Why is There Blood in My Urine and Should I Worry?

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group
Published: July 9, 2025Updated: July 9, 2025

Key Takeaways

Seeing blood in urine—called hematuria—usually comes from a urinary-tract infection, kidney stone, or an enlarged prostate, but it can also signal kidney disease or bladder cancer. Any visible red, pink, or cola-colored urine needs prompt medical evaluation within 24 hours, especially if it’s accompanied by pain, clots, or difficulty passing urine.

What are the most common reasons urine turns red or pink?

Blood in urine (hematuria) happens when red blood cells leak anywhere from the kidneys down to the urethra. The leak may be microscopic—seen only on a dipstick—or visible to the naked eye. Knowing the likely sources helps you decide how urgently you need care.

  • Urinary-tract infections irritate the bladder liningBurning, urgency, and foul-smelling urine often accompany UTIs. Up to 30 % of cases of visible blood in younger adults are due to an infection.
  • Kidney stones scrape the collecting systemSharp crystals can cut tiny vessels, causing sudden bleeding and crampy flank pain. Stones are responsible for about 10–15 % of gross hematuria visits.
  • An enlarged prostate bleeds where it touches the urethraMen over 50 frequently pass blood when benign prostatic hyperplasia (BPH) flares, especially after vigorous activity or sex.
  • Strenuous exercise can cause ‘jogger’s hematuria’Long-distance runners sometimes see pink urine that clears within 48 hours of rest. Sina Hartung, MMSC-BMI notes, “Repeated bladder wall trauma from running is benign but should still be confirmed by a dipstick.”
  • Cancer remains a critical but less common causeBladder or kidney cancer explains roughly 4 % of first-time hematuria episodes; the risk rises with age, smoking, and occupational chemical exposure.
  • Foods and medications can harmlessly tint urine redMayo Clinic notes that beets, blackberries, rhubarb, rifampin, and the bladder-pain reliever phenazopyridine are well-known culprits that color urine pink or red without any blood present. (MayoClinic)
  • Hematuria is found in about 1 in 5 urology clinic patientsAccording to the NIDDK, at least 20 % of people evaluated by urologists are diagnosed with blood in the urine, underscoring how common the problem is. (NIDDK)

When is blood in urine an emergency that needs same-day care?

Not all hematuria is life-threatening, but certain patterns point to major bleeding, obstruction, or infection in the kidneys. Seek immediate help if any danger signs appear.

  • Passing clots that plug the urine streamClot retention can suddenly block the bladder; emergency catheterization may be needed. “Clots bigger than a pea warrant an ER visit,” advises the team at Eureka Health.
  • Back or side pain with fever over 101 °FThese signs suggest pyelonephritis—an infection reaching the kidneys—which can progress to sepsis within hours.
  • Visible blood after recent abdominal traumaGross hematuria following a fall or car crash can indicate kidney laceration; CT imaging must be arranged urgently.
  • New bleeding while on blood thinnersWarfarin, DOACs, or aspirin may turn a small leak into significant hemorrhage; dosing often needs adjustment under medical supervision.
  • Pink urine that persists longer than 48 hoursEven painless bleeding deserves urgent attention to rule out malignancy, especially in smokers over 40.
  • Can’t pee at all after seeing red urineSudden urinary retention alongside hematuria points to clot obstruction; Advocate Health Care recommends calling 911 if you cannot pass urine once blood appears. (Advocate)
  • Hematuria occurs in up to 30 percent of adultsThe Cleveland Clinic notes that 2 %–30 % of adults experience blood in the urine at some point, underscoring why any visible bleeding deserves prompt evaluation. (CCF)

What can you do at home until you see a clinician?

Self-care will not replace medical evaluation, but it can relieve symptoms and reduce the chance of complications while you wait for test results or appointments.

  • Drink enough to keep urine pale yellowAim for 2–3 L of water per day unless your doctor has restricted fluids; flushing the tract may reduce clot formation.
  • Use a heating pad for mild flank discomfortGentle heat eases muscle spasm around an irritated ureter. Sina Hartung, MMSC-BMI cautions, “Skip heat if you also have fever—it can mask worsening infection.”
  • Avoid strenuous exercise or heavy liftingRest limits additional micro-trauma to the urinary tract, especially after stone passage or prostate bleeding.
  • Skip beetroot, blackberries, and food dyesThese can mimic blood and confuse the picture; keep a simple diet until hematuria is clearly resolved.
  • Write down timing, color, and associated symptomsA symptom diary helps your provider link bleeding to triggers like sex, medications, or physical activity.
  • Seek urgent care if fever or trouble passing urine developsKaiser Permanente notes that hematuria with a fever or difficulty urinating may indicate infection or obstruction and warrants prompt evaluation in an urgent care or emergency setting rather than waiting for a scheduled appointment. (KP)

Which tests and treatments are commonly ordered for hematuria?

Your clinician’s first step is confirming that what looks like blood truly contains red blood cells. Next comes locating the source and deciding on treatment.

  • Dipstick and microscopic urinalysis are gatekeepersA positive blood pad plus >3 red cells per high-power field defines hematuria; false positives from myoglobin or beet pigment are quickly ruled out.
  • CT scan with contrast visualizes kidneys and uretersComputed tomography detects 95 % of stones and most tumors larger than 5 mm, often within 30 minutes in the emergency department.
  • Cystoscopy inspects the bladder wall directlyUrologists pass a tiny camera via the urethra under local anesthesia; it finds 90 % of bladder cancers at first presentation.
  • Antibiotics target infection when culture grows ≥100,000 CFUThe team at Eureka Health explains, “Choosing the right antibiotic depends on local resistance rates and kidney function.”
  • Alpha-blockers ease passage of small kidney stonesMedications like tamsulosin relax the ureter; randomized trials show a 29 % higher stone-free rate for stones 5–10 mm compared with placebo.
  • Urine cytology detects malignant cells missed by imagingFor patients at higher cancer risk, laboratories examine exfoliated cells in a fresh urine sample; abnormal cytology prompts closer cystoscopic or imaging follow-up even when other tests appear normal. (WisUro)
  • Scheduled follow-up confirms that bleeding has resolvedMayo Clinic recommends repeat urinalysis after treatment because persistent hematuria can signal stones, infection, or tumors that were initially occult. (Mayo)

Frequently Asked Questions

This content is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for diagnosis, treatment, and personalized medical recommendations.

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