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26-05-2024 Team Medicover pulmonology

Written by Medicover Team and Medically Reviewed by Dr Meghana Reddy S, Pulmonology

Coughing Up Blood: Causes, Risks, and When to See a Doctor

We all experience coughing occasionally due to colds, dust or allergies. But what if you cough and notice blood coming out? That's when most of us get worried and it's completely normal to feel scared. Blood in the cough is not something to ignore.

In India, where infections like tuberculosis and pneumonia are still quite common, coughing up blood should never be taken lightly. However, coughing up blood is not an emergency every single time. It's important to know when to see a doctor immediately and when you can take a little time to get checked.

This article will explain what coughing up blood means, the possible causes, how serious coughing up blood can be and what you should do if it happens to you or your family members.

What is Coughing Up Blood?

Coughing up blood, also called hemoptysis, is the act of expelling blood or blood-streaked mucus from the lungs or airways when coughing. The blood may be bright red, pink or rust-colored and can appear with phlegm or on its own. It may come from the throat, trachea, bronchi or lungs due to an infection, inflammation or other respiratory conditions.

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What Does It Mean When You Cough Up Blood with Mucus?

Hemoptysis means the blood comes from your lungs or airways, not just your mouth or throat. The blood may look bright red, dark or mixed with mucus.

Knowing where the blood is coming from is important because the causes and treatment can differ.

Is Coughing Up Blood a Serious Concern?

Coughing up blood can be serious based on the amount, frequency and its cause. While small amounts of blood like streaks in mucus from coughing too hard or throat irritation are often not life-threatening, any instance should be evaluated by a doctor to find out the problem.

When It's Less Serious:

Small streaks of blood due to severe coughing or throat irritation
Mild respiratory infections like acute bronchitis
Nosebleeds or bleeding gums that mix with saliva

When to worry about Coughing Up Blood :

Large amounts of blood (more than a few teaspoons or recurring)
Blood comes out in pure form without mucus.
Coughing up blood is accompanied by shortness of breath, chest pain, dizziness or fever.
History of lung disease, tuberculosis or cancer.
You are a smoker or have unexplained weight loss and fatigue.

In such cases, coughing up blood could be a sign of conditions like lung cancer, pulmonary embolism, tuberculosis or severe infections and medical diagnosis is essential.

Understanding the Difference Between Blood in Cough and Vomit

Though they may seem similar, coughing up blood (hemoptysis) and vomiting blood (hematemesis) are very different and come from different parts of the body:

Feature	Coughing Up Blood (Hemoptysis)	Vomiting Blood (Hematemesis)
Source	Lungs or airways	Stomach or upper digestive tract
Appearance	Bright red, frothy, may mix with mucus	Dark red or brown (coffee-ground appearance), may mix with food
Associated Symptoms	Coughing, chest pain & shortness of breath	Nausea, abdominal pain & vomiting
Common Causes	Lung infection, TB, cancer and trauma	Peptic ulcer, liver disease and esophageal varices

What are the Causes of Coughing Up Blood?

Lung infections like pneumonia or tuberculosis can cause damage and bleeding.
Chronic lung diseases such as COPD or bronchiectasis cause ongoing damage.
Lung cancer can erode blood vessels inside the lungs.
Blood clots in lungs (pulmonary embolism) cause damage and bleeding.
Chest injuries or inhaling foreign objects can also cause bleeding.
Blood thinners increase the chance of bleeding in the lungs.

Other health Conditions cause Hemoptysis

Bronchoscopy
Spirometry
Laryngoscopy
Tonsillectomy
Nasal surgery
Upper airway biopsy

Risks of Coughing Up Blood

Coughing up blood can range from mild to life-threatening, depending on its cause and severity. Here are the main risks associated with this condition:

Airway blockage: Large amounts of blood can obstruct breathing and lead to respiratory failure.
Severe blood loss: Persistent bleeding can cause a significant drop in blood volume, leading to weakness, dizziness or shock.
Health issues: It may be a sign of lung cancer, tuberculosis, pulmonary embolism or other life-threatening illnesses.
Infection complications: If caused by pneumonia or bronchitis, delayed treatment may worsen the infection and lung damage.
Delayed diagnosis: Ignoring the symptoms can delay the detection of diseases like cancer or severe infections.
Emotional distress: Repeated episodes can cause anxiety, fear and reduced quality of life.

