Blood in Urine (Haematuria): Causes and When to Seek Help
Blood in urine means red blood cells are present, either visible (gross haematuria) or detectable only under a microscope (microscopic haematuria). Causes range from urinary tract infections to kidney stones or, rarely, cancers. While often not life-threatening, it always warrants medical evaluation to determine the underlying cause.
In plain words
Blood in urine means red blood cells are found in your pee. You might see it (could look pink, red, or brown) or only find it under a microscope. Causes can be UTIs, kidney stones, or problems with kidneys or prostate. Sometimes, it could be serious, so you should see a doctor to find out why it's happening.
What is Blood in Urine (Haematuria): Causes and When to Seek Help?
Blood in urine means red blood cells are present, either visible (gross haematuria) or detectable only under a microscope (microscopic haematuria). Causes range from urinary tract infections to kidney stones or, rarely, cancers. While often not life-threatening, it always warrants medical evaluation to determine the underlying cause.
Symptoms
Early symptoms
- Pink, red, or cola-colored urine: Urine may appear discolored due to blood. Sometimes the color change is slight and only noticeable in certain lighting. (2) (3)
- Blood clots in urine: Small or large clots may be seen, especially with visible bleeding. Clots can sometimes make urination difficult. (2)
- Painful urination: Burning or stinging during urination often accompanies blood from infections or kidney stones. (2) (3)
- Frequent urination: Feeling the need to urinate more often than usual, especially with small amounts each time. (3)
- No other symptoms (silent haematuria): Blood may be present without any pain or noticeable symptoms, especially with microscopic haematuria. (3)
Serious or emergency symptoms
- Inability to urinate: Complete blockage of urine flow due to large blood clots is a medical emergency. Seek emergency care immediately. (3) (4)
- Severe flank or abdominal pain: Intense pain in the side or lower abdomen may indicate kidney stones, infection, or other serious conditions. Seek urgent medical attention. (4)
Causes
Primary causes
- Urinary tract infections (UTIs): Bacterial infections in the bladder or kidneys are a common cause, especially in women. The infection irritates the urinary tract lining, causing bleeding. (1) (3) (4)
- Kidney or bladder stones: Hard mineral deposits can scrape the urinary tract as they pass through, causing bleeding and often intense pain. (1) (3)
- Enlarged prostate: In older men, an enlarged prostate can press on the urethra and cause bleeding, often with difficulty urinating. (3) (4)
- Kidney disease: Glomerulonephritis and other kidney diseases can cause microscopic bleeding by damaging the kidney's filtering system. (3) (4)
- Cancer: Kidney, bladder, or prostate cancers may cause bleeding, especially in older adults. Blood is often the first sign. (1) (3)
Risk factors
Age (men over 50)
Prostate problems become more common as men age, increasing risk of haematuria. (3)
Recent infection
Recent viral or bacterial illness can trigger kidney inflammation that bleeds. (3)
Family history
Kidney disease or kidney stones in relatives raises your risk of similar problems. (3)
Certain medications
Aspirin, blood thinners, and some pain relievers increase bleeding risk. (3)
Diagnosis
Your doctor will start by asking about your symptoms and medical history. A physical exam checks for pain or masses. Urine tests confirm blood is present and look for infection. Imaging like ultrasound or CT scans visualize the kidneys and bladder. For persistent or unexplained cases, a cystoscopy (tube with camera) may examine the bladder directly. Additional blood tests assess kidney function when needed.
Urinalysis
Confirms the presence of blood and checks for infection, crystals, or other clues to the cause. (2) (6)
CT scan
Detailed images show kidney stones, tumors, or structural problems in the urinary tract. (6) (4)
Cystoscopy
A thin tube with a camera examines the bladder and urethra for abnormalities. (6) (4)
Treatment
Medication options
Antibiotics
Treat bacterial infections causing bleeding. The specific antibiotic depends on the identified bacteria and your health factors. (5) (6)
Pain relievers
Reduce discomfort from conditions like kidney stones or UTIs. Stronger prescription pain medication may be needed for severe cases. (4) (5)
Lifestyle and self-care
- Increased fluid intake: Drinking more water helps flush the urinary system and may prevent stone formation. Aim for clear or pale yellow urine as a sign of good hydration. (5)
- Avoid irritants: Coffee, alcohol, and spicy foods can irritate the bladder. Temporarily avoiding them may help until the cause is treated. (5)
- Follow-up testing: Repeat urine tests or imaging ensures the bleeding resolves. Some cases need monitoring even after treatment. (5)
Always discuss dosing and treatment changes with your own prescriber.
Possible complications
When to see a doctor
Routine follow-up
- Schedule an appointment if you notice blood in your urine, even if you have no pain. Early evaluation is key to finding and treating the cause. (1) (3)
Seek emergency care
Frequently asked questions
What causes blood in urine?
Common causes include UTIs, kidney stones, enlarged prostate (in men), kidney disease, certain medications, and cancers of the urinary system. Intense exercise or trauma can also sometimes cause harmless bleeding. (1) (3)
When should I worry about blood in urine?
While not always serious, blood in urine always warrants medical evaluation. Seek care immediately if you also have fever, severe pain, inability to urinate, or large clots. Even painless bleeding needs checking within a few days. (1) (3) (4)
Is blood in urine serious?
It can be, though many causes like minor infections aren't dangerous if treated promptly. The only way to know is through medical testing—some serious conditions show no other symptoms early on. (3)