Coughing Up Blood (Hemoptysis)
The sight of blood produced by coughing can be scary and worrisome. There are numerous conditions that can cause an individual to cough up blood, some more serious than others. If you find yourself coughing up blood, you should consult a physician to determine the underlying cause.
Coughing up blood can be caused by a variety of lung conditions and can take a variety of forms: blood may be bright red or pink and frothy, or it may be mixed with mucus. Also known as hemoptysis (he-MOP-tih-sis), coughing up blood, even in small amounts, can be alarming. While producing a little blood-tinged sputum isn't uncommon and typically isn't serious, you should always consult your physician if you are coughing up blood.
Numerous lung conditions can result in the coughing up of blood. There are different appearances to blood that is expelled from the lungs and the respiratory tract, depending upon the underlying cause. Blood that is expelled from the lungs can take on the following appearances:
- Bright red blood
- Brown-tinged sputum
- Frothy pink mucus
Blood that comes from the mouth as a result of bleeding from the throat, gastrointestinal tract or the mouth itself is not the same thing as coughing up blood. When coughing up blood, the blood that comes out of the respiratory tract mixes with air and mucus, resulting in an almost bubbly appearance. Most of the time it is either bright red or it appears rusty. Other times it is mucus that is tinged with streaks of blood.
There are a wide variety of causes for coughing up blood. The first step is to identify whether the blood is a result of hemoptysis or if it the blood is coming from another source, such as the stomach or esophagus. Sometimes the symptoms can be similar, so it is important to receive a definitive diagnosis from a doctor so that the underlying cause can be treated.
Chronic bronchitis is the most common cause for coughing up blood. There are other conditions that also commonly result in coughing up blood, including:
- Chronic obstructive pulmonary disease (COPD)
- Cystic fibrosis
- Mitral valve prolapse (MVP)
- Drug Use
- Chest trauma
- Lung abscess
When To See A Doctor
Any time you cough up blood, you should contact your doctor. It is important to have your condition evaluated so that your doctor can determine where the blood is coming from. If your doctor confirms that the blood is coming from the lungs or respiratory tract, he can then take steps to identify the underlying cause and begin necessary treatment. If you cough up an excessive amount of blood or if you continue to cough off blood repeatedly, call 911 or seek immediate emergency assistance. Other symptoms that would prompt a call to 911 when coughing up blood include:
- Coughing up blood that amounts to more than a few teaspoons
- Passing blood in the stool
- Blood in the urine
- Pain in the chest
- Severe shortness of breath
- Feeling lightheaded
Your doctor will perform a complete physical exam to evaluate your health and attempt to diagnose your condition. Your doctor will start by asking a host of medical questions relevant to your condition. He will ask questions specifically about your cough such as:
- The amount of blood that is being brought up when you cough
- Whether or not you can notice blood in any mucous you expel
- How many instances of coughing up blood have occurred
- How suddenly the condition developed
- Whether or not the condition has increased
- How long the cough has been present
- Whether or not the coughing worsens during the night
- What other symptoms are present along with the cough
After asking questions, your doctor will do a complete physical exam, paying special attention to your chest and lungs. Additional tests that may be performed include:
- CT scan of the chest
- Chest X-ray
- Bronchoscopy to view the airways
- Blood tests
- Biopsy of the lungs
- Lung scan
- Sputum culture
- Sputum smear
- Pulmonary arteriography
Treatment options will depend largely on the underlying condition. The first step in treatment will be treating any emergency conditions that require immediate medical attention to stop any internal bleeding. Treatment for certain underlying conditions, such as pneumonia, will consist of keeping you comfortable while the condition heals and reducing the amount of blood that is coughed up. More serious causes will be treated with the appropriate treatment measures.
For minor conditions that can lead to the coughing up of blood, such as irritation of the throat or esophagus that leads to excessive violent coughing, throat lozenges to soothe irritation and cough suppressants may be helpful. It is important to only use these remedies under the advice of your doctor, as they may lead to airway blockages in some cases.
Coughing up blood can be scary. Most of the time, it is not a serious condition and minor treatment is necessary. It is important to contact your doctor any time you cough up blood. Seek immediate medical attention if you cough up excessive amounts of blood or if you continue to cough up blood for an extended amount of time.