What Should You Do If You Cough Up Blood?

Stay calm, but don't ignore it.
Note how much blood and for how long you are coughing it up.
If bleeding is heavy or you feel breathless, rush to the hospital immediately.
For small amounts, book an appointment with your doctor quickly.
Tell the doctor about your medical history, medicines, smoking, or any recent illness or injury.

Diagnosis of Coughing Up Blood

Physical exam: Your doctor will ask about symptoms, smoking history, recent infections, chronic illnesses and medications.
Chest X-ray: This is the first imaging test to detect lung infections, tumors or other abnormalities.
CT scan: It provides a more detailed view of the lungs to detect small tumors, infections or blood clots.
Bronchoscopy: A thin tube with a camera is inserted into the airways to visually inspect for bleeding sources, tumors or infections.
Sputum analysis: A sample of coughed-up mucus is tested for infections like tuberculosis or cancer cells.
Blood tests: To check for clotting issues, infections or low blood counts (anaemia).

Treatment of Coughing Up Blood

How is coughing up blood treated? Treatment depends on the cause, the amount of bleeding and the patient's health condition. Here's how it is typically managed:

Antibiotics or antivirals are prescribed to eliminate the infection.
Cough suppressants can be used if the cough is irritating the throat and worsening the bleeding.

Coughing Up Blood While Pregnant

Coughing up blood during pregnancy is not common and should be taken seriously. It may occur due to respiratory infections, bronchitis, pneumonia, or, in rare cases, lung or blood vessel issues. Pregnancy causes changes in the immune system and increased blood volume, which can make minor irritations or nasal bleeding more noticeable in sputum.

Possible Causes:

Respiratory infections: Viral or bacterial infections can inflame the airways and lead to blood-streaked mucus.
Bronchitis or pneumonia: Lung inflammation can cause coughing up small amounts of blood.
Nasal or throat irritation: Increased blood flow during pregnancy can make minor nose or throat bleeding appear in cough.
Severe causes: Rarely, conditions like tuberculosis or blood clotting issues can be involved.

When to See a Doctor:

If coughing up blood is frequent or in large amounts.
If accompanied by fever, chest pain, shortness of breath, or fatigue.
Immediate medical attention is essential to ensure both mother and baby's safety.

Management and Safety Tips:

Drink plenty of water to keep airways hydrated.
Avoid smoking or exposure to second-hand smoke.
Follow all doctor-prescribed treatments for infections or underlying conditions.

Home Remedies for Coughing Up Blood

If you are experiencing coughing up blood mucus, several home remedies may provide relief. These remedies help soothe irritation and prevent further complications:

Stay Hydrated: Drink plenty of fluids like water, herbal teas or clear broths to help keep your respiratory tract moist and thin out mucus.
Warm Saltwater Gargle: Gargling with warm salt water can help soothe a sore throat and reduce irritation in the throat and airways.
Humidifier: A humidifier in your room adds moisture to the air, which can help ease coughing and loosen mucus.
Steam Inhalation: Inhaling steam from a bowl of hot water or taking a hot shower can help loosen mucus and relieve congestion.
Honey: Consuming honey, either alone or mixed with warm water or herbal tea, may help soothe a sore throat and suppress coughing.
Avoid Irritants: Minimise exposure to smoke, pollutants and other respiratory irritants that can exacerbate coughing and airway irritation.
Rest: Get plenty of rest to allow your body to recover and heal from any underlying conditions that may be contributing to coughing up blood.
Elevate Your Head: Sleeping with your head elevated can help reduce nighttime coughing and prevent blood from pooling in your throat.

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How to Stop Coughing Up Blood?

