Gastroenterology

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Blood in the Urine

What is blood in the urine?

Blood in the urine means there are red blood cells (RBCs) in the urine. Often the urine looks normal to the naked eye. But when checked under a microscope, it contains a high number of RBCs. In some cases, the urine is pink, red, or the color of tea. This can be seen without a microscope.

What causes blood in the urine?

Many of the causes of blood in the urine are not serious. For example, heavy exercise may cause blood in the urine. This often goes away in a day.

Other more serious causes include:

  • Cancer

  • Kidney infection or disease

  • Urinary tract infection (UTI)

  • Enlarged prostate (men only)

  • Kidney or bladder stones

  • Certain diseases (such as sickle cell anemia and cystic kidney disease)

  • Kidney injury

What are the symptoms of blood in the urine?

There may not be enough blood in the urine to change the color. In severe cases, the urine may look pink, red, or tea colored.

How is blood in the urine diagnosed?

Your healthcare provider will review your health history and do a physical exam. Other tests may include:

  • Urinalysis. Urine is tested for different cells and chemicals. These include red and white blood cells, bacteria, glucose, or too much protein.

  • Blood tests. Blood is checked for high levels of waste products and kidney function.

  • Urine cytology. Urine is examined under a microscopic to look at the cells in the urine sample.

If these tests aren’t clear, you may need other tests, such as:

  • Ultrasound. An imaging test that uses high-frequency sound waves to make images of the organs of the urinary tract on a computer screen.

  • Cystoscopy. A thin, flexible tube and viewing device (cystoscope) is put in through the urethra. This allows your healthcare provider to examine the parts of the urinary tract for structure changes or blockages, such as tumors or stones.

  • CT scan. A computer-generated, detailed X-ray that can image the inner organs, such as the kidneys, ureters, and bladder.

How is blood in the urine treated?

If you have blood in your urine that lasts more than a day, see a healthcare provider. This is especially necessary if you have unexplained weight loss, discomfort with urination, frequent urination, or urgent urination.

Treatment will depend on the cause of the blood in the urine.

Key points about blood in urine

  • Blood in the urine means there are red blood cells (RBCs) in the urine. Often the urine looks normal. But when checked under a microscope, it contains a high number of red blood cells. In some cases, the urine is pink, red, or the color of tea. This can be seen without a microscope.

  • Most of the causes of blood in the urine are not serious. For example, in some cases, strenuous exercise will cause blood in the urine, which usually clears up in a day.

  • Some more serious causes of blood in the urine are cancer, infection, enlarged prostate (men only), kidney or bladder stones, and certain diseases (such as sickle cell anemia and cystic kidney disease).

  • Blood in the urine can often be diagnosed with urine tests. If these are not clear, imaging tests may be needed to look at the urinary tract.

  • Treatment depends on the cause of the blood in the urine.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your provider tells you.

  • At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

  • Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

  • Ask if your condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if you do not take the medicine or have the test or procedure.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your provider if you have questions

Online Medical Reviewer: Marc Greenstein MD
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Online Medical Reviewer: Rita Sather RN
Date Last Reviewed: 1/1/2023
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