Blood In Urine

Overview

Blood in your urine (doctors call it haematuria, say 'hee-ma-tyoo-ree-ah') means that blood is getting into your pee. Sometimes you can see it — your urine may look pink, red or the colour of weak tea. Other times it is invisible to the eye and only shows up when your urine is tested. The blood can come from anywhere along the urinary tract: the kidneys, the tubes that carry urine down (ureters), the bladder, the prostate gland in men, or the tube you pee from (the urethra). Blood in your urine is not a diagnosis on its own. It is a sign that something needs checking, and in most people the cause turns out to be something treatable, such as an infection or a kidney stone.

Yes. Blood in urine is a common reason people visit their doctor or nurse. It becomes more common as people get older, but it can happen at any age, including in children.

It can affect anyone. Urine infections are more common in women, prostate problems and bladder stones are more common in men, and kidney stones can affect anyone. In older adults, and in people who smoke or have worked with certain chemicals, blood in urine needs checking more urgently.

Symptoms

Common symptoms

• Urine that looks pink, red, rusty or dark brown
• Blood clots in your urine
• A burning or stinging feeling when you pee
• Needing to pee more often, or suddenly and urgently
• Pain in your lower tummy, side or lower back
• Blood in your urine with no other symptoms at all — this is common and still needs checking

Symptoms in children

• Pink or reddish urine, or blood spots in a nappy or on underwear
• Crying or discomfort when peeing
• Needing to pee very often, or new bedwetting in a child who was dry
• Fever with tummy pain or back pain
• Sometimes no symptoms at all — blood is only found when a urine sample is tested for another reason

Symptoms in older adults

• Blood in urine that comes and goes, with no pain
• Needing to pee more often at night, or a weak urine stream (in men, often an enlarged prostate)
• Urgency or leakage, which may be put down to age but is worth mentioning to your doctor
• Tiredness or shortness of breath if blood has been lost slowly over time
• Confusion or generally feeling unwell, which can be a sign of infection in older adults

Causes

Main causes

• Urine infection (cystitis) — the most common cause, especially in women
• Kidney or bladder stones, which can scratch the urinary tract
• An enlarged prostate gland, common in men over 50
• Inflammation of the kidneys (glomerulonephritis) — a condition where the kidney's filters become inflamed
• Some medicines, such as blood thinners, can make bleeding more likely — ask your doctor or pharmacist about your own medicines
• Vigorous exercise, especially long-distance running, which can cause temporary blood in urine
• An inherited condition such as sickle cell trait, which can cause blood in urine
• Rarely, growths in the bladder, kidney or prostate, which is why blood in urine is always checked
• In women, period blood can get into a urine sample and look like blood in the urine

Risk factors

• Being over 45 years old
• Smoking, or having smoked in the past
• Working with chemicals used in rubber, dye, leather, printing or painting, without protective equipment
• A family history of bladder or kidney problems
• Repeated urine infections or a history of kidney stones
• An enlarged prostate
• Diabetes or high blood pressure, which can affect the kidneys over time
• Radiotherapy to the pelvis in the past
• Using a urinary catheter

When to see a doctor

See a doctor urgently if:

• You notice blood in your urine — book an appointment promptly, even if it happens only once
• Blood in your urine with a fever, shivering or pain in your side or back — contact your doctor the same day
• You cannot pee, or clots are blocking your urine — this is an emergency
• Blood in your urine while you are pregnant
• Blood in your urine after an injury

Book a routine appointment if:

• Blood was found in a urine test you had for another reason and you feel well
• You have had blood in your urine before and it has come back
• You have other urinary changes, such as needing to pee more often or a weaker stream
• You have a urine infection that does not settle with treatment, or keeps coming back

Diagnosis

Your doctor will start by asking about your symptoms, your medical history and any medicines you take. They will usually ask for a urine sample, which is tested in the surgery and often sent to a laboratory. Depending on your age, symptoms and test results, they may arrange blood tests, scans, or a referral to a specialist in urinary problems (a urologist). The aim is to find the cause, so that if treatment is needed it can start quickly.

