Blood in Urine After Bowel Movement: Causes and Concerns

Q: Blood in Urine After Bowel Movement: Causes and Concerns

Hello： The bladder and prostate must be thoroughly examined. <br>Generally, it is important to check if the patient is taking anticoagulants. <br>2) If the ultrasound is normal, the physician may consider a cystoscopy. <br>3) Most likely, the bleeding is due to vascular exertion,

Hematuria after bowel movements?

In the early morning, I first urinate, then after about ten minutes, I have a bowel movement.
Recently, while sitting on the toilet after defecating, I noticed that the first small amount of urine was reddish-brown, followed by normal-colored urine.
Since this only occurs after a bowel movement, I feel quite anxious.
Three years ago, I had a similar situation, and at that time, the doctor conducted urine tests, ultrasound, PSA tests, and bacterial cultures, and treated me with antibiotics.
I would like to ask the doctor: 1.
Given that I urinate before having a bowel movement, where could the blood possibly be coming from? 2.
What tests should I undergo? 3.
What diseases could this indicate? Thank you, doctor!

Sakamura, 50~59 year old female. Ask Date: 2020/04/04

Dr. Du Shixi reply Urology

Hello: The bladder and prostate must be thoroughly examined.
Generally, it is important to check if the patient is taking anticoagulants.
2) If the ultrasound is normal, the physician may consider a cystoscopy.
3) Most likely, the bleeding is due to vascular exertion, but tumors cannot be ruled out (for individuals over 50 years old, visible hematuria must be taken seriously and a thorough examination is recommended at a major hospital's urology department).
Wishing you good health.

Reply Date: 2020/04/04

More Info

Blood in urine after bowel movement can be concerning, and it’s important to understand the potential causes and necessary steps to address this issue. Based on your description, it seems that you are experiencing a situation where the first part of your urine is reddish-brown after having a bowel movement, which then normalizes. This pattern raises several questions regarding the source of the blood, the appropriate diagnostic tests, and potential underlying conditions.

1. Source of the Blood: Given that you are experiencing blood in your urine specifically after a bowel movement, it is essential to consider the anatomical proximity of the urinary and gastrointestinal tracts. The blood could potentially originate from several sources:
- Urinary Tract: This includes the kidneys, ureters, bladder, or urethra. Conditions such as urinary tract infections (UTIs), kidney stones, or even tumors can lead to hematuria (blood in urine).

- Gastrointestinal Tract: If there is significant straining during bowel movements, it could lead to rectal bleeding or hemorrhoids, which might mix with urine if there is any backflow or if the blood is present in the perineal area.

- Prostate: In males, issues related to the prostate, such as prostatitis or benign prostatic hyperplasia (BPH), can also lead to blood in the urine.

2. Recommended Tests: To determine the cause of the hematuria, several diagnostic tests may be necessary:
- Urinalysis: This will help identify the presence of blood, protein, or signs of infection in the urine.

- Urine Culture: If a UTI is suspected, a culture can help identify the specific bacteria causing the infection.

- Ultrasound or CT Scan: Imaging studies can help visualize the kidneys, bladder, and surrounding structures to identify stones, tumors, or other abnormalities.

- Cystoscopy: This procedure allows direct visualization of the bladder and urethra, which can help identify any lesions or sources of bleeding.

3. Potential Conditions: The presence of blood in urine can be associated with various conditions, including:
- Urinary Tract Infections: Commonly cause hematuria, especially if accompanied by other symptoms like burning during urination or frequent urination.

- Kidney Stones: These can cause bleeding as they irritate the lining of the urinary tract.

- Prostate Issues: In men, conditions affecting the prostate can lead to blood in the urine.

- Bladder or Kidney Tumors: Though less common, tumors can cause hematuria and should be ruled out, especially if there are risk factors present.

Given your history of similar symptoms three years ago, it is advisable to consult a healthcare professional for a thorough evaluation. Since you have previously undergone tests like urinalysis, ultrasound, and PSA testing, it may be beneficial to revisit those tests, especially if your symptoms have recurred.
In conclusion, while blood in urine can be alarming, understanding the potential causes and seeking appropriate medical evaluation is crucial. Early diagnosis and treatment can significantly improve outcomes and address any underlying health issues effectively. If you notice any additional symptoms such as pain, changes in urinary habits, or persistent bleeding, do not hesitate to seek medical attention promptly.

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