Seeing pink, red or cola-coloured urine is alarming. Often the cause is an infection or kidney stone, but blood in urine (haematuria) can also be an early sign of bladder or kidney cancer, so it should always be checked.
Imagine noticing red urine once, with no pain at all. It’s clear the next day, so you forget about it. A few weeks later it happens again. This time you see a healthcare provider, and tests find an early bladder tumour that’s removed successfully. Painless bleeding was the only warning.
Common causes
- Urinary tract infection, often with burning and frequency
- Kidney stones, often with severe pain in the side or back
- Enlarged prostate in men
- Kidney conditions such as glomerulonephritis
- Vigorous exercise
- Blood thinners, which can unmask another cause
- Schistosomiasis, a parasitic infection in some parts of the world
- Bladder, kidney or prostate cancer, more likely over 45, in smokers and with certain chemical exposures
Some foods (beetroot, berries) and medicines change urine colour without blood, and in women period blood can mix with urine.
But what tests will I need?
Usually a urine test and blood tests first. Depending on your age and risk, you may be referred for an ultrasound or CT scan and a cystoscopy, where a thin camera looks inside the bladder. Many of these are quick outpatient tests.
Seek urgent help if you can’t pass urine, are passing clots, have severe pain, fever with back pain, or feel faint.
Your next step: If you’ve seen blood in your urine, even once and even without pain, book a healthcare provider’s appointment this week.
Sources: NHS (Blood in urine), American Urological Association, Cancer Research UK (Bladder cancer symptoms), World Health Organization (Schistosomiasis).
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