Blood in Urine (Haematuria): Causes, Symptoms, and When to Worry
Discover the causes, symptoms, and when to worry about blood in urine (haematuria). Learn the difference between visible and microscopic haematuria, possible health risks, and when to seek medical attention.
Noticing blood in your urine can be a startling and anxiety-inducing experience. Medically known as hematuria, this symptom is a clear signal from your body that something requires attention. While it can sometimes be a sign of a serious condition, it's important to know that hematuria often stems from easily treatable issues. This comprehensive guide will walk you through everything you need to know—from the different types and common causes to the diagnostic process and the critical question of when to seek medical help. Our goal is to empower you with knowledge, so you can take the right next steps for your health with confidence.
What is Hematuria?
At its core, hematuria is the presence of red blood cells in the urine. It's not a disease itself but a symptom of an underlying condition. This condition is primarily categorised into two types, which are important to understand.
- Gross Hematuria: Gross hematuria means the blood is visible to the naked eye. Your urine may appear pink, red, brown, or tea-colored. Sometimes, you might even see small clots. The amount of blood does not necessarily correlate with the seriousness of the condition. Even a small, visible amount warrants a doctor's visit.
- Microscopic Hematuria: As the name implies, microscopic hematuria means the blood is only detectable under a microscope during a urine test. The urine looks completely normal. This form is often discovered incidentally during a routine check-up or an exam for another issue. It is equally important to investigate, as it can also be a sign of underlying disease.
Common Causes of Hematuria
The causes of blood in urine are numerous, ranging from minor, temporary issues to more significant medical conditions. Understanding this spectrum can help contextualise your symptoms.
- Infections and Inflammation: A urinary tract infection (UTI) is one of the most common causes, especially in women. Bacteria infect the bladder (cystitis) or kidneys (pyelonephritis), causing inflammation and irritation that leads to bleeding. Similarly, inflammation of the urethra (urethritis) or the kidneys' filters (glomerulonephritis) can also cause hematuria.
- Kidney and Bladder Stones: Minerals in concentrated urine can crystallise and form hard stones in the kidneys or bladder. These stones can irritate or block the urinary tract, often causing significant pain and blood in urine.
- Enlarged Prostate: In middle-aged and older men, the prostate gland often enlarges—a condition known as benign prostatic hyperplasia (BPH). As the prostate grows, it can compress the urethra and partially block urine flow, which can lead to blood in the urine.
- Kidney Disease: Underlying kidney disease, such as glomerulonephritis, can be a cause. This inflammation of the kidney's filtering system can occur on its own or as part of another disease, like diabetes or lupus.
- Certain Medications: Some drugs, including blood thinners (like aspirin, warfarin), pain relievers (like NSAIDs), and certain antibiotics (like penicillin), can lead to urinary bleeding. It's crucial to inform your doctor of all medications you are taking.
- Cancer: Visible hematuria can sometimes be the first sign of advanced kidney cancer, bladder cancer, or prostate cancer. This is why a thorough medical evaluation is essential, even if you have no other symptoms. The good news is that when caught early, these cancers are often highly treatable.
- Other Potential Causes: Vigorous exercise (runner's hematuria), injury to the kidney from a blow or accident, and inherited disorders like sickle cell anemia can also be culprits.
How is Hematuria Diagnosed?
If you report blood in urine, your doctor will not guess the cause—they will investigate. The process is systematic and designed to rule out serious conditions first.
The First Step: Urinalysis and Urine Culture
A urinalysis confirms the presence of red and white blood cells and checks for protein or other substances. A urine culture can then identify if a bacterial infection is the cause and determine the right antibiotic for treatment. Apollo24|7 offers convenient home collection for tests like urinalysis and urine culture, making this first step easy and hassle-free.
Imaging Tests: Ultrasounds, CT Scans, and MRIs
If an infection isn't found, imaging is the next step. A CT urogram is a specialised scan that provides detailed images of the kidneys, ureters, and bladder, making it excellent for detecting stones, tumours, and other abnormalities. An ultrasound is also a common, non-invasive first choice.
Cystoscopy:
In this procedure, a urologist inserts a thin, flexible tube with a camera (cystoscope) through the urethra to examine the inside of the bladder and urethra. It is a crucial tool for directly visualising any problems, such as tumours or inflammation, that might not show up on scans.
Consult Top Specialities
Treatment Options for Hematuria
There is no single "treatment for blood in urine." The treatment is entirely focused on the root cause:
- UTIs are treated with antibiotics.
- Kidney stones may require increased fluid intake, pain relievers, or procedures to break up or remove larger stones.
- An enlarged prostate can be managed with medication or surgery.
- Kidney disease requires managing the underlying condition with medication and lifestyle changes.
- Cancers may involve surgery, chemotherapy, radiation, or immunotherapy.
The approach is highly personalised. If your hematuria is linked to medication, your doctor will discuss alternatives.
