Symptoms A-Z

9 Reasons You're Coughing Up Blood & When to Call a Doctor

Coughing up blood may seem like an emergency. While coughing blood can be a sign of serious illness, there are also many common conditions that cause blood in your saliva that can be readily treated. Determining the severity will depend on associated symptoms, if any. Read more below to learn 9 possible conditions that are causing blood in your cough, treatment options, and more.

This symptom can also be referred to as: blood in sputum

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Coughing Up Blood Explained

Coughing up blood, whether it's a trace amount or far more, can be concerning. You should remember many conditions can cause blood in your saliva, and some can be treated. However, coughing up blood can be a sign of significant illness, and it's one of those symptoms that you should never ignore. The medical name for coughing up blood is hemoptysis [1].

Common characteristics of coughing up blood

If you're coughing up blood, it probably resembles:

  • Bright red blood, with or without mucus or saliva
  • Frothy saliva and phlegm that is streaked with blood: It may also be rust-colored or pink.
  • Dark blood with bits of food in it
  • Dark blood that looks like coffee grounds

Who is most often affected?

The following people are more likely to cough up blood.

  • Any current or former smoker
  • Anyone with an illness or condition that causes prolonged, heavy coughing
  • Those over 40 years of age

When it is most likely to occur?

You are more likely to cough up blood if:

  • You have a heavy cough on awakening from sleep
  • You are exposed to cigarette smoke: Smoke can trigger a heavy cough and subsequent bleeding.

Is it serious?

The severity of coughing up blood depends on the cause.

  • Not serious: Coughing up a small amount of blood is not usually severe in a young person, unless it recurs.
  • Moderately serious: If you also have signs of illness such as fever, pain, and fatigue, the appearance of blood is a concern. Aside from the illness that's causing your cough or bleeding in the first place, one of the main dangers of this condition is choking on the blood that comes up.
  • Serious: Coughing up blood can be severe if you also have shortness of breath or chest pain, the blood looks very dark, or there is more than just a small amount of blood.

What Does It Mean When You Cough Up Blood?

The following details may help you better understand your symptoms. However, coughing up blood, if it occurs frequently or worsens, necessitates a doctor's visit.

Anything that causes severe coughing

Respiratory system infections, trauma, or other diseases can lead to coughing up blood, such as the following.

  • Bacterial, viral or fungal infections
  • Certain congenital illnesses: These are conditions you are born with.
  • Environmental-related illness: These illnesses occur later in life, and the most common are cigarette smoking and working around hazardous substances, such as asbestos.
  • Pulmonary edema: This condition involves fluid in your lungs.
  • Injuries or invasive exams: Traumatic damage to your lungs from an automobile accident, a gunshot or knife wound, a sports injury, or an internal examination of your lung (bronchoscopy)
  • Use of illicit drugs: Such as cocaine
  • Aspiration: Aspiration is when you breathe in food, liquid, or another foreign body into your nose, trachea, or lungs.
  • Prolonged and heavy coughing for any other reason: This coughing can cause severe irritation of the tissues of your throat.

Circulatory causes

Diseases of the circulatory system may result in coughing up blood, such as the following.

  • Pulmonary embolism: This is a blood clot in your lungs.
  • Mitral valve stenosis: This is an abnormality in your heart that blocks proper blood flow. This can cause pulmonary edema and subsequent coughing of blood.
  • Accident or injury: Traumatic damage to the arteries of your lungs, such as from an automobile accident or another injury may cause you to cough up blood.

Rare and unusual causes

Rare and unusual causes of coughing up blood include the following.

  • Nosebleed
  • Injury to your mouth
  • Certain medications: Anticoagulants (blood thinners) slow down blood clotting and allow you to bleed more readily and freely.
  • Parasitic infection of your lungs: This infection is present in some parts of the world.

9 Possible Coughing Up Blood Conditions

The list below shows results from the use of our quiz by Buoy users who experienced coughing up blood. This list does not constitute medical advice and may not accurately represent what you have.

