Blood in your urine (haematuria)

Seeing blood in your urine (pee) can be alarming and needs to be checked by your healthcare provider. However, in most cases, it's not a sign of a serious problem.

Have I actually got blood in my urine?

Sometimes blood isn’t the cause of red, pink or brown peeOther causes include: 

  • Certain foods, eg, beetroot, blackberries, red food dyes which can turn your pee pink. 
  • Some medicines, such as senna or antibiotics (nitrofurantoin and rifampicin), which can turn your pee red or brown. Ask your pharmacist for more information.
  • Bleeding from the bottom (can be caused by haemorrhoids) which can mix with pee when you go to the toilet and look like you have blood in your urine.
  • Menstrual bleeding (periods) can also turn your urine pink. 

Signs of blood in urine (pee)

Blood in your pee may be pink, red or dark brown. Depending on the cause, you may also notice other symptoms such as fever or pain when you urinate (pee). It is important to contact your family doctor or nurse if you notice blood in your pee.

If you notice bright red blood in your urine, or if your urine has turned pinkish or reddish brown because it has blood in it, call Healthline 0800 611 116 or contact your healthcare provider for advice.

Why might I have blood in my urine?

Your kidneys make urine and then it's passed to your bladder, through tubes called ureters, and then out of your body. If you have blood in your urine it is usually because there is a problem with your bladder or kidneys.  

Image credit: 123rf

There are many different reasons for having blood in your urine and the treatment depends on the cause. The most common cause is infection of your urinary tract,  kidney (pyelonephritis) or prostate (prostatitis).

Infections will make you want to pee frequently or feel burning when you are peeing. Kidney and prostate infections are also likely to cause high temperatures (fever) and low back pain.

Other causes of blood in the pee include: 

  • Kidney stones which are caused by a blockage of a tube from your kidneys. This can cause severe pain in the side, lower back and groin areas.
  • An enlarged prostate which is a common condition in older men. 

Less common causes include:

  • Kidney disease
  • Cancer of some part of the urinary system – 1 in 5 adults with visible blood in their urine and 1 in 12 adults with non-visible blood in their urine have bladder cancer.
  • Medications such as anticoagulants (eg, warfarin) or non-steroidal anti-inflammatories (eg, ibuprofen or naproxen)
  • Blood conditions such as sickle cell disease
  • Trauma eg, from an accident, severe exercise or after catheter removal.

How is a diagnosis made?

Your healthcare provider will ask questions about your symptoms and will probably ask you for a urine (pee) sample. They may also arrange for you to have a blood test. If you have an infection, you may be given antibiotics. In some instances, your healthcare provider may do a physical examination. For men, this will may involve a rectal examination and women may have a vaginal examination. 

Your may be referred to a specialist doctor for further tests such as an ultrasound scan (to see a picture of the inside of your body) or a  cystoscopy (a procedure used to look closely at the inside of the bladder). 

Other treatment options will depend on why you have blood in your urine. Your healthcare provider will talk to you about any test results and what might happen next. 

Learn more

Blood in urine (hematuria) Mayo Clinic, US
Blood in urine (haematuria) NHS, UK 
Blood in urine Patient Info, UK

References

  1. Haematuria Patient Info, UK, 2021
  2. Blood in urine (haematuria) Ministry of health, NZ, 2014
  3. Blood in the urine (haematuria) The British Association of Urological Surgeons, UK, 2021
  4. Interpreting urine dipstick tests in adults – a reference guide for primary care BPAC, NZ, 2013
Credits: Health Navigator Editorial Team. Last reviewed: 14 Oct 2022