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What causes blood in the urine?

Seeing blood in your urine is understandably upsetting. The causes of this symptom can range from harmless to serious. Joel Garrison, D.O., a Piedmont family medicine physician, shares the most common causes of blood in the urine and when to see your health care provider.

Blood in the urine is also known as hematuria. If you can see visible blood in your urine, that’s called gross hematuria. Hematuria can cause your urine to look red, pink or brown and usually isn’t painful. Dr. Garrison says dehydration can also cause the urine to appear darker, but if you’re well-hydrated and still have dark urine, that could be a sign of hematuria.

Sometimes, blood in the urine isn’t visible and can only be detected in an urinalysis test.

Conditions that can cause blood in the urine

Blood in the urine can be caused by a wide range of health conditions, from benign to life-threatening. Dr. Garrison says hematuria can be caused by:

Sometimes, eating beets or taking certain over-the-counter urinary tract infection medications can cause the urine to look red.

What increases your risk of hematuria?

You may be at increased risk of having blood in your urine if you:

  • Are a male and over 50

  • Smoke

  • Have high blood pressure

  • Have diabetes

  • Have a history of urinary tract, kidney or bladder infections

  • Have a personal or family history of kidney stones or kidney disease

  • Take antibiotics, nonsteroidal anti-inflammatory pain relievers or aspirin

  • Are a long-distance runner or frequently do intense workouts  

When to see a doctor for blood in your urine

“It’s worth seeing your health care provider if there’s blood in your urine,” Dr. Garrison says. “It’s generally not something that resolves on its own.”

He notes that even if your urine returns to a normal color, there could still be a microscopic amount of blood present, so it’s best to make an appointment if you notice anything abnormal, even for just a day or two.

“If your urine is back to normal, your provider can do a quick urine test,” he says. “If everything is normal, and you’re feeling well, you likely won’t need any follow-up visits or tests.”

If your provider sees a structural condition, like a kidney stone, or an infection, they may order an ultrasound or CT scan to look at your urinary system.

How is hematuria treated?

Treatment for blood in your urine depends on the underlying cause.

“Treatment could be anything from monitoring and rechecking your urine in a week or two, or it could be symptom-directed treatment,” Dr. Garrison says. “If you have a common issue like a urinary tract infection or a kidney stone, you’ll need treatment for those conditions.”

If you notice discolored urine and you’re not dehydrated, make an appointment with your primary care provider to get checked out.

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