What Causes Haematuria? Symptoms and When To Seek Care 

If you’re wondering what causes haematuria, you’re not alone. Haematuria simply means blood in the urine. Sometimes it’s obvious (pink, red or tea‑coloured urine), and sometimes it’s only picked up on a routine urine test. While common causes include urinary tract infections or kidney stones, blood in the urine can occasionally be a warning sign of something more serious. The key is not to ignore it.

This guide explains what counts as haematuria, why it matters, and the most common — and important — causes to consider. You’ll learn which symptoms to watch for, when to seek urgent help, how doctors investigate blood in urine, and the treatment options available. We’ll also cover differences in women, men and children, things that can mimic blood, ways to lower your risk, and how private urology can speed up answers. Let’s start with what you might notice.

What counts as haematuria? Types and what you might notice

Haematuria means red blood cells in urine. It comes in two forms: visible (‘gross’) and microscopic. Visible shows as pink, red or cola–coloured urine; it can be painless, though passing clots may hurt. Microscopic is picked up on a urine test and often has no other symptoms. There’s also ‘dipstick’ positivity, which needs lab confirmation because strip tests can give false positives.

• Visible colour change: pink, red or dark brown.
• Clots: you may notice clots; passing them can hurt.
• Microscopic only: no colour change, but a lab test shows blood.
• Not everything red is blood: beetroot or rhubarb, medicines (phenazopyridine), or period/rectal bleeding can mimic it.

Why haematuria matters: ruling out serious disease early

Haematuria matters because, while often due to urinary infections or stones, it can be the first warning of bladder, kidney or prostate cancer, significant kidney infection or inflammation. The NHS advises that any blood in urine — even once, even a small amount, even if you’re not sure — should be checked, as cancer is easier to treat if found early. Microscopic haematuria deserves attention too. Prompt assessment rules out serious disease, picks up treatable causes, and prevents missed, time‑critical diagnoses.

What causes haematuria? Common and serious reasons

Blood appears in urine when the kidneys or urinary tract leak red cells into the stream. If you’re asking what causes haematuria, the answer spans harmless to serious conditions, and some are age‑ or sex‑specific. The key causes clinicians consider are:

• Urinary tract infections (UTIs): burning, urgency, smelly urine; visible or microscopic blood.
• Kidney infection (pyelonephritis): UTI symptoms plus fever and back/flank pain.
• Stones (kidney or bladder): can be painless or very painful; cause gross or microscopic bleeding.
• Prostate enlargement or prostatitis: common in men over 50; weak flow, frequency, haematuria.
• Kidney inflammation (glomerulonephritis): typically microscopic blood; kidney function may be affected.
• Cancer: bladder, kidney or prostate; blood in urine can be an early warning sign.
• Inherited disorders: sickle cell disease; Alport syndrome.
• Trauma, medicines and exertion: injury, cyclophosphamide/penicillin, aspirin/anticoagulants, contact sports or long‑distance running.

Occasionally, no clear cause is found.

Symptoms that often accompany blood in urine

Haematuria can be painless, but associated symptoms often point to the cause. UTIs usually add burning, urgency and smelly urine. Kidney infections bring fever and pain in the back or side. Stones cause severe, wave‑like flank‑to‑groin pain. In men, prostate problems add weak flow or night‑time frequency.

• UTIs: burning, urgency, frequency, cloudy/strong‑smelling urine.
• Kidney infection: fever, chills, back/side (flank) pain.
• Stones: severe colicky pain, nausea, restlessness.
• Prostate (men): hesitancy, weak stream, getting up at night.
• Passing clots: painful; may intermittently block flow.

When to seek care: urgent signs versus routine review

Don’t watch and wait: any blood in urine warrants medical assessment. In the UK, arrange an urgent GP appointment if you notice pink, red or dark brown urine — even once or in a small amount, even if you’re not sure it’s blood. If blood is only found on a urine test and you feel well, book a routine review soon.

• Seek urgent help now if you have blood in urine plus fever, chills and back/side (flank) pain — this can signal a kidney infection.
• Severe, wave‑like pain in the side or groin with nausea/restlessness suggests a stone and needs prompt assessment.
• Heavy bleeding or clots with significant pain should be reviewed urgently.
• After a fall or blow to the back/abdomen with blood in urine, get urgent care.
• Any visible blood at any age should be checked, as it can be a sign of cancer and is easier to treat if found early.

