Hematuria - Pacific Crest Trail


Hematuria is basically blood in the urine. There are many causes, but one of them is referred to a Sport’s or Runner’s hematuria. It is common in long distance runners where the lack of fluids in the bladder allows the walls of the bladder to rub against each other and cause red blood cells to enter the urinary tract. It also has a relation to excessive jarring of the bladder and hydration levels. Depending upon the level of fluid in the bladder, the signs range from a tinge of red to bright red. I had an issue with this on a recent trip along the JMT but there does not seem to be much information about it’s occurance in backpackers. Since most of the trips along this trail include long strenuous days, I was wondering if some of you also noticed these conditions?

Old Grey


Yup!! Been there, done that! But it really isn’t the kind of thing that most people want to talk about.

I did the PCT last year and experienced this phenomenon twice. Scared the hell out of me! And I didn’t have a medical name to call it. But I knew better than to check with a doctor because I figured that he would tell me that I needed to get off the Trail and get some rest. If I did that, I might not finish, and I was determined to complete the trip in one hiking season!

Just so that you don’t think that I am totally irresponsibible–I did have a physical after completing the trip. After a very invasive urinary/badder procedure, I was pronounced to be in very good physical condition.

Thanks for asking the question–now I know what to call the condition if it happens again next year!



Another cause is from a urinary tract infection which are also common when thru hiking. The important thing is to watch for fever & chills associated w/ hematuria and then get yourself to a doctor to get on an antibiotic!!!



A UTI while hiking is one of my worst nightmares. I carry pyridium (UT analgesic) and Cipro just in case. Ugh.

Shelly Culbertson


Wildcat: blood in your urine and you concluded that you should avoid a doctor? I’m not sure I follow the logic there. I understand the desire to finish in one year, I had to stop in 2004 due to a stress fracture, but I’d rather stay healthy to hike again than risk some more serious/permanent problem.



Everyone must make personal decisions regarding their own medical situation. One person’s decision to move on can be considered idiotic by some, but strong by others. Another person’s decision to stop can be considered rationale by some but weak by others. It’s personal. Your logic was obviously different.



In all fairness to Wildcat, if the symptoms were similar to mine it never seemed life threatening, just scary as hell! It would subside when rested and get worse under stress. Once I rested for a day or so, there were no symptoms at all. So to go off trail and see the doctor was an option but not the only one and not crazy to not do. I’m not saying all hematuria is mild, but under the situation I hiked for another 4 days and 40+ miles and bailed because it was a logical place and to continue would have been another 40 miles or so to the next bail out point. Would I bail out where I did again, under the circumstance, yes. Knowing what I know now, I would drink much more water and fluids and take it easy for a day or so and keep hiking. But heck, I’m an old fart so who knows!:oh

Old Grey


Hematuria is fairly common among distance runners I’ve been around groups of a few hundred people training for marathons and it seems to crop up every year It is seldom serious, but for someone training for a marathon with easy access to health services who observes blood in the urine for the first time, it is smart to see a doctor However, some of the more experienced runners who had experienced it before saw it merely as a sign to back off a bit and pay attention to hydration The condition usually disappeared quicky with rest and water The decision would be more difficult on the trail, but I think slowing down, hydrating concientiously to see if the symptoms disappear is a rational approach If you continue to see blood in your urine after rest and rehydration, I say get off the trail and see doctor I wouldn’t fault anyone who bailed at the first sign of Hematuria either If “better safe than sorry” characterizes your approach to life, by all means get treatment



Happened to me last week after 9 days on the trail. Pissed painful blood every 20 min for 5 days before I got off the trail. I would rest and wake up thinking I am cured then as the hike progressed the painful bloody pee would come back. Got off the trail afraid I would be in a spot needing evacuation. Got home and Doc cant find anything wrong with scans and urine tests. Made me take antibiotics. Thanks now I have a name for it. I got to be known on the trail as the guy pissing blood.