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Haematurie
Even once and painless it needs assessment — precisely because it feels harmless.
Also known as: blood in urine · haematuria · red/brown urine
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Reddish or brown urine, or blood found in the lab. Common and usually treatable causes are a urinary infection (cystitis), kidney stones or — in women — mixing with menstrual blood. Some foods (beetroot) and medicines also turn urine red without any blood. Even so: visible blood in the urine should always be medically assessed to safely rule out rarer but important causes (bladder or kidney disease) — usually with a reassuring result. Accompanying signs help: burning and frequent urging suggest infection, crampy flank pain suggests stones, and painless blood should always be assessed.
Blood, visible or only on the dipstick, together with a wave-like pain in the flank makes a stone the nearest explanation. Visible blood without pain, by contrast, belongs clarified in its own right.
The key step — even if the blood goes away again.
Burning, flank pain, fever or painlessness help the assessment.
The common causes are treatable — drinking plenty often helps.
With red urine, consider beetroot/medicines — when unsure, have the urine tested.
Bathing or wading in lakes and rivers south of the Sahara can cause blood in the urine weeks to months later — through a fluke that travels into the bladder wall. The search is in the urine and in the blood, and the treatment is simple.
In young people from Africa this is such a common sign that it was long taken there for normal. It is treatable, and the treatment prevents the late consequences.
In adults over thirty-five, visible blood in the urine is a sign of a bladder or kidney tumour in about ten to twenty out of a hundred cases — which is why even a single painless episode is investigated. Blood detectable only under the microscope, without visible colour, is far more often harmless. After hard exertion, during menstruation and after an infection, blood can appear temporarily; a check follows after two to four weeks.
There is no drug for blood in the urine — the cause is treated, and finding it is the whole task here. An antibiotic is right only if there really is an infection; if one is given for visible blood without symptoms and the blood disappears, nothing has been clarified. Tranexamic acid can slow a bleed and is used only after the work-up, because it can encourage clots in the bladder.
Points to a urinary infection (cystitis).
Points more to kidney stones.
Painless visible blood in particular should always be assessed.
Beetroot or medicines can colour the urine red.
The single most important hint of worms in the blood. They are raised with worms that travel through tissue — not with giardia, threadworms and amoebae, which stay in the bowel. A normal value therefore rules nothing out.
Where blood is lost regularly the store empties long before the haemoglobin falls. Ferritin shows this earlier than the blood count — and refilling takes months, not weeks.
A sufficient amount of urine across the day dilutes what would otherwise crystallise or irritate. Spread evenly it works better than in two large portions.
Clearly improves the uptake of plant iron. A glass of orange juice or some pepper with the iron-rich meal does more than the choice of preparation.
With reduced kidney function it rises and becomes dangerous for the heart rhythm; under water tablets it falls. In both directions it belongs measured and not guessed.
Belongs in the workup of any anaemia, because a lack makes the same picture as iron deficiency — only with large instead of small red cells. Both can exist side by side.
Visible blood in the urine belongs examined, even if it appears only once and does not hurt — precisely then. No preparation, no tea and no bladder course stands before that work-up, and an agent that makes the colour look normal again has clarified nothing.
Before blood is assumed, a look at the plate is worthwhile: beetroot colours the urine strongly red in a proportion of people, as do blackberries and rhubarb. From the pharmacy rifampicin, some senna laxatives and phenazopyridine do it. Riboflavin makes bright yellow, not red.
Readily taken at the first sign of a bladder matter. It can slightly lower the number of recurring bladder infections in women — but it does not treat an existing one, and it certainly does not clarify blood in the urine. With warfarin-type medicines it belongs discussed, because it can shift the clotting value.
Clearly effective with proven deficiency, useless without. Take only with a documented deficiency — excess is harmful.
Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.
After menopause the lining of the urethra becomes thin and fragile — visible blood without an infection can come from that. The reason still belongs looked for: this explanation is only taken once the others are ruled out.
Kidney stones are a common source, and an overactive parathyroid is one of the few fixable reasons for them. With repeated stones the calcium in the blood belongs measured — it is missed for years.
Beetroot, rhubarb and some medicines colour urine red. A test strip tells the difference in seconds — real blood in urine always belongs investigated.
Blood in the urine always belongs investigated — even if it happened once and did not hurt. This stands here so no one waits it out with a home remedy.