Blood in urine

Anyone of any age can pass blood in their urine, which is known medically as haematuria. Sometimes a tiny, unnoticeable amount of blood in urine is detected during routine health checks.

In most cases, passing blood in your urine isn’t something to worry about, although it can be alarming. It can usually be easily and effectively treated.

However, as it can be a symptom of a serious health condition, such as cancer, it’s important to see your GP. The sooner cancer is detected, the easier it is to treat.

Make an urgent appointment to see your GP if you have blood in your urine and:

• It is only a small amount of blood
• It is the first time it has happened
• You aren't sure it is blood 
• You have no other symptoms

Blood in urine can be pink, bright red or dark brown.

Your kidneys are always making urine, with a continuous trickle of urine passing from your kidneys to your bladder. Different amounts of urine are made depending on how much you drink, eat and sweat. Urine exits your body through a small tube connected to your bladder called the urethra. 

Your bladder is made of muscle and stores urine. As it fills up with urine, it expands. Muscles around your urethra keep it closed until your bladder is full. When you urinate, your bladder muscles squeeze and the muscles around your urethra and your pelvic floor muscles relax, letting the urine flow out. 

Blood in your urine can come from any part of your urinary system. Other symptoms could suggest the underlying cause. It is important to see your GP to get a diagnosis.

A urinary tract infection (UTI) triggering inflammation of the bladder (cystitis) is a common cause of blood in urine, especially in women. Other symptoms of cystitis, which can also affect men, include:

• Burning pain when passing urine, which may be strong-smelling
• Fever and/or feeling unwell
• Pain in sides, lower abdomen (stomach) and/or lower back
• Urinating more than usual

If you have blood in your urine, excruciating pain in your sides, groin or lower back, feel sick and can’t lie still, you may have kidney stones. Kidney stones are small, hard lumps of crystallised urine which can become trapped in your urinary tract. As you pass the kidney stones, they rub against your urethra, causing it to bleed.

Blood in urine in men over the age of 50 may be the result of an enlarged prostate. Other symptoms of an enlarged prostate include difficulty urinating and an increased need to urinate, especially at night.

Other conditions that can cause blood in urine include:

• Bladder or kidney cancer — most cases of blood in urine are not cancer but it is important to see a doctor for investigations as blood in urine can be an early sign of these cancers; the sooner cancer is detected, the easier it is to treat
• Bleeding disorders — where your blood doesn't clot properly; if you are taking blood-thinning medication and have blood in urine, see a doctor immediately as your medication dose may be too high
• Glomerulonephritis (inflammation of the kidneys), which is the most common cause of blood in urine in children and teenagers and is detected by carrying out a dipstick test of your urine — it is caused by a variety of conditions and symptoms include swelling around the eyes and legs, and tiredness
• Kidney infection, which can be caused by cystitis, kidney disease or kidney injury, and is treated with antibiotics, sometimes administered at a hospital directly into a vein — symptoms are more severe than a UTI and include a very high temperature and pain in your side
• Sickle cell disease — a genetic condition that is more likely if you’re of African or African/Caribbean descent

Side effects of some medications can also cause blood in urine eg aspirin, ibuprofen and some antibiotics. Strenuous exercise is another cause — long-distance runners are particularly prone to passing blood in their urine.

You may mistake having blood in urine if you:

• Are taking a new medicine that can turn your urine red or brown
• Are bleeding from your anus
• Are having your period
• Have recently eaten beetroot — this can turn your urine pink

If you are concerned that you may have blood in urine, see your GP.

Your GP will ask you about passing blood in your urine, any other symptoms and your general health. They may examine you and test your urine to check for conditions such as cystitis or kidney stones.

Investigations will vary depending on other symptoms, illnesses and conditions you may have, and your age.

Your GP may also arrange for you to have a CT or MRI scan or a cystoscopy. A cystoscopy is an examination of your bladder using a tiny camera attached to the end of a thin, flexible tube. This is usually carried out under local anaesthetic.

In some cases, your GP may refer you to a consultant for further assessment, diagnosis and treatment.

If you have a urinary tract infection, such as cystitis, your GP or consultant may prescribe antibiotics.

To treat an enlarged prostate, your GP or consultant may prescribe medication. To help relieve your increased need to urinate, your GP may refer you for bladder training. Avoiding fizzy drinks, caffeine and alcohol, and drinking less fluids in the evening may also help.

Kidney stones often pass naturally in urine. If your doctor recommends waiting for this to happen, they may prescribe pain relief. If the stone is very large, your doctor may refer you for shock wave therapy to break it up or surgery.

If another condition is responsible for blood in your urine, your GP or consultant will recommend treatment depending on your diagnosis.