Next, here’s how clinicians investigate haematuria to pinpoint the cause.

How haematuria is investigated and diagnosed

Assessment starts with a detailed history (including infections, stones, medicines such as anticoagulants, exercise and trauma) and an examination that may include a pelvic or digital rectal exam. A positive dipstick is confirmed with microscopic urinalysis because false positives occur. Your clinician will then tailor tests to your symptoms, age and risk profile (for example, visible versus microscopic haematuria, fever or flank pain), aiming to identify infection, stones, kidney inflammation or a tumour and to localise the source (kidney versus bladder).

• Urinalysis and microscopy: confirms red cells; looks for protein, white cells and casts.
• Urine culture: checks for urinary tract infection.
• Blood tests: kidney function and markers of infection or inflammation.
• Urine cytology: assesses for abnormal cells when cancer risk is a concern.
• Imaging: ultrasound, CT or MRI to visualise kidneys, ureters and bladder.
• Cystoscopy: a tiny camera examines the bladder and urethra when clinically indicated.

What to expect at your appointment

Most people feel calmer when they know what will happen. We’ll start by clarifying your symptoms, risks and goals. Expect a careful history, an examination of your abdomen and back, and—where appropriate—a pelvic or digital rectal exam. You’ll usually give a urine sample and may have blood tests. We’ll explain likely causes, red flags to watch for, and agree next steps (imaging or cystoscopy) with clear timeframes.

• Provisional diagnosis and safety‑netting
• Tests arranged: urinalysis/culture, ultrasound or CT, cystoscopy if needed
• Immediate treatment and follow‑up: e.g., antibiotics for infection and a set review date

Treatment options based on the cause

Treatment targets the reason for bleeding and aims to stop it recurring. After confirming true haematuria and identifying the source, your clinician will recommend a tailored plan; many causes are straightforward to treat, while others need specialist care and follow‑up.

• Infections (UTI or kidney infection): antibiotics, hydration and pain relief; prompt therapy reduces complications.
• Stones (kidney or bladder): pain control and fluids; if needed, sound‑wave stone break‑up or endoscopic removal.
• Prostate enlargement (men): alpha‑blockers and 5‑alpha‑reductase inhibitors; surgery if bleeding or symptoms persist.
• Kidney inflammation/CKD: nephrology‑led care with medicines to protect kidney function; treatment tailored to the underlying cause.
• Cancer (bladder, kidney, prostate): stage‑appropriate combinations of surgery (including minimally invasive/robotic where suitable), radiotherapy, immunotherapy and/or chemotherapy.

Your clinician will also advise on safety‑netting, monitoring, and when to return if bleeding recurs.

Haematuria in women, men and children: key differences

What causes haematuria can vary by sex and age, so context matters. Women may notice blood around a period or from vaginal sources that mimic urinary bleeding, while men—especially over 50—have prostate‑related causes to consider. In children, visible haematuria is often linked to infection but can occasionally signal stones or kidney inflammation. Whatever your age, visible blood should be checked.

• Women: Period blood can contaminate samples; frequent causes include UTIs. Endometriosis can also lead to haematuria.
• Men: Prostate enlargement or prostatitis can cause bleeding and urinary symptoms; cancer risk (bladder, kidney, prostate) rises with age.
• Children: UTIs are a common cause of visible haematuria; stones, glomerulonephritis, and inherited conditions (e.g., sickle cell disease, Alport syndrome) are important differentials.

Medicines, foods and exercise that can mimic or trigger blood in urine

Not everything red in the loo is blood, and some perfectly safe activities can still trigger true haematuria. Knowing the difference helps you decide what to do next. If you’re unsure whether it’s blood, a urinalysis can confirm whether red cells are present.

