About this symptom
Blood in the urine is called haematuria. The urine may look pink, red or dark brown, and a small amount of blood is enough to change the colour. Sometimes there is too little blood to see, and it is found only on a urine test.
The blood can come from the kidneys, the bladder or the tube that carries urine out of the body. The causes range from minor to serious. Visible blood usually does not hurt, so a lack of pain does not mean it is harmless.
Possible causes
This is not a diagnosis. These are the causes doctors think about, with the ones that are most urgent to rule out first.
- Bladder or kidney cancerBlood in the urine may be the first sign, and it usually does not hurt. Cancer is easier to treat when found early, which is why every case is checked.
- Kidney infectionFever, shivering, feeling sick, and pain in the lower back or in the back just under the ribs, sometimes with burning when passing urine.Read about it
- Kidney stonesIntense pain in the side, lower back or groin that comes and goes, with being unable to keep still and feeling sick.Read about it
- Urinary tract infectionBurning when passing urine, needing to pass it often, cloudy or smelly urine, a high temperature, or pain in the sides or lower back.Read about it
- Enlarged prostateIn men over 50: trouble starting to pass urine, sudden urges to go, and getting up at night to pass urine.Read about it
- Blood-thinning and other medicinesBlood thinners, aspirin and some other pain relievers and antibiotics can cause it. Tell the doctor about every medicine you take.
- Hard exerciseStrenuous exercise, such as long-distance running, can cause blood in the urine. A doctor should still check that nothing else is behind it.
- Beetroot, some medicines or bleeding from elsewhereUrine can look red from beetroot or some medicines, or the blood may come from the bowel, a period or the vagina, not the urine.
When to get help
Blood in the urine always needs a doctor. See one soon, within a day or two, for:
- Any blood, even a small amount or only once
- Pink, red or dark brown urine when you are not sure why
- Blood with burning when passing urine, or needing to pass urine often or urgently
- Blood with weight loss you cannot explain
- Blood in a man over 50 with a weak stream, or getting up at night to pass urine
- Blood found on a urine test report, even if the urine looks normal
Urine can look red from beetroot or some medicines, and the blood can come from the bowel, a period or the vagina instead. You cannot be sure at home, so let a doctor check.
What you can do at home
There is no safe home treatment for blood in the urine, and it should not wait while you try one. Use the time before you are seen to get ready.
Do
- Note when you first saw blood, its colour, and whether it hurts or comes with other symptoms
- Make a list of all the medicines you take, including blood thinners, aspirin and other pain relievers
Do not
- Do not wait to see if it clears, even if you feel well
- Do not assume it is from heat, spicy food or beetroot
- Do not drive yourself if you have an emergency sign
What the doctor will do
The doctor will ask when the bleeding started, the colour of the urine, whether you have pain, burning or fever, which medicines you take, and about any recent injury, surgery or foods that colour the urine. They will examine you.
Tests depend on the likely cause. They may include:
- Urine tests, including a urine culture and a check for abnormal cells
- Blood tests, such as kidney function (creatinine), a blood count and clotting tests
- An scan or a of the abdomen
- Cystoscopy, a look inside the bladder with a thin lit tube
- Less often, a kidney
Treatment depends on the cause. A doctor may prescribe if an infection is suspected, and if no serious condition is found you may not need treatment.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“If it does not hurt, it is nothing.”What is true?
Fact
Blood in the urine usually does not hurt, including when the cause is serious. Pain is not a guide, so have it checked even if you feel completely well.
Myth“It is just body heat (garmi) or something I ate, such as beetroot.”What is true?
Fact
Beetroot and some medicines can colour the urine, but you cannot tell at home whether the red is food or blood. Get it checked even if you think you know the reason.
Myth“It happened only once and has stopped, so I do not need a doctor.”What is true?
Fact
Always get blood in the urine checked, even a small amount and even once. The causes range from minor to serious, and a doctor needs to find out which one it is.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
I saw blood in my urine only once and it has gone. Do I still need to see a doctor?
Yes. See a doctor even for a small amount or a single time, because the cause still needs to be found. Go to the hospital at once if you cannot pass urine, pass clots, or have a fever, vomiting or severe pain with the blood.
Is blood in the urine always cancer?
No. Infections, kidney stones, an enlarged prostate and some medicines are common causes. But it can be a sign of cancer of the bladder or kidney, and cancer is often easier to treat when found early, which is why it is always checked.
Can beetroot or medicines make my urine look red?
Yes, beetroot and some medicines can colour the urine, and blood from the bowel, a period or the vagina can mix with it. You cannot tell at home, so a doctor needs to check. A urine test can show whether there is blood in it.
What if the blood is from my period?
Menstrual blood can show up on a urine test and cause a false result, so the doctor may repeat the test after your period. Still see a doctor if you see blood in your urine when you are not on your period.
