There is an exceptional case when a woman after the menopause experiences confusing vaginal bleeding with blood in the urine, but this is rare. Blood in haematuria may originate from the kidney or the collecting system. The initial determination of microscopic haematuria should be based on microscopic examination of urinary sediment from a freshly voided, clean-catch, midstream urine specimen.
Causes and Symptoms: The blood in the urine may come from any part of the urinary tract, including the bladder. Haematuria is sometimes found in cystitis or inflammation of the bladder. Inflammation of the kidneys due to Bright's disease may also, in some cases, lead to haematuria. The presence of blood in the urine gives it a brownish or smoky colour. Another condition leading to haematuria is the presence of stones in the urinary tract. Sometimes, when the stone moves with the flow of the discharge, it tends to scratch the urethra, which produces blood. The difference is not very different. In one case of the scratching of the urethra, the blood will be of bright colour, whereas in another case if the blood is from the bladder or the kidneys, the urine will have a brownish hue.
Other causes of red or dark urine can be mentioned as Haemoglobinuria i.e. dipstick positive but no red cells on microscopy, Myoglobinuria, Food, e.g. beetroot, Drugs, e.g. rifampicin, nitrofurantoin, senna, Porphyria i.e. urine darkens on standing, Bilirubinuria i.e. obstructive biliary disease.
Ayurveda treats haematuria as a variety of Adhoga Raktapitta, that is, the downward vitiation of the pitta in blood.
In severe cases of this malady, the patient may be found to be passing blood in place of urine.
Medicines and Prescriptions: Goksura i.e. Tribulus rerrestris is the drug of choice for this condition. Powder of the seed of the drug is administered in one-teaspoonful doses twice a day. It should be taken with honey for better results. Another drug, which is highly effective, in this case is Silajatu. It should be given in one-teaspoonful doses with milk, twice a day.
Diet and Other Regimen: The diet recommended for patients of haematuria comprises vegetables such as Karela (bitter gourd) and drumsticks. Hot and spicy foods should be avoided; meat soups may be given in moderate quantities. The juice of white pumpkin mixed with sugarcane juice helps towards a faster recovery. Pomegranate and amla are useful in any form.
The patient should be advised to desist from sexual intercourse during the course of the treatment. The intake of liquids, particularly water, should be increased. Alcohol and other drinks should be avoided.
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