Blood in urine: causes, warning signs and what to do

For your safety, do not wait for a video visit: go to the emergency room or call 911 if you have any of these signs. See when to go to the ER.

• Severe pain in your side or back with fever, chills or vomiting
• You cannot pee, or only a little comes out with a lot of effort
• Blood clots in your urine
• A lot of blood, or you feel dizzy or weak
• Blood in your urine after a fall, blow or accident

Doctors call it hematuria. According to the NIH there are two kinds: blood you can see, when urine looks pink, red or tea-colored, and blood you cannot see that only shows up on a urine test.

The most common causes are an infection of the bladder, kidney or prostate, kidney or bladder stones, an enlarged prostate and very hard exercise. Blood thinners can also cause it. Less common but serious causes include bladder or kidney cancer and kidney disease. That is why MedlinePlus says never to ignore blood you see in your urine.

Are you sure it is blood? Beets, other foods and some medicines can turn urine red. In women, blood may come from a period rather than the urine. A urine test settles it.

Video doctor visits 24/7 — book online and choose your time right away.

A doctor visit has the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the clinic can’t see you. The lab charges for the tests separately. For existing patients, reviewing the results the doctor ordered is a follow-up visit. See all prices.

The first step is almost always a urinalysis, which confirms whether there is blood and looks for signs of infection. Depending on your case, a urine culture and blood tests such as a blood count and creatinine are added.

According to the NIH, if the test confirms blood and there is no clear cause, the next step may be imaging (ultrasound or CT) and a cystoscopy, a look inside the bladder with a thin camera. Those tests are done in person: the doctor tells you which specialist you need and refers you.

According to the National Cancer Institute, smoking is a major risk factor for bladder cancer, and the risk goes up with age. If you smoke or used to, do not let blood in your urine slide, even if it went away on its own.

In women, the most common cause of blood in urine is a urinary tract infection, with burning and needing to pee often. Period blood can mix with the sample: if a test taken during your period shows blood, it is repeated once your period ends. If you are pregnant and see blood in your urine, call your OB.

In men, especially older men, blood in urine can come from an enlarged prostate or a prostate infection. Because smoking and age raise the risk of bladder cancer, if you can see blood and there is no infection, the doctor refers you to a urologist in person.

In children, blood in the urine can come from a urinary tract infection, an injury, or kidney inflammation after a throat infection. The doctor evaluates your child by video with you on camera and gives you the order for a urine test. Patients under 21 need a parent or legal guardian on camera for the whole visit, with ID. For safety, go to the ER if your child has blood in the urine with a swollen face or legs, is peeing very little or has severe pain.