Coughing Up Blood

The act of coughing blood or the medical condition of hemoptysis differs from bleeding from the gastrointestinal tract, mouth or throat. In this case the person spits up blood-filled mucus from the throat and lungs. If blood is being coughed up from the lungs or respiratory tract then it is likely to contain bubbles as a result of being mixed with mucous and air in the lungs. This condition should not be taken lightly, although the severity determined by the amount of blood being coughed up and how long the condition has persisted.

Causes of Coughing Up Blood

Coughing up blood is merely a symptom which can result from a variety of different medical issues from a simple throat irritation to something as severe as lung cancer. Some possible reasons for coughing up blood include:

1. Infection & Tuberculosis

A number of infections, including tuberculosis are caused by mycobacteria. These usually result in the formation of holes in the walls of the air passages, thereby destroying the pulmonary tissue. A mild to moderate form of hemoptysis usually occurs along with other associated symptoms like coughing, weight loss, and thick, yellowish, opaque sputum.

2. Bronchitis

Bronchitis is a common cause of a mild form of hemoptysis. It describes the condition of swollen bronchi which can occur suddenly or persist over time. It results when constant coughing results in the irritation and eventual breakdown of the mucous linings of the membranes. Patients usually present with thick, yellowish or white sputum, a low fever and wheezing.

3. Bronchiectasis

Bronchiectasis is a chronic condition which results when the bronchi and bronchioles become dilated and infected due to an obstruction. This is due to the destruction to the tissue surrounding the bronchi because of scarring or fibrosis. This can result from cystic fibrosis. Bronchiectasis is usually accompanied by thick, yellowish white discharge and a persistent cough.

4. Lung Cancer

Bronchogenic carcinoma is the cancer that is formed in the lining of the bronchi. These account for about 90% of cancers. The more advanced form of the disease can result in unexplainable weight loss. About 20% of patients with lung cancer will present with hemoptysis at some point during their illness. This is usually as a result of the death of tumor cells or the rupture of blood vessels around the area, especially if it invades the pulmonary vessels.

5. Pneumonia

The common lung infection is caused by several different microorganisms. It is more likely to affect people with compromised immune systems than those who are healthier. The microbes tend to populate the lungs. In an effort to protect themselves, the lungs become filled with pus and liquid. The symptoms of pneumonia include hemoptysis, high fever, chest pains and cough.

6. Severe Mountain Sickness

This condition is also known as altitude sickness or high altitude pulmonary edema. It results from climbing too quickly at altitudes above 8,000 feet for example. This causes a lowering of the amount of oxygen in the blood. Mild effects of the condition result in dizziness, rapid heart rate, shortness of breath, loss of appetite and nausea. More severe symptoms include blue coloring of the skin, coughing up blood, confusion, tightness of the chest, and reduced consciousness.

7. Other Pulmonary Diseases

Diseases associated with the lungs such as pulmonary venous hypertension and pulmonary oedema can cause affected people to cough up blood. These diseases directly affect the blood vessels, mucous lining or air sacs in the lungs. They can cause a person to cough up blood in addition to other symptoms which include finding it hard to breathe when lying down, fatigue, severe chest pains, swollen legs and wheezing or gurgling while breathing.

8. Systemic Lupus Erythematosus

In this disease the body’s own immune system turns on itself and destroys healthy tissues such as those in the lungs. It is more prevalent in African-American and Asian women. When the lung tissue is destroyed the most common sign is the coughing up of blood and difficulty breathing. Other symptoms are pain in the joints and chest area, hair loss and swollen lymph nodes.

Treatments for Coughing Up Blood

The condition of coughing up blood is usually as a result of weakened or broken blood vessels in the airway or lungs. This results in bleeding. Treatments for this condition generally target the bleeding while trying to address the underlying cause.

1. Treatments for Mild Hemoptysis

If your hemoptysis is mild or inconsistent you may not be in need of urgent treatment; however, remember that you should always get a thorough checkup to make sure that there are no serious underlying conditions. Heavy coughing can possibly be treated with cough suppressants although you should get the advice of your doctor before use as these can cause your airway to become blocked. Pay close attention to the length of time that you’ve been coughing up blood and keep your doctor informed as there is never any way to tell if a mild case of hemoptysis can develop into something more severe.

2. Treatments for Massive Hemoptysis

Major hemoptysis is usually considered to be a serious medical condition. Affected people can die, usually from suffocation. Medical staffs generally focus on finding the source and controlling the bleeding while ensuring that the patient is breathing properly. Some of the more common ways to control bleeding are through surgical resection, bronchial artery embolization and bronchoscopic laser therapy. Mild to moderate cases are mainly treated with antibiotics. For cases of bronchogenic carcinoma, treatment will depend on the progression of the disease. In about 90% of cases in which a bronchoscopy and a chest x-ray is done, the hemoptysis generally dissipates within six months.

  • Bronchial artery embolization

In this method of treatment, substances are injected into the bloodstream, which work to stop the constant flow of blood. It can prove quite successful in controlling life-threatening cases of hemoptysis in both the short term and long term. However, it is associated with a few complications.

  • Surgical resection

In this procedure the tissue that is responsible for the hemoptysis is removed. This is usually seen as the best course of treatment in the early stages of hemoptysis which results from aspergilloma.

  • Bronchoscopic laser therapy

This treatment for hemoptysis employs laser technology in tandem with a bronchoscopy to widen air passages or remove lesions and tumors.

  • Radiology or bronchoscopy

Radiology and bronchoscopy are used to find the original point of bleeding and stop it. One technique used is to inflate a balloon inside the airway.

When to See a Doctor

Acute bronchitis is the most common cause for coughing up blood. This condition usually clears up on its own without the need for treatment. If you are suffering from bronchitis and coughing up small amounts of blood mixed with mucus for less than one week, you should monitor your condition and watch for signs of improvement. This symptom can indicate a more serious health issue. If you experience any of the following signs you should contact your doctor immediately:

  • The presence of blood in the mucus for more than one week that is either intermittent or growing worse
  • Pain in the chest
  • Undue weight loss
  • Night sweats
  • Fever that exceeds 101 degrees
  • Shortness of breath with usual amount of exertion

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