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Coughing up blood (blood in phlegm)

Introduction

Coughing up blood (blood in phlegm)

Coughing up blood is rarely a sign of anything serious in young people or in those who are otherwise healthy. But in older people, especially smokers, there are more causes for concern.

Bringing up small amounts of blood in your sputum (phlegm and saliva) can sometimes just be the result of prolonged coughing. However, if you have other symptoms too, such as a fever, you may have a chest infection or more serious medical condition that needs investigating and treating.

The medical term for coughing up blood is haemoptysis.

You should see your GP immediately if there is blood in your sputum and:

  • you cough up more than a few teaspoons of blood
  • there is also blood in your urine or blood in your stools
  • you also have chest pain, dizziness, fever, light-headedness and/or severe shortness of breath
  • you have a loss of appetite or weight loss

Your GP will be able to assess whether there's any other serious medical condition that needs to be investigated and treated.

Further tests that may be needed

You may be asked for a sample of your sputum so that it can be analysed for infection. Other tests, such as blood tests, may also be needed.

Your GP may decide to refer you to a specialist at your local hospital for a chest X-ray or a more detailed scan, such as a CT scan.

In some cases, further tests may be required to find out where the blood is coming from. For example, you may be referred to a specialist who will carry out a bronchoscopy (where the major air passages of your lungs are examined using a tube with a camera at one end).

This page can give you a better idea of the cause, but don't use this guide to diagnose yourself with a condition. Always leave that to your GP.

Where is the blood coming from?

Before you read on, it is worth considering where the blood is coming from.

A severe nosebleed or bleeding from the mouth or throat can cause blood to come out in your saliva when you cough. This is different from coughing up blood from deep within your chest, which is often mixed with mucus (there may just be streaks of blood in the mucus or frothy bloodstained mucus).

Also, be clear that you are coughing up blood (from the airways or lungs), rather than vomiting blood from the stomach, which may indicate a different problem such as a peptic ulcer.

Common causes of blood in sputum

The most common reasons for coughing up blood are:

  • prolonged, severe coughing
  • chest infection such as bronchitis - this is most likely if your sputum is coloured or contains pus, you have a fever, and/or you have a tight feeling in your chest
  • bronchiectasis, a long-term lung condition causing excess mucus in the airways

You can click on the above links for more information on these conditions.

Less common causes of blood in sputum

Less commonly, coughing up blood may be the result of:

You can click on the above links for more information on these conditions.

Sometimes, no cause can be found (known as unexplained haemoptysis) and the episide never happens again.

Rare causes

Rarely, coughing up blood may be the result of:

  • a heart valve problem called mitral stenosis
  • a serious blood vessel disease called polyarteritis nodosa
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Selected links

NHS Direct Wales links

Bronchitis

External links

British Lung Foundation

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 26/08/2014 15:29:52

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