When to seek care for blood in urine

Overview

Blood in urine means there is blood in your pee. It can be visible (pink, red, or cola-colored) or only found during a lab test (called microscopic hematuria). It often points to an issue somewhere in your urinary tract — from your kidneys to your bladder to the tube that carries urine out.

Yes, blood in urine is fairly common. It affects about 1 in 5 people at some point in their lives.

It can affect anyone, but it is more common in older adults, smokers, and people with a family history of kidney or bladder problems.

Symptoms

Common symptoms

• Visible blood that makes urine pink, red, or dark brown
• No symptoms at all (found during a routine urine test)

Symptoms in children

• Often bright red urine
• Sometimes with pain or discomfort when peeing
• May also have fever or tummy pain if there’s an infection

Symptoms in older adults

• Visible blood without pain (especially important to check for bladder issues)
• Blood with difficulty urinating or feeling like you need to go often

Causes

Main causes

• Urinary tract infection (a common infection in the bladder)
• Kidney stones (hard crystals that form in the kidneys)
• Enlarged prostate (in men)
• Kidney or bladder infection
• Injury to the kidney area
• Vigorous exercise
• Certain medications (like blood thinners)

Risk factors

• Age – risk increases over 40
• Smoking
• Family history of kidney disease or bladder cancer
• Frequent kidney stones or repeat infections
• Long-term use of certain medicines like blood thinners

When to see a doctor

See a doctor urgently if:

• Any visible blood in your urine – see a doctor the same day or within 24 hours
• Blood with pain, fever, or trouble urinating

Book a routine appointment if:

• If blood was found during a routine urine test and you have no other symptoms
• If you have had blood in the past and it was checked, but you notice it again

Diagnosis

Your doctor will take a medical history, ask about your symptoms, and do a urine test to confirm blood and look for infection or other clues. They may also order imaging tests or refer you to a specialist.

Tests that may be done

• Urine dipstick test or lab urinalysis (checks for blood, infection, and proteins)
• Urine culture (grows bacteria to find an infection)
• Blood tests to check kidney function
• Ultrasound, CT scan, or X-ray of the kidneys and bladder
• Cystoscopy (a thin tube with a camera is used to look inside the bladder)

What to expect at your appointment

First, you will be asked to give a urine sample. The doctor may also take blood. If initial tests show something, you might have an imaging scan or see a urologist. For most people, the process is straightforward and not painful.

Treatment

Treatment for blood in urine depends on the cause. The goal is to treat the underlying problem, not just the blood. Most causes are treatable.

Self-care at home

• Drink plenty of water to stay hydrated
• Avoid irritants like caffeine, alcohol, and spicy foods if you have an infection
• Rest and avoid strenuous activity if the cause is exercise-related
• Do not stop any prescribed medicines without talking to your doctor

Medical treatments

If an infection is found, antibiotics may be prescribed. For kidney stones, pain relief and medicine to help pass the stone may be used, or a procedure to break up large stones might be needed. If an enlarged prostate is the cause, medications to help relax the prostate or shrink it are common. For more serious causes like tumors, treatment could involve surgery, radiation, or chemotherapy – but this is less common.

When is surgery considered?

Surgery may be needed for large kidney stones that do not pass, for some types of bladder or kidney tumors, or to correct a physical problem in the urinary tract. Your doctor will discuss options if surgery is right for you.

Living with this condition

Most people with blood in urine do not have long-term symptoms. If the cause is chronic (like a long-term kidney problem), you may need regular urine tests and follow-up appointments.

Lifestyle tips

• Drink enough water each day
• If you smoke, consider quitting – smoking is a major risk factor for bladder and kidney cancers
• Maintain a healthy weight
• Practice good bathroom habits – empty your bladder completely and urinate after sex

Diet and exercise

Eat a balanced diet with plenty of fruits and vegetables. If you have a history of kidney stones, your doctor might suggest limiting salt or certain high-oxalate foods. Regular, gentle exercise is good for overall health.

Mental health and emotional wellbeing

Worrying about blood in urine can cause anxiety. It is normal to feel concerned. Talk to your doctor about your worries – most causes are not serious, and knowing the results can bring peace of mind.

Prevention

You can reduce your risk by staying hydrated, not smoking, and treating infections early. Some causes, like kidney stones, may be prevented with diet changes. But not all cases can be prevented.

Screening programmes

There is no routine screening for blood in urine in healthy people. If you have a family history of kidney or bladder cancer, talk to your doctor about whether regular check-ups are right for you.

Complications

If left untreated

• If the cause is an infection, it can spread to the kidneys and cause more serious illness
• Kidney stones that are not treated can block urine flow and damage the kidney
• Very rarely, undiagnosed cancer can grow and become harder to treat

Long-term outlook

Most people with blood in urine have a good outlook because the cause is often treatable. Even when the cause is more serious, finding it early gives the best chance for successful treatment. Your doctor can explain your personal outlook based on your specific situation.

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