What should you know about blood in urine and vomit?

Blood in urine, also called haematuria, may come from the kidneys, bladder, ureters, or urethra. Causes include a urinary tract infection, kidney infection, kidney stones, prostate inflammation, or an enlarged prostate. Less common but important causes include bladder or prostate cancer, and some inherited blood conditions such as sickle cell disease. The colour can range from pink to red or brown, and blood may be visible or found only on a urine test.

Blood in vomit can look bright red, dark, or like coffee grounds. It may arise from bleeding in the upper digestive tract, sometimes after repeated forceful vomiting, irritation, an ulcer, or another condition. Swallowed blood from the nose or mouth can also appear in vomit, but it should not be assumed to be the cause without assessment. These two symptoms may have separate causes, so tell the clinician about both.

Arrange a same-day medical assessment if you see blood in your urine or vomit, even if it settles. Note when it started, how much you saw, its colour and appearance, and whether it followed injury, strenuous activity, or repeated vomiting. Mention burning when passing urine, fever, flank or abdominal pain, difficulty passing urine, black stools, or recent medicines such as blood thinners or anti-inflammatory painkillers.

Do not drive if you feel faint or weak. Avoid alcohol and do not take extra doses of pain medicine while waiting for advice. A clinician may examine you and arrange urine and blood tests; further tests depend on the suspected source of bleeding.

Go to an emergency department or call emergency services now if you are vomiting a large amount of blood, passing clots or a lot of blood in urine, or have fainting, confusion, severe weakness, rapid breathing, severe abdominal or back pain, or trouble breathing. Urgent help is also needed if you cannot keep fluids down, cannot pass urine, have black tarry stools, or take medicine that affects clotting.

While waiting for help, sit or lie down if light-headed and have someone stay with you. Do not eat or drink if you are actively vomiting blood unless an emergency clinician tells you to do so.

Ask: Where might the bleeding be coming from? Which urine or blood tests are needed? Could my medicines be contributing? What symptoms should send me straight to emergency care? If the bleeding stops, when should I be rechecked?