Medicines for Coughing up blood

What it is

Haemoptysis means coughing up blood or blood-stained phlegm from the lungs or airways. It can range from small streaks of blood in the phlegm to, rarely, larger amounts, and it always needs to be assessed, because although many causes are not serious, it can occasionally be a sign of a serious lung condition. Common and often treatable causes include chest infections (such as bronchitis or pneumonia, a frequent cause of blood-streaked phlegm during a cough), and other airway conditions. Other causes include bronchiectasis, blood clots on the lung (pulmonary embolism), and, importantly, lung cancer — which is a key reason coughing up blood is taken seriously, particularly in smokers, older people, or when it is persistent or unexplained. It is important to distinguish true haemoptysis (from the lungs, usually coughed up, often frothy and bright red or mixed with phlegm) from blood coming from the nose, mouth or gut, which have different causes. Because the range of causes includes both minor infections and serious conditions, and because finding a serious cause early improves outcomes, any coughing up of blood should be checked promptly.

How it is treated

Assessment aims to find the cause. A doctor will ask about the amount and pattern of blood, associated symptoms (such as a cough, fever, breathlessness, chest pain, or weight loss), smoking history, and risk factors, and examine the chest. Investigations usually include a chest X-ray, and often blood tests, and, depending on the picture, further tests such as a CT scan of the chest and sometimes a camera examination of the airways (bronchoscopy), particularly where a serious cause needs excluding. Because coughing up blood can be a warning sign of lung cancer, it is often investigated promptly, sometimes via an urgent cancer pathway, especially in higher-risk people — although many cases turn out to be due to a treatable infection. Treatment then depends entirely on the cause: for example, treating a chest infection, managing bronchiectasis or a blood clot, or treating a cancer if found. A large amount of coughed-up blood is a medical emergency needing immediate care. Where investigations find no serious cause, this is reassuring. The key message is that any coughing up of blood should always be assessed promptly, as many causes are treatable infections, but it can occasionally signal a serious condition that is best caught early.