Blood In The Sputum- Symptoms, Causes, Risk Factors & Treatments

Sputum is a thick mix of both saliva as well as mucus that comes out from the respiratory tract while coughing. In general, it is not a serious issue, but sometimes, blood can be seen in the sputum while coughing or splits. However, blood in the sputum can be alarming. It may not always indicate a serious condition in healthy persons or youngsters; it can occur in several respiratory infections, including mild bronchitis and asthma. However, there are some cases where a substantial amount of blood is present in the sputum, and the severity of the symptoms can indicate a severe lung or stomach infection that should not be neglected at any cost. A person needs to get diagnosed with the root cause of the bloody phlegm and get proper treatment, especially for the elderly. Consulting the lung doctor, Dr. Arvind Kumar is a must to get yourself thoroughly checked immediately.

Causes of blood in sputum or phlegm

Blood in phlegmis generally caused due to prolonged coughing or when a person’s airways are dried. Also, blood can be noticed in people who take anticoagulants. If a person notices copious amounts of blood in the phlegm that lasts for three days or if they experience some specific symptoms, they must consult an experienced lung doctor to get the possible treatment. The causes include:

• Persistent cough, along with allergy and flu, can cause blood in phlegm, and it occurs due to irritation in the respiratory airways that become cracked.
• Dried airways are another cause as they affect the nose, larynx, and pharynx. These dry airways are due to colds, allergies, and flu.
• The use of anticoagulant medications irritates the respiratory tract and puts a person at higher risk of bleeding in many body parts.
• Respiratory infections commonly cause blood in phlegm, which can range from mild cold or flu infection to severe conditions like TB.
• Using nasal decongestants regularly can cause bloody phlegm because it irritates and dries the nasal mucosa.
• Allergic rhinitis is a condition that makes the lining inflamed and involves hypersensitivity to the mucus.
• Some serious diseases can cause blood in sputum, like lung cancer, throat cancer,
• Serious injuries like chest trauma can be a cause.
• Dry weather causes this issue, which can occur while climbing high altitudes, