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Coughing up blood

Coughing up blood, or coughing up blood with mucus, isn’t usually serious and isn’t unusual but it can be alarming.

Summary introduction

Coughing or spitting up blood is also known as haemoptysis. The blood can be bright red, rust-coloured, pink and frothy or streaked through sputum (phlegm) or mucus.

The blood you’re coughing up usually comes from your lungs or the airways in your throat. It’s often the result of prolonged coughing or an infection, although it can be caused by a bleeding nose or mouth.

Occasionally, coughing up blood can be a sign of a serious condition. Coughing up any amount of blood, even just a few specks, must always be checked by your GP.

Causes of coughing up blood

Severe, persistent coughing is one of the most common reasons for coughing up blood. This may be the result of bronchitis, an infection of the airways in your lungs. Bronchitis can be accompanied by:

  • Fever
  • Coughing up blood with mucus
  • Yellow or green sputum (phlegm)

Bronchitis can last for a few weeks (acute bronchitis) or it may be a long-term (chronic) condition.

If you’re also wheezing or experiencing breathlessness and are bringing up a lot of sputum, you may have bronchiesis. Bronchiesis is a chronic condition which can make your lungs prone to infection.

Pneumonia, which is a lung infection, is another common cause for coughing up blood. Other symptoms of pneumonia include breathlessness, flu-like symptoms, chest pain, rapid heartbeat and coughing up blood with mucus.

Talk to your doctor if you're concerned about symptoms.

Talk to your doctor if you’re concerned about symptoms

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Conditions related to coughing up blood

Other, less likely, causes of coughing up blood include:

  • Pulmonary embolism – a potentially life-threatening blood clot on the lungs which also causes sudden breathlessness and chest pain
  • Pulmonary oedema (fluid on the lungs) – if you have a heart condition, you’re at a higher risk of developing fluid on the lungs
  • Lung cancer – the risk of developing lung cancer increases if you’re over 40 and a smoker
  • Tuberculosis (TB) – a relatively rare lung infection which can also cause fever and excessive perspiration
  • Side effects of certain medications, including anticoagulants, which help prevent blood clots
  • An injury to your lung – coughing up blood can happen when a piece of food or a small object is mistakenly inhaled into your lungs

Getting a diagnosis for coughing up blood

If you’re coughing up a lot of blood, call 999. You should also seek immediate medical attention if you’re vomiting blood as this can be a sign of a serious problem with your digestive system.

If you’re coughing up smaller amounts of blood, see your GP. Your GP will ask you how often you cough up blood, how much blood there is and any other symptoms. They’ll take a sample of your sputum and examine your chest and lungs.

Your GP may refer you for further investigations, including:

  • Blood tests – to check for conditions that can cause blood to be coughed up
  • A CT scan or X-ray – to provide an image of your lungs
  • Bronchoscopy – using a tiny camera attached to a thin flexible tube to check your lungs and airways for abnormalities

In some cases, your GP may refer you to a consultant for further assessment, diagnosis and treatment.

Treatments for coughing up blood

Sometimes, coughing up blood only happens once, clears up on its own or stops once an infection has passed.

If an underlying condition is causing you to cough up blood, your GP or consultant will recommend treatment. The treatment your doctor recommends will depend on your diagnosis and will take into account your general health and preferences.