Having bloody urine is frightening for anyone. Medically, this condition is called Hematuria. Hematuria can indicate a serious illness such as cancer, or it may just indicate a kidney stone or urinary tract infection. If you have bloody or red urine, contact your doctor right away.

Types of Hematuria

There are two types of Hematuria: gross (visible to the naked eye) and microscopic (visible under a microscope).


Patients may notice varying colors of their urine, depending on the type and severity of hematuria present. Fresh blood will lead to bright pink or red urine, whereas old blood can produce dark brown or coca-colored fluids. Rarely, this could result in a blockage of the urethra requiring urgent medical attention. Severe flank pain and the passage of thread-like blood clots can be indicative of kidney stones or cancer.

Causes of Hematuria

1. Cancer of the kidneys or bladder
2. Stones in the kidneys or bladder
3. Infection of the urinary tract
4. A patient who is taking a blood thinning medication, such as aspirin, clopidogrel, or warfarin
5. Diagnosis of polycystic kidney disease
6. Cancer of the prostate or benign prostate enlargement (in elderly men)
7. Trauma to the kidneys or bladder
8. Disease of the kidneys (glomerulonephritis, for example, Ig A nephropathy)

While these are serious disease which cause hematuria , there are other benign causes or mimicker which may look like Hematuria. For eg. 

1. Strenuous exercise – It is common for long distance runners or anyone who exercises regularly to suffer from hematuria, which is called jogger’s hematuria. This usually clears on its own, but one should still undergo further testing to rule out more serious conditions.
2. Menstruation can sometimes be confused with hematuria.
3. If you eat beat root or rhubarb, your urine may turn red.
4. Phenazopyridine, cyclophosphamide, multivitamins, etc. can change the color of urine and may confuse it with hematuria.

When to consult doctor

If you are concerned that you have passed blood into your urine even once, you should consult your doctor. The doctor will take a history of your symptoms, as well as any associated flank pain, urinary burning, and medications. An examination of the abdomen and general health are done after the history is taken. An initial investigation usually involves urine microscopic examination and ultrasound. Further social investigations may be ordered if necessary after a working diagnosis is achieved with this workup.


The severity of symptoms, the clinical condition, and the cause of hematuria determine the treatment. Antibiotics are prescribed for urinary infections. Kidney stones are treated with medicine or endoscopic surgery, depending on the condition. Blood thinners are stopped for a few days if they are the culprit. If an ultrasound reveals cancer, appropriate treatment will be advised.

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