Noticing blood in your urine, or learning that blood was found on a routine urine test, is understandably worrying. The medical term for it is haematuria, and while the causes range from something entirely benign to something that needs prompt attention, the right response is always the same: get it checked.
Visible versus hidden blood
When you can actually see the colour change, usually pink, red, or cola-coloured, it is called gross or macroscopic haematuria. Sometimes blood is present only in microscopic amounts and is picked up on a urine test during a routine check. Both deserve the same investigation. The amount of blood visible does not reliably tell you how serious the underlying cause is.
Common causes
- Urinary tract infection (UTI): one of the most common causes, especially in women. It usually comes with burning during urination and increased frequency.
- Kidney stones: a stone moving through the urinary tract can scratch the lining and cause bleeding, often with severe flank or lower abdominal pain.
- Enlarged prostate (BPH): in older men, a large prostate can cause bleeding alongside difficulty starting urination and a weak stream.
- Vigorous exercise: long-distance running or intense workouts can sometimes cause temporary haematuria that resolves with rest.
- Medications: blood thinners and certain other drugs can increase the risk.
- Kidney disease: conditions affecting the kidney's filtering units can cause blood to leak into the urine.
- Bladder or kidney growths: less common, but this is the reason haematuria should never be brushed off, especially in people over 40 or those who smoke.
In women, it is also important to confirm that the blood is coming from the urinary tract and not from menstrual bleeding or a vaginal source.
What your doctor will check
The evaluation typically starts with a detailed history, a physical examination, and a urine test (urinalysis with microscopy). From there, your doctor may order blood tests to check kidney function, an ultrasound of the kidneys and bladder, and, in some cases, a referral for a cystoscopy, where a urologist looks inside the bladder with a small camera. The exact workup depends on your age, symptoms, and risk factors.
When to act
Any episode of visible blood in the urine warrants a visit to your doctor, even if it happens just once and goes away on its own. Painless haematuria, where you see blood but have no discomfort, is actually the pattern that most needs investigation, because it can be the only early sign of a bladder or kidney issue.
If blood in the urine is accompanied by severe pain, inability to pass urine, high fever with chills, or if you feel faint, that needs urgent care. Call 108 or go to the nearest hospital.
Worrying about what a test might show can be stressful, and if that anxiety is getting to you, support is available. You can reach the free national Tele-MANAS mental health helpline at any time on 14416 (or 1800-891-4416). If you or someone near you is in immediate danger, call 108 or go to the nearest hospital.
A word from our clinic
I am Dr. Jayprakash Shirpurwar, an internal medicine specialist at Prudent International Health Clinic in Viman Nagar, Pune. If you have noticed blood in your urine or it was flagged on a test, come in for an evaluation. We will run the initial workup, identify the likely cause, and refer you to a specialist if further investigation is needed. We are open all 7 days, 9 AM to 9 PM, with walk-ins welcome. Call or WhatsApp us on +91 70287 22200 to book a consultation. For current pricing, call the clinic on +91 70287 22200.