Coughing up blood

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 10, 2015
StartSymptomsCoughing up blood

There are many underlying conditions that can result in an individual coughing up blood. While the condition can be serious, it may not be a cause for alarm. Known as hemoptysis, seeing even a small amount of blood in phlegm can be alarming, but it’s important to remain calm.


Definition & Facts

Blood that is being coughed up will have a bubbly appearance because it has mixed with mucus and air. The blood comes from some part of the lungs, although it is possible to bring up blood from other areas, such as the stomach. It’s common to see bloody sputum when a person has a common infection of the lungs, including acute bronchitis.

The condition should be checked to rule out other causes and begin any necessary treatments. In most cases, people can schedule a convenient appointment with the family doctor. However, a visit to the emergency room is warranted any time the blood is coming up frequently or in large amounts.


There are many potential causes, including the use of some medications like blood thinners, anticoagulants, and even some antibiotics. Some of the less challenging causes include bronchitis, inflammation in the blood vessels, or a blood clot in the lungs. In some cases, the blood is nothing more than ruptured blood vessels that can occur during prolonged periods of coughing.

People may also see blood in their sputum if they’ve recently had a nosebleed. There are also some underlying problems that are a serious cause for concern. These include a parasitic infection, a foreign body in the lungs, or an abscess. People with pneumonia or a pulmonary embolism will often find blood when they cough.

Serious conditions that can leave blood in the lungs include COPD, cystic fibrosis, Wegener’s granulomatosis, emphysema, lung cancer, and tuberculosis. Other conditions, such as cancer of the throat or windpipe, can also lead to bloody sputum. Finally, doctors commonly see this symptom in people who are using crack cocaine, and it can also be the result of trauma to the chest area.

When to see a doctor

In most cases, people who are coughing up blood will want to seek medical assistance as soon as possible. One of the concerns with coughing up blood is that the level of blood in the lungs can continue to advance and eventually lead to secondary infections.

If the cough is bringing up more than a few teaspoons of blood or it’s accompanied by blood in the urine or stool, then an appointment is in order. Also, people should contact a doctor if the coughing also comes with chest pain, shortness of breath, dizziness, fever, or lightheadedness. Coughing up a small amount of blood may not be cause for immediate concern, but the condition should still be checked to determine the severity and outline an effective treatment plan.

If a person is seeing this occasionally or in small amounts, they can generally wait for regular office hours and schedule a convenient appointment. If the amount coming up is more than a few teaspoons or it shows no signs of slowing down, then it’s important to seek emergency medical care by calling for an ambulance or proceeding to the nearest emergency room. While the condition may not be serious, it could also be a warning sign of a potentially life-threatening illness that should be addressed immediately.

Treatment & Therapy

Treatment begins with determining the underlying causes. Tests may be performed to pinpoint the problem and start developing a treatment plan. The doctor will ask questions concerning any progression of the coughing or the blood, and they may want to establish a timeline to show when the problem began as well as the onset of other symptoms.

The doctor will take a full medical history to help gather clues and identify the cause. People can expect to undergo a series of tests, including a bronchoscopy to view the airways, chest X-ray, CT scan and complete blood count. Additionally, there may be the need to do a lung scan and even a biopsy to determine the most effective treatment. Blood chemistry profiles and coagulation tests may be performed to determine if the body’s blood clotting abilities are working properly.

In some cases, surgery may be required to remove a severely damaged lung and allow the remaining one to function normally. Antibiotics are often prescribed for more common medical conditions like pneumonia, and medications are also available to treat tuberculosis and other diseases. Some patients with cancer have had great success with chemotherapy or radiation therapy. Steroids may be used to effectively treat inflammatory conditions that are known to cause bloody sputum.

Other treatment options include bronchial artery embolization. With this technique, a catheter is moved through the leg and into the lung to find where an artery is blocked and address the problem. A balloon inflated inside the damaged or defective airway can also alleviate pressure and help stop the bleeding. Most people will be admitted to the hospital so that their condition can be monitored while the treatment plan is developed and implemented.

Prevention & Prophylaxis

The best way to prevent bloody sputum is to pinpoint and treat the underlying condition. Effective treatment of cancer, tuberculosis and other serious diseases can help prevent a recurrence. People who have had pneumonia or bronchitis can learn how to monitor their health condition so that these ailments can be treated at the earliest signs rather than allowing them to progress.

Rigorous coughing or living with the cough for prolonged periods can cause inflammation of the lungs and airways, increasing the risk of bleeding in the future. In many cases, the medical condition will require professional monitoring even after the initial symptoms have subsided and the patient is feeling healthy again.

People who have had this condition once are encourage to take care of themselves and pay close attention to their body for warning signs that the lungs are being stressed. Seeking treatment earlier on can help prevent a relapse.

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