Preventing coughing up blood or hemoptysis largely depends on addressing and managing the health risks. People with chronic lung conditions, infections or a history of smoking should be particularly cautious.

Quit smoking to reduce the risk of lung damage and bleeding.
Manage chronic respiratory conditions like COPD or asthma with regular medication and check-ups.
Get vaccinated and practice hygiene to prevent respiratory infections.
Use doctor-approved cough medications to avoid irritating your airways.
Take blood thinners only under the supervision of a doctor to minimise bleeding risks.
Report any signs of blood in sputum to your doctor immediately.
Stay hydrated and use a humidifier to keep your airways moist.

Conclusion

Never ignore coughing up blood. Early diagnosis and treatment can save your life. Always consult a doctor or the best pulmonologist near you when you notice blood while coughing, especially if it recurs or is accompanied by other symptoms.

Remember, your lungs are vital organs that keep you alive with every breath. Taking care of them promptly at signs of trouble like coughing up blood is the most innovative and safest approach.

Frequently Asked Questions

A small amount of blood in mucus can sometimes occur due to minor irritations in the respiratory tract, such as from coughing forcefully, and may not necessarily indicate a serious issue.

Blood in spit can be caused by various factors, including respiratory infections, bronchitis, pneumonia, or more severe conditions such as lung cancer or tuberculosis. Consulting a healthcare professional for proper evaluation is crucial.

Yes, blood thinners like warfarin or aspirin can increase the risk of bleeding. If you're on these medications and notice blood in your cough, it's important to contact your doctor to rule out any serious internal bleeding or complications.

Acid reflux or GERD rarely causes coughing up blood. In severe cases, frequent acid exposure may irritate and damage the esophagus or throat, leading to minor bleeding. Still, coughing up blood usually points to a lung or airway issue.

Yes, pink or frothy sputum can be a sign of pulmonary edema, a serious condition where fluid collects in the lungs. Itâ€™s often linked to heart failure and needs immediate medical attention, especially if it's accompanied by shortness of breath.

Coughing up blood with a simple cold is not considered normal. Sometimes tiny streaks may appear from throat irritation due to frequent coughing. If it continues or increases, medical evaluation is needed.

Pneumonia can cause blood in sputum because of infection and inflammation in the lungs. It may appear as streaks or mixed with mucus. Since it can signal complications, a doctor's check is important.

Even a small amount of blood should not be ignored. It can be from minor irritation or something more serious. Medical advice is the safest way to rule out risks.

Blood in the morning may result from secretions and dried blood collecting overnight. Conditions like bronchitis, infections, or lung irritation often cause this. Persistent morning bleeding should be checked by a doctor.

Dehydration itself does not directly cause coughing up blood. However, it can dry out the airways, making them more fragile. This dryness may lead to irritation and minor bleeding while coughing.

Diseases like tuberculosis, pneumonia, and chronic bronchitis can lead to blood in the cough. Lung cancer or severe lung infections are also possible causes. Heart or blood vessel problems may contribute in some cases.

If you are coughing up blood, stay calm but seek medical attention immediately, especially if the bleeding is large or persistent. Avoid self-medicating and note any accompanying symptoms like fever, chest pain, or shortness of breath. Follow your doctor's guidance for proper diagnosis and treatment to ensure both safety and recovery.

Seeing blood in your cough for the first time in the morning may be due todried secretions or minor irritationin the airways overnight. It can also result from infections, bronchitis, or mild lung conditions. If it happens again or the bleeding is significant, consult a doctor immediately for proper evaluation.

Blood in phlegm from the throat may occur due to irritation from coughing, tonsillitis, or minor injuries in the throat. Infections or inflammation can also cause small blood streaks. If the bleeding continues or increases, medical attention is necessary.

A sore throat can cause small blood vessels to break, leading to blood in the phlegm. Infections, severe coughing, or tonsil inflammation can make this more noticeable. See a doctor if the blood is frequent, heavy, or accompanied by other symptoms like fever or difficulty breathing.