Noticing blood in your urine can be alarming, but it is a symptom that many people experience at some point in their lives. Medically known as haematuria, blood in the urine can range from being clearly visible to only detectable under a microscope. While it is sometimes caused by minor, easily treatable conditions, haematuria can also indicate more serious underlying health problems that require prompt medical attention.
This comprehensive guide explores the symptoms, causes, and risk factors associated with blood in urine, helping you understand when to seek medical advice and what investigations may be necessary.
What Is Haematuria?
Haematuria refers to the presence of red blood cells in the urine. It is classified into two types:
Gross (visible) haematuria: Blood is visible to the naked eye, causing urine to appear pink, red, or cola-coloured. Even a small amount of blood can significantly change urine colour.
Microscopic haematuria: Blood is not visible but is detected during a urine test. This is often discovered incidentally during routine health screenings or investigations for other conditions.
Both types warrant medical investigation, as the underlying causes can be similar regardless of whether the blood is visible.
Symptoms Associated with Haematuria
Blood in the urine itself is a symptom rather than a disease. However, depending on the underlying cause, you may experience additional symptoms:
Urinary symptoms:
Pain-related symptoms:
Systemic symptoms:
It is important to note that haematuria can occur without any accompanying symptoms, particularly in cases of microscopic haematuria or early-stage conditions.
Common Causes of Blood in Urine
Haematuria can result from numerous conditions affecting different parts of the urinary system. Understanding these causes helps contextualise why thorough investigation is essential.
### Urinary Tract Infections (UTIs)
UTIs are one of the most common causes of haematuria, particularly in women. Bacteria entering the urinary tract cause inflammation and irritation, leading to bleeding. Symptoms typically include painful urination, frequency, and urgency. UTIs are usually easily treated with antibiotics.
### Kidney Infections (Pyelonephritis)
When bacteria travel from the bladder to the kidneys, they can cause a more serious infection. Kidney infections often present with haematuria alongside fever, flank pain, and general malaise. Prompt treatment is essential to prevent complications. Monitoring kidney health through kidney function tests can help assess the impact of infections on renal function.
### Kidney Stones
Mineral deposits that form in the kidneys can cause significant pain and bleeding as they move through the urinary tract. The sharp edges of stones can damage the delicate lining of the ureters and bladder. Symptoms often include severe colicky pain, nausea, and visible blood in urine.
### Bladder Stones
Similar to kidney stones, bladder stones form when minerals crystallise in the bladder. They can cause irritation, infection, and bleeding. Men with enlarged prostates are at higher risk due to incomplete bladder emptying.
### Enlarged Prostate (Benign Prostatic Hyperplasia)
In men, an enlarged prostate gland can compress the urethra and affect urination. This common age-related condition can cause microscopic or visible haematuria, along with urinary symptoms such as weak stream, frequency, and nocturia (waking to urinate at night).
### Kidney Disease
Various forms of kidney disease, including glomerulonephritis (inflammation of the kidney's filtering units), can cause blood to leak into the urine. These conditions may be associated with other symptoms such as protein in the urine, high blood pressure, and swelling. Regular monitoring through kidney function blood tests is important for managing kidney conditions.
### Bladder or Kidney Cancer
While less common, haematuria can be an early sign of bladder or kidney cancer. This is particularly important to consider in individuals over 50, smokers, or those with other risk factors. Painless visible haematuria in older adults should always be investigated promptly.
### Inherited Disorders
Conditions such as sickle cell disease and Alport syndrome can cause haematuria. Sickle cell disease affects red blood cells and can damage the kidneys over time. Alport syndrome is a genetic condition affecting the kidney's filtering membranes.
### Medications
Certain medications can cause haematuria, including:
### Strenuous Exercise
Intense physical activity, particularly long-distance running, can cause temporary haematuria. This is thought to result from bladder trauma, dehydration, or breakdown of red blood cells. Exercise-induced haematuria typically resolves within 48 to 72 hours.
### Trauma
Injury to the kidneys or bladder from accidents, sports injuries, or medical procedures can cause bleeding into the urinary tract.
Risk Factors for Haematuria
Certain factors increase your likelihood of experiencing blood in urine:
Age: Men over 50 are at increased risk due to prostate enlargement. The risk of bladder and kidney cancer also increases with age.
Sex: Women are more prone to UTIs due to their shorter urethra, while men are more likely to develop bladder stones and prostate-related haematuria.
Family history: A family history of kidney disease, kidney stones, or inherited conditions increases risk.
Smoking: Tobacco use significantly increases the risk of bladder and kidney cancer.
Certain medications: Long-term use of pain relievers, blood thinners, or certain antibiotics increases risk.
Occupation: Exposure to certain chemicals and dyes (particularly in the rubber, textile, and paint industries) increases bladder cancer risk.
Recent infections: A recent bacterial or viral infection can trigger post-infectious glomerulonephritis.
Strenuous exercise: Athletes, particularly runners, may experience exercise-induced haematuria.
When to Seek Medical Advice
You should see a healthcare professional if you:
Do not assume that blood in your urine will resolve on its own or is simply due to menstruation (in women) or minor causes. Proper evaluation is essential to rule out serious conditions.
Investigations for Haematuria
Your doctor may recommend several tests to determine the cause of haematuria:
Urine tests: Urinalysis to check for infection, protein, and blood cells. Urine culture to identify bacterial infections.
Blood tests: Full blood count to assess for anaemia or infection. Kidney function tests to evaluate how well your kidneys are working. In some cases, a PSA test may be recommended for men to assess prostate health.
Imaging: Ultrasound, CT scan, or MRI to visualise the kidneys, ureters, and bladder.
Cystoscopy: A procedure where a thin camera is inserted into the bladder to examine the bladder lining directly.
Taking Action for Your Health
If you are concerned about blood in your urine or have risk factors for urinary tract conditions, proactive health monitoring can provide peace of mind and early detection of potential problems.
At Private Blood Tests London, we offer comprehensive blood testing services at our CQC-registered clinic in South Kensington. Our kidney function tests, full blood count, and other relevant investigations can help assess your overall health and identify potential concerns.
Explore our [kidney function tests](/kidney-function-test), [full blood count testing](/full-blood-count-test), and [health screening packages](/health-screening).
Do not ignore symptoms that could indicate underlying health issues. Book your blood test today and take control of your health.