Tests that may be done

• Urine dipstick test — a simple strip dipped in your sample that checks for blood and signs of infection
• Urine culture — a laboratory test to see whether bacteria are growing and which treatment would work
• Blood tests to check kidney function, blood count and general health
• Ultrasound scan of the kidneys and bladder — painless, using sound waves
• CT scan or other imaging, if more detail is needed
• Cystoscopy — a thin tube with a camera looks inside the bladder, usually done as a short outpatient procedure with numbing gel or light sedation

What to expect at your appointment

Most of the tests are quick and painless, though you may feel a little anxious. A cystoscopy can sound daunting, but it is a common, short procedure and your care team will explain each step and answer your questions. Results can take a few days to a couple of weeks. Ask your doctor when to expect them and who will contact you, so you are not left wondering.

Treatment

Treatment depends entirely on what is causing the blood. Once the cause is known, your doctor will explain the options and what they involve. Many people need only simple treatment or monitoring, and some need no treatment at all beyond keeping an eye on things.

Self-care at home

• Drink plenty of fluids — water is best — unless your doctor has told you to limit how much you drink
• If you have been asked for a repeat urine sample, avoid very strenuous exercise for 24 hours beforehand, as it can affect the result
• Keep a simple note of when you saw blood, what it looked like and any other symptoms, to share with your doctor
• Check with your pharmacist before taking painkillers, especially if you have kidney problems or take other medicines
• Do not delay going back to your doctor if symptoms change or get worse

Medical treatments

Treatment is aimed at the cause. Urine infections are usually treated with a course of antibiotics prescribed by your doctor. Kidney stones may be left to pass on their own with pain relief, or removed with a procedure if they are large or causing problems. An enlarged prostate may be managed with medicines or a procedure, depending on how much it affects you. Other kidney conditions may need specialist care and monitoring. If a growth is found, your team will discuss the treatment options with you in detail. Always follow the advice of your own healthcare team rather than guessing what is right for you.

When is surgery considered?

Surgery or a procedure is only needed for some causes — for example, to remove a kidney stone, treat an enlarged prostate, or remove a growth in the bladder or kidney. Many people with blood in their urine never need an operation. If a procedure is suggested, your specialist will explain why, what it involves, and the risks and benefits, so you can decide together.

Living with this condition

While you are waiting for tests or results, you can carry on with normal life. Drink regularly, keep active, and note any changes in your symptoms. If you find yourself checking your urine often, that is a very normal reaction — try to note what you see without letting it take over your day.

Lifestyle tips

• Stay well hydrated, particularly in warm weather or when exercising
• Stop smoking if you smoke — this is one of the most helpful things you can do for your bladder and kidney health, and your doctor can offer support
• Wear protective equipment if your job involves chemicals
• Treat urine infections promptly and go back to your doctor if they keep returning
• Keep up with any follow-up appointments or repeat tests you have been offered

Diet and exercise

There is no special diet that treats blood in the urine, but a balanced diet and regular activity support your general health and help prevent some causes, such as kidney stones. Staying well hydrated is the single most useful habit for most people. If you have kidney disease, your team may give you specific dietary advice — follow that rather than general advice online.

Mental health and emotional wellbeing

Seeing blood in your urine can be frightening, and waiting for test results can feel stressful. It is very common to feel anxious or to imagine the worst. Talking to someone you trust, writing down your questions before appointments, and keeping to your normal routines can all help. If worry is affecting your sleep, mood or daily life, tell your doctor — support is available, and you do not have to cope alone. If you ever feel overwhelmed or in crisis, contact your doctor or local mental health service, or call your local emergency number.

Prevention

Not all causes of blood in the urine can be prevented, but you can lower your risk of some of the common ones. Not smoking, drinking enough fluids, treating urine infections early, and protecting yourself from workplace chemicals all make a real difference.

Vaccines

There is no vaccine that prevents blood in the urine. Keeping up with routine vaccinations, including flu and any vaccines your doctor recommends, helps you stay well overall.

Screening programmes

There is no national screening programme for blood in the urine in the UK. This is why noticing it yourself — and getting it checked — matters. If you are offered a urine test as part of another health check, it can be a useful opportunity to catch problems early.

Complications

If left untreated

• A urine infection could spread to the kidneys, which makes it harder to treat
• Kidney stones could grow or block the flow of urine, causing pain and pressure
• Ongoing slow blood loss could lead to anaemia (low iron in the blood), causing tiredness and breathlessness
• A serious cause, such as a growth in the bladder or kidney, could be found later than it needed to be

Long-term outlook

The outlook is good for most people. Many causes of blood in the urine are minor and settle with simple treatment, and some people never find out exactly what caused it — which can happen and is usually not a worry once checks are complete. For the less common serious causes, finding them early gives the best chance of successful treatment. The most important thing is that you have taken the step of getting checked.

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