passed several clots in the urine.

I have been on antibiotics with each of the five episodes that have taken me to the doctor.  On four of five of the episodes, the urine dipstick showed blood only with no WBCs or bacteria.  They were sent for culture anyway and all except the last one came back negative.  I ended up developing a UTI all five times based on repeat dipsticks and continued pain.  That's why I feel like I most have a stone somewhere in the tract that is predisposing me to infections.  The doctor says it's probably not a stone--just infection causing the blood since they haven't seen anything on CT.  However, I feel like something is continuing to cause the infections.

I wipe front to back; I urinate before and after sex; I take showers instead of tub baths; I wear cotton panties; I drink 6-8 glasses of water a day, usually more.  However I used to drink 5-6 diet sodas a day and 3-4 cups of coffee with 1-2 glasses of water.  I've stopped doing that for well over six months and I've continued to have problems.  I will try the other suggestions you mentioned.  I am also seeing a urologist next week who wants to perform a urodynamics study.
Avatar universal
MEDICAL PROFESSIONAL
Hi,

The sediment that appears like sand could be tiny stones from the kidney.
The stage of urination at which blood appears is indicative of the part of the urinary tract that is injured. So it would help if you noticed it.

The shape of the clots - long and thin, or round - would also indicate which area of the tract the bleeding is from.

If you have been pregnant or lactating and have not been taking significant amounts of calcium in your diet (1000 mg), that would aggravate the problem.

Oxalate-rich foods have been known to cause calcium oxalate stones in individuals predisposed to developing renal stones, so it would be a good idea to avoid them.

The infection and stone formation forms a vicious cycle which only good management and appropriate diet can resolve. So you need to continue the present lifestyle changes you have made, while making a few more.

Do keep us posted on your doubts and progress.
regards
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