Coughing Up Blood: 8 Common Causes & What to Do

Updated in July 2022

Coughing up blood is not always a serious symptom, especially when it occurs in young, healthy people. It can occur due to a small nose or throat wound that bleeds with coughing. It can also happen if the respiratory airways are dried out for long periods of time. 

Coughing up copious amounts of bright red blood, however, can be a sign of a more serious illness, like pneumonia, tuberculosis, or lung cancer, especially if it occurs more than once per day. This symptom is often referred to as hemoptysis. 

Therefore, you should see your family doctor or a lung specialist if you are coughing up blood for more than 24 hours, or if it occurs with other symptoms like difficulty breathing, wheezing, or if you notice copious or increasing amounts of blood.

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The main causes of blood when coughing include: 

1. Wounds in the airway

In most cases, coughing up blood occurs due to mild wounds or irritation in the nose or throat. This can happen following tests, like a bronchoscopy, lung biopsy, endoscopy or tonsil removal surgery. 

What to do: Usually, this type of blood will resolve on its own without treatment. However, if it persists for over a day, you should see your doctor to determine why it is happening and to start appropriate treatment. 

2. Long periods of coughing 

Dry and prolonged coughing is a common symptom of the flu, and therefore it is possible notice blood when coughing. This is due to irritation in the airways, which can last for a few days if left untreated. 

What to do: If the blood in your cough or other flu symptoms do not improve within a few days, you should see a doctor for assessment and treatment. The doctor may advise anti-inflammatory and fever medication. Read more about what can cause persistent coughs and how to treat them.

3. Pneumonia

Pneumonia is a serious lung infection that generally leads to symptoms like hemoptysis, fever, shortness of breath, chest pain and palpitations. Diagnosis is confirmed through testing and it is often treated with antibiotics. Learn more about the causes and symptoms of pneumonia.

What to do: Because some types of pneumonia require treatment with antibiotics, you should see your doctor to confirm a diagnosis and start treatment as necessary. In more severe cases, pneumonia can greatly affect breathing, and admission to the hospital for monitoring may be required. Check-out these home remedies for pneumonia that can be used as a complement to your medical treatment. 

4. Tuberculosis

In addition to coughing up blood, which is very characteristic of tuberculosis, this illness can also cause symptoms like constant fever, night sweats and excessive fatigue. Coughing usually persists for over 2 weeks, and diagnosis is usually confirmed through a sputum test. 

What to do: Tuberculosis is caused by bacteria, and therefore, treatment usually consists of a long-term course of antibiotics that can last for several months. If you suspect you have tuberculosis, you should see a lung specialist. Once confirmed, you should advise the people with whom you have had close contact to also be tested, as this illness is easily spread. 

5. Bronchiectasis

Bronchiectasis is a respiratory illness that causes coughing up blood that worsens overtime due to a permanent dilation or widening of the bronchi. This leads to excess mucus production and causes frequent episodes of shortness of breath. This condition is mainly caused by cystic fibrosis, pneumonia or fungal lung infections. 

What to do: It is important to se ea doctor for assessment, diagnosis and treatment. Treatment is usually aimed at relieving symptoms and improving quality of life. 

6. Bronchitis

Bronchitis can cause coughing with blood, although it is more rare. Bronchitis is associated with a recurrent inflammation within the bronchi, which can increase airway irritation, leading to a greater risk of bleeding. 

What to do: In most cases, rest and increased fluid intake are able to relieve bronchitis-related symptoms. However, if symptoms persist or if you have difficulty breathing, you should seek medical attention, as medications may be necessary. 

7. Pulmonary embolism

A pulmonary embolism (PE) is a serious health issue that should be treated as quickly as possible in a hospital setting. It is characterized by the presence of a clot that obstructs blood flow to the lungs, resulting in tissue death in the surrounding area and severe difficulty with breathing. In addition to coughing up blood, many people also experience shortness of breath, blue-tinged fingers, chest pain and increased heart rate. 

What to do: Anytime you feel intense shortness of breath, chest pain and coughing, you should proceed immediately to the emergency room for assessment and treatment.

8. Lung cancer

Lung cancer is often suspected when a patient present with hemoptysis and unexpected weight loss. Other symptoms include fatigue and weakness, which can occur when the cancer starts off in the lungs (which is common in smokers) or when there is metastatic cancer in the lungs. Be sure to know the most common symptoms of cancer

What to do: The success of cancer treatment often depends on how early the cancer was diagnosed. Therefore, if you notice any symptoms that can indicate a lung problem, you should see your doctor for testing and assessment. Treatment will vary based on the stage of cancer present. 

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When to see a doctor

You should see a doctor when the blood you cough up is copious, lasts for over three days, or if you have other symptoms like: 

  • Urine or stool with blood 
  • Intense chest pain
  • Dizziness
  • Fever over 38°C (or 100.4°F)
  • Difficulty breathing 

If you suspect that your case is severe, you should call for an ambulance or proceed to the closest emergency room  for assessment. The doctor will likely order tests like an x-ray, bronchoscopy, CT scan or MRI to identify the cause of hemoptysis, which will then help to guide treatment. 

Babies and children coughing up blood 

The most common cause for coughing up blood in children is the presence of small objects in the lungs or airways that are swallowed or shoved in a nostril. Scant amounts of blood are usually noted with these cases, however it is still important to take the child to the emergency room for an x-ray to confirm whether this is the case. 

The doctor may use a small instrument to evaluate the ears, nose and throat to rule out small objects like an earring, screw, corn, pea, bean or toys being lodged in the airway. Depending on the object and its location, the doctor may remove it with tweezers or opt to remove it with surgery. 

Other, but less common, causes of hemoptysis in babies and children are lung or cardiac diseases, which should be diagnosed and monitored by a pediatrician. If you have any doubts or if you are unsure about the cause of the blood, consult your child’s pediatrician.