Can Hematuria Be Prevented?
While not all causes are preventable, you can reduce your risk:
- Stay hydrated: Drinking plenty of water helps flush bacteria and prevents stone formation.
- Practice good hygiene: This helps prevent UTIs, especially for women.
- Avoid smoking: Smoking is the single greatest risk factor for bladder cancer.
- Limit chemical exposure: If you work with chemicals, follow all safety protocols.
- Eat a balanced diet and manage chronic conditions like high blood pressure and diabetes to protect your kidneys.
When to See a Doctor Immediately?
- Hematuria is a symptom, not a disease, and always requires a medical evaluation.
- It can be visible (gross) or only microscopic.
- Causes range from simple UTIs to kidney stones to, less commonly, cancer.
- Diagnosis involves urine tests, imaging, and sometimes a cystoscopy.
- Treatment is directed at the underlying cause.
See a doctor immediately if you have visible blood in your urine, especially if it's accompanied by:
Severe pain in your back, side, or abdomen.
- Difficulty urinating or inability to urinate.
- Fever, nausea, or vomiting.
- Unintended weight loss.
Do not ignore blood in your urine, even if it's painless or goes away on its own. If you experience this symptom, consult a doctor online with Apollo24|7 for an initial evaluation and to determine if you need further testing.
Conclusion
Discovering blood in your urine is understandably worrying, but knowledge is your most powerful tool. Remember that while hematuria can signal a serious condition like kidney cancer or bladder cancer, it is far more frequently linked to manageable issues like infections or stones. The critical takeaway is that it should never be ignored. A proper medical evaluation is the only way to identify the cause and get you on the path to the right treatment. Taking prompt action ensures the best possible outcome for your health and provides invaluable peace of mind. Your health is worth that proactive step.
Consult Top Specialities
Consult Top Specialities
Dr. Sudhakar G V
Urologist
25 Years • MBBS, MS(Gen.Surgery), DNB Urology
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Pavan Kumar S K
Urologist
11 Years • MBBS, MS , Mch( Urology) DNB (Urology)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Prabir Basu
Urologist
19 Years • MBBS, MS General Surgery, DNB Genito-Urinary Surgery
Jodhpur Park
Dr. Prabir Basu urology clinic, Jodhpur Park
(150+ Patients)
Dr. Pradeep Champawat
Urologist
10 Years • MBBS, MS, DNB Urology
Delhi
Apollo Hospitals Indraprastha, Delhi
(150+ Patients)
Dr Anupam Sharma
Urologist
18 Years • MBBS, MS(Gen Surgery), DNB (Urology)
Delhi
Apollo Hospitals Indraprastha, Delhi
Consult Top Specialities
Dr. Sudhakar G V
Urologist
25 Years • MBBS, MS(Gen.Surgery), DNB Urology
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Pavan Kumar S K
Urologist
11 Years • MBBS, MS , Mch( Urology) DNB (Urology)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Prabir Basu
Urologist
19 Years • MBBS, MS General Surgery, DNB Genito-Urinary Surgery
Jodhpur Park
Dr. Prabir Basu urology clinic, Jodhpur Park
(150+ Patients)
Dr. Pradeep Champawat
Urologist
10 Years • MBBS, MS, DNB Urology
Delhi
Apollo Hospitals Indraprastha, Delhi
(150+ Patients)
Dr Anupam Sharma
Urologist
18 Years • MBBS, MS(Gen Surgery), DNB (Urology)
Delhi
Apollo Hospitals Indraprastha, Delhi
Frequently Asked Questions
Can dehydration cause blood in urine?
Yes, severe dehydration can concentrate the urine and, in some cases, cause minor irritation and microscopic hematuria. However, it's more commonly associated with kidney stones, which themselves can cause bleeding. Hydration is key to prevention.
I have blood in my urine but no pain. What does that mean?
Painless hematuria can be a cause for greater concern because it is sometimes the only early sign of conditions like bladder or kidney cancer. It can also be from an enlarged prostate or medication. It is absolutely essential to see a doctor for painless hematuria to rule out these serious causes.
Can strenuous exercise cause hematuria?
Yes, this is known as 'runner's hematuria.' It can result from bladder trauma, dehydration, or the breakdown of red blood cells during prolonged exercise. It usually resolves on its own with rest and hydration within 24-72 hours, but if it persists, see a doctor.
Are women or men more likely to get hematuria?
The causes differ by gender. Women are far more prone to UTIs, a leading cause. Men have a higher risk of hematuria due to an enlarged prostate (BPH) and prostate cancer. Both genders are equally at risk for conditions like kidney stones and cancers.
What should I do before my doctor's appointment for hematuria?
Note when you first saw the blood, what your urine looks like (pink, red, brown), if you have any other symptoms (pain, fever, frequency), and make a list of all medications and supplements you are taking. This information will be very helpful for your doctor.