Understanding Hematuria: Causes, Symptoms, Diagnosis & Treatment

What Exactly Is Hematuria?

When someone says “I’m seeing red,” they may refer to a bold shade of blood in the toilet, or to a mere blush of pink in their urine. That’s hematuria. There are two types:

• Gross (visible) hematuria: You can actually see the blood yourself—ranging from light pink or red to a deep, cola‑colored hue.

• Microscopic hematuria: The urine looks normal to the naked eye, but a lab test reveals red blood cells. This type is more common and often discovered during routine screening.

Whether visible or invisible, hematuria can indicate anything from harmless factors—like a recent workout—to serious conditions like infection or kidney disease.

Who Gets It—and Why?

Hematuria can appear in anyone at almost any age. Here's a breakdown of common causes and who may be at risk:

1. Urinary Tract Infections (UTIs): Especially in women, UTIs frequently cause irritation and bleeding in the lining of the bladder or urethra. You might notice pain with urination, urgency, or a foul smell.

2. Kidney Stones: Sharp, sudden pain in your back or side, nausea, and blood in the urine—that’s the classic kidney stone picture. Even tiny stones can cause micro‑bleeding as they scrape their way along.

3. Exercise‑Induced Hematuria: Endurance athletes—particularly long‑distance runners—sometimes experience mild, temporary hematuria. Blame it on bladder jarring or mild dehydration.

4. Medications and Foods: Beets, blackberries, and even rifampin and some blood‑thinning medications can cause a harmless color change. If you recently tried a new antibiotic, blood thinner, or worked out hard after eating a bunch of beets—rule that out first.

5. Benign Prostatic Hyperplasia (BPH): Older men may notice blood in the urine due to an enlarged prostate putting pressure on the urinary tract.lder men may notice blood in the urine due to an enlarged prostate putting pressure on the urinary tract.

6. Bladder or Kidney Cancer: This is rarer overall, but any persistent gross hematuria, especially in adults over 50 or smokers, should be investigated thoroughly.

7. Glomerular (Kidney) Disease: Conditions affecting the kidney’s filtering units—like glomerulonephritis—can cause micro or macro‑hematuria, often accompanied by protein, swelling, or high blood pressure.

8. Trauma: A hard bump to the kidney area, pelvic injury, or anything that causes damage to urinary structures may result in blood appearing in your urine.

Symptoms That Usually Tag Along

Hematuria doesn’t appear in isolation. Here are symptoms to watch for:

• Burning or pain during urination (often UTI‑related)

• Frequent urge to urinate or inability to fully empty the bladder

• Pain in your side, back, or abdomen, possibly radiating

• Fever or chills, signaling infection

• Swelling in hands, feet, or face, or high blood pressure—suggesting kidney issues

Understanding these symptoms helps clinicians categorize the likely cause and speed up your diagnosis.

How Is Hematuria Diagnosed?

Here’s what your healthcare provider will likely do:

1. Detailed Medical History
   They’ll ask about any recent illness, exercise, medication use, herbs, or foods. Smoking and cancer risk are also important to discuss.

2. Physical Exam
   They’ll check your abdomen, flank, bladder, and for men—testicles and prostate.

3. Urine Test (Urinalysis)
   This is the first lab step. It identifies red blood cells, infection, protein, or crystals. If bacteria show up or there’s evidence of infection, that’s the obvious culprit.

4. Repeat Test
   Especially for microscopic hematuria, doctors often repeat the urine test at a later date to confirm whether it’s persistent or a one‑time fluke.

5. Imaging Studies

   • Ultrasound of kidneys and bladder to spot stones or growths.

   • CT scan offers more detail and is especially useful for detecting kidney stones, masses, or anatomical abnormalities.

   • Cystoscopy, where a tiny camera inspects the bladder and urethra directly—used when cancer or bladder pathology is suspected.

6. Blood Tests
   These help assess kidney function (e.g., creatinine, BUN), check clotting if you’re on blood thinners, and screen for diseases like lupus or vasculitis if glomerular disease is suspected.

Treatment: What to Expect

Treatment depends on the underlying cause:

• UTIs typically clear up with antibiotics in days. A follow‑up urine test confirms resolution.

• Kidney stones: Small stones often pass on their own with hydration and pain control. Larger stones might need lithotripsy (sound wave breakup) or surgical removal.

• Enlarged prostate symptoms can be managed with medications like alpha blockers or 5‑alpha reductase inhibitors, sometimes surgery.

• Glomerular disease: May need steroids or immunosuppressants if caused by autoimmune or inflammatory conditions.

• Cancer or suspicious growths: Might require surgical removal, chemotherapy, or radiation, depending on type and stage.

Throughout the process, hydration, pain control, and follow‑up are key. Persistent or recurring hematuria always demands thorough evaluation.

Lifestyle, Prevention & When to See a Doctor

Preventive habits:

• Stay well‑hydrated—aim for pale, straw‑colored urine.

• Don’t hold it in too long—urinate regularly.

• Avoid excessive back‑to‑back endurance competitions without hydration management.

• Share a complete medication & supplement list with your doctor, including OTC pain relievers and herbs.

• If you're a smoker, quitting reduces your risk of bladder cancer—and improves overall urinary tract health.

Urgent signs—get medical help if you notice:

• Large, bright‑red or dark red blood.

• Clot formation.

• Severe pain or inability to urinate.

• Fever with hematuria (suggests infection).

• New swelling, foamy urine, or high blood pressure.

  
  

FAQ Section

Q1: Can dehydration alone cause hematuria?
Yes—especially if paired with heavy exercise. Dehydration can concentrate urine and exacerbate bladder irritation, sometimes leading to temporary hematuria.

Q2: If I only see microscopic hematuria once, do I need a full work‑up?
Typically, doctors will repeat the test. One isolated episode might be harmless, but persistent microscopic hematuria usually warrants evaluation with imaging and possibly a referral.

Q3: Are there any foods that mimic hematuria?
Yes. Beets, blackberries, and rhubarb can color your urine red or pink temporarily. It’s harmless—but worth ruling out before jumping to alarms.

Q4: Does hematuria always mean cancer?
Not at all. Only a small share of cases turn out to be cancer—though it’s important to rule out, especially if you have risk factors like age over 50, smoking history, or visible blood in the urine.

Q5: Can medications cause hematuria?
Absolutely. Blood thinners, certain antibiotics (like rifampin), and even NSAIDs or supplements may increase bleeding risk or color your urine. Always discuss new medications with your provider.

Hematuria can feel scary, but in many cases, it’s benign or easily treatable. What matters is recognizing when to pay attention—and when to get checked. Simple steps like staying hydrated, tracking medications and recent activity, and consulting your provider can make a big difference.

If you’re looking for expert guidance and compassionate care in your area, consider turning to Urology Partner Of North Texas.