• Foods that mimic: beetroot, rhubarb, blackberries and fava beans can tint urine pink, red or brown without any blood.
• Medicines that mimic: phenazopyridine (for urinary symptoms) can turn urine orange‑red without haematuria.
• Medicines that trigger bleeding: cyclophosphamide, penicillin, and blood thinners such as aspirin (antiplatelet) or heparin (anticoagulant) can cause true haematuria.
• Exercise and contact sports: long‑distance running and impacts (e.g., football) can cause transient haematuria; it often settles within a week, but don’t assume—get it checked.

Risk factors and how to lower them

Understanding what causes haematuria also means knowing who’s at higher risk. Your chances rise if you’re over 50, smoke, have recurrent UTIs or stones, a family history of kidney disease, congenital urinary abnormalities, do heavy endurance or contact sports, take blood thinners/NSAIDs/antibiotics, or work with certain chemicals or radiation. Some of these can be modified.

• Hydrate well: aim for regular water intake, especially with exercise.
• Prevent UTIs: pee before/after sex; if you have a vagina, wipe front to back.
• Stop smoking: lowers cancer risk in the urinary tract.
• Review medicines: discuss anticoagulants/NSAIDs with your clinician; never stop on your own.
• Healthy weight and diet: limit salt, sugar and excess animal protein.
• Reduce exposures: follow safety measures if you work with dyes, rubbers, metals or radiation.

Living with haematuria: practical tips after an episode

After an episode of haematuria, it’s normal to feel uneasy. While investigations or treatment are arranged, a few simple habits can reduce risk and help you spot problems early. Stay hydrated, avoid obvious triggers, complete any medicines, and keep a short note of symptoms and timing.

• Hydrate and pause exertion: Hydrate; pause strenuous or contact sport until reviewed. Exercise‑related haematuria often settles within a week.
• Use medicines safely: Finish antibiotics if prescribed; don’t stop blood thinners without medical advice.
• Be ready for retesting: Before retesting, avoid beetroot or urine‑tinting remedies; provide a fresh urine sample. Seek urgent help if you pass clots with pain, can’t pee, have fever with back/side pain, or heavy bleeding.

How private urology can help you get answers sooner

If you’re worried about blood in your urine, private urology offers fast, discreet access to the right tests and decisions. With streamlined pathways and direct consultant input, you can move quickly from first assessment to a clear plan, helping you get to the bottom of what causes haematuria without delay.

• Rapid access: short‑wait appointments and timely scans or cystoscopy.
• One‑stop work‑ups: urine testing, imaging and consultation coordinated together.
• Direct consultant care: continuity from assessment to treatment.
• Specialist expertise: prostate, bladder and kidney evaluation, including robotic surgery where appropriate.
• Clear next steps: personalised plans, safety‑netting and fast follow‑up.

FAQs about haematuria

When you first notice blood in your urine, clear answers help you act with confidence. The questions below cover the essentials: cancer risk, when to call your GP, what can mimic blood, and what simple steps help while you’re waiting to be seen. Keep in mind: don’t ignore visible blood.

• Does blood in urine always mean cancer? No, but it can—get checked promptly.
• Can haematuria be painless? Yes; colour change alone is common. Clots can hurt.
• I saw blood once—should I see a GP? Yes; visible blood even once needs assessment.
• Can foods or medicines change urine colour? Yes—beetroot, rhubarb and phenazopyridine can mimic it.
• Is haematuria contagious? No; UTIs aren’t, though bacteria can sometimes pass during sex.
• Will drinking more water make it stop? Hydration helps, but it won’t treat serious causes.

Key takeaways

Blood in urine is common but never “normal”. UTIs and stones are frequent culprits, yet visible haematuria can be an early sign of bladder, kidney or prostate cancer. Don’t self‑diagnose foods or period blood—confirm with a test. Early assessment, targeted investigations and cause‑led treatment are the safest route to clarity and peace of mind.

• Get checked promptly: Any visible blood warrants an urgent GP review.
• Know red flags: Fever with flank pain, severe colicky pain, clots, or trauma need urgent care.
• Expect structured tests: Urinalysis/culture, imaging and, when indicated, cystoscopy.
• Treat the cause: Antibiotics, stone management, prostate therapies or cancer pathways as needed.
• Control risks: Hydration, stop smoking, UTI prevention, and medicine review.

For fast, discreet answers and a clear plan, consider a private consultation with Ashwin Sridhar Urology.