Nosebleed requiring treatment

Nosebleeds are a common disorder that many (60%) will experience. It can be caused by a number of things that rupture the blood vessels in the nose such as: dry air, picking your nose, getting hit in the nose, or even just getting older

Rarity: Common

Top Symptoms: severe nosebleed

Symptoms that always occur with nosebleed requiring treatment: severe nosebleed

Urgency: In-person visit

Lung cancer (non-small cell)

Lung cancer is one of the leading causes of cancer-related deaths in the U.S. and worldwide. In 2012, lung cancer was diagnosed in 1.8 million people and caused approximately 1.6 million deaths. When someone is diagnosed with lung cancer, one of the first steps is to stage the disease in order to determine both treatment and prognosis. Ninety-five percent of all lung cancers can be categorized as “small cell” or “non-small cell.” About 10 to 15 percent of lung cancers are considered small cell lung cancers while 80 to 85 percent are non-small cell lung cancers. Cancer, in general, is a condition characterized by overgrowth of a certain cell type. Our bodies naturally have a variety of cell types to serve different functions. The distinction between small cell and non-small cell lung cancer can be determined by looking at a small sample of the lung tissue where the cancer is growing and determining what cell type is overgrowing. Based on the stage of the lung cancer, surgical resection may offer the best outcomes. There are a number of symptoms associated with lung cancer that will be discussed in this article, the most common of which being cough.

Rarity: Rare

Top Symptoms: cardinal symptoms of lung cancer like chest pain or changes in breathing, fatigue, cough, shortness of breath, chest pain

Urgency: Primary care doctor

Small cell lung cancer

Small cell lung cancer (SCLC) is a fast-growing type of lung cancer. It spreads much more quickly than non-small cell lung cancer and is typically found in adult smokers.

Rarity: Rare

Top Symptoms: fatigue, cough, shortness of breath, loss of appetite, new headache

Urgency: Primary care doctor

Pulmonary embolism

An embolus is a blood clot that forms in the bloodstream, breaks loose, and is carried by the blood to become lodged elsewhere in the circulatory system. If this clot (embolus) blocks part of the bloodstream in the lungs (pulmonary system,) this condition is called pulmonary embolis...

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Goodpasture syndrome

Goodpasture syndrome is an autoimmune disorder, which means immune system mistakenly attacks and destroys healthy body tissue. Persons with this syndrome develop substances that attack a protein called collagen in the tiny air sacs in the lungs and the filtering units (glomeruli) of the kidneys.

Rarity: Ultra rare

Top Symptoms: fatigue, nausea, shortness of breath, muscle aches, fever

Urgency: Primary care doctor

Cystic fibrosis

Cystic fibrosis (CF) is an inherited disease of the mucus and sweat glands, affecting multiple organs, especially the lungs. The mucus clogs the lungs, causing breathing problems and making it easy for bacteria to grow. This can lead to problems such as repeated lung infections and lung damage.

Rarity: Rare

Top Symptoms: shortness of breath, productive cough, salty-tasting skin, decreased exercise tolerance, recurring problem with leaking urine

Urgency: Primary care doctor

Valley fever

Valley fever, or coccidioidomyocosis, is a lung infection from fungus spores, usually Coccidioides immitis or Coccidioides posadasii. People and animals may become infected after inhaling spores or, in rare cases, a wound is contaminated with spores.

The fungus lives in the soil in the southwestern United States. Anyone living there may be exposed, especially if working outside where the earth is disturbed and dusty.

Pregnant women, and anyone over age 60 or with a weakened immune system, may be most vulnerable. It is not contagious between people or between people and animals.

Symptoms include fever, cough, chest pain, and body aches, as well as red, spotty rash on the lower legs and back.

Untreated valley fever can become chronic or spread from the lungs to other parts of the body, causing very serious illness.

Diagnosis is made through sputum (material produced with a cough) and blood tests.

Treatment consists of bed rest, fluids, monitoring, and sometimes antifungal medications. A person who has had valley fever usually gains immunity and will not get it again.

Rarity: Ultra rare

Top Symptoms: fatigue, headache, loss of appetite, muscle aches, shortness of breath

Urgency: Primary care doctor

Bronchogenic cyst

A bronchogenic cyst is an abnormal sac of air that grows out of normal airways and is present at birth. It can enlarge and compress the lung tissue around it, causing symptoms such as cough, difficulty breathing, pain, and fever.

Rarity: Ultra rare

Top Symptoms: shortness of breath, constant cough, coughing up green or yellow phlegm, shoulder blade pain, deep chest pain, behind the breast bone

Symptoms that always occur with bronchogenic cyst: constant cough

Urgency: Primary care doctor

Tuberculosis

Tuberculosis, or TB, is a lung infection caused by the bacteria Mycobacterium tuberculosis. In some cases, it can affect other organs such as the brain or kidneys.

The disease spreads when an infected person exhales, speaks, or coughs and someone else inhales the bacteria. Tuberculosis is not transmitted any other way. Some patients carry TB without ever showing symptoms, though the disease may become active if something happens to weaken the immune system.

Most susceptible are those with weakened immune systems; infected with HIV; living or working in homeless shelters, correctional facilities, or nursing homes; and children under age 5.

Symptoms include severe cough that may bring up sputum and/or blood; chest pain; weakness; weight loss; fever; chills, and night sweats.

Diagnosis is made through skin tests, blood tests, sputum tests, and chest x-ray.

Treatment involves a course of specialized antibiotics under close medical supervision, along with rest and supportive care.

There is a vaccine for tuberculosis, but it is not entirely effective and not routinely given in the United States.

Rarity: Rare

Top Symptoms: fatigue, cough, shortness of breath, rib pain, dry cough

Urgency: In-person visit

When and How to Seek Treatment for Coughing Up Blood

At-home treatments

If your cough and is severe at times, you can use an over-the-counter cough suppressant. This medication can help lessen a heavy cough and help you sleep through the night, for example, but you should still see a physician about any cough that produces blood consistently.

When to see a doctor

You should schedule an appointment to see your doctor for the following.

  • Coughing up blood when you also have fever, lightheadedness, or other symptoms of illness
  • Occasionally coughing up traces of blood: Even if you have no other symptoms
  • You also have blood in your urine or blood in your stool

When it is an emergency

Seek immediate treatment in the emergency room or call 911 if:

  • You are coughing up blood and also have shortness of breath or chest pain
  • There are more than a few drops of blood: Especially if your bleeding does not stop
  • The blood is dark or looks like coffee grounds: This indicates it is probably coming from your stomach [5].

FAQs About Coughing Up Blood

Here are some frequently asked questions about coughing up blood.

Can coughing up blood be due to stress?

No, coughing up blood is not a sign of stress, and is not associated with stress — unless there is an underlying medical condition aggravated by stress. Possible causes of hemoptysis, or coughing up blood, include a cut or laceration in the esophagus, pharynx, or mouth. This injury can occur after swallowing a sharp object or a penetrating wound from outside of the body. Damage to the lungs causes you to cough up blood as well.

Can asthma cause coughing up blood?

Hemoptysis, or coughing up blood, is not commonly caused by asthma. Asthma is caused by constriction of the upper airways by any number of triggers, including stress, smoke, dust, and cold air. It does not cause people to cough up blood. People with asthma who cough up blood should see a physician.

Are there instances when coughing up blood is harmless?

Yes, there are. However, any time you cough up blood, see a physician, unless you have previously diagnosed bronchitis. Coughing up blood is abnormal, and many causes of coughing up blood can be immediately life-threatening.

Why am I coughing up blood after drinking alcohol?

If you are coughing up blood after drinking alcohol, see a physician. Coughing up blood after drinking alcohol can be due to many processes. Liver failure causes blood vessels that line the esophagus to fill with blood and eventually burst due to a mixture of pressure and abrasion from swallowed food. This bleeding takes place very rapidly and can cause one to exsanguinate (bleed out) within minutes. Alcoholic liver disease can also cause blood to clot less efficiently, resulting in increased risks of bleeding.

Is coughing up blood with a cold normal?

Generally no, coughing up blood with a cold is not normal. However, with a constant and severe cough, it is possible to injure the skin of the pharynx and cough up a small, dime-sized amount of blood. You should, however, see a physician to make sure that you do not have a more significant infection.

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Coughing Up Blood Symptom Checker Statistics

People who have experienced coughing up blood have also experienced:

  • 20% Cough With Bloody-Streaked Phlegm
  • 6% Cough
  • 3% Abdominal Pain (Stomach Ache)

People who have experienced coughing up blood were most often matched with:

  • 38% Nosebleed Requiring Treatment
  • 30% Lung Cancer (Non-Small Cell)
  • 30% Small Cell Lung Cancer

Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

Coughing Up Blood Symptom Checker

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References

  1. Coughing up blood. U.S. National Library of Medicine: MedlinePlus. Updated Jan. 7, 2019.MedlinePlus Link
  2. Earwood JS, Thompson TD. Hemoptysis: Evaluation and Management. Am Fam Physician. 2015 Feb 15;91(4):243-249. AAFP Link
  3. Ittrich H, Bockhorn M, Klose H, Simon M. The Diagnosis and Treatment of Hemoptysis. Dtsch Arztebl Int. 2017;114(21):371-381. NCBI Link
  4. Corey R. Hemoptysis. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 39. NCBI Link
  5. Lechtzin N. Coughing Up Blood. Merck Manual Consumer Version. Updated May, 2018. Merck Manuals Consumer Version Link

Disclaimer: The article does not replace an evaluation by a physician. Information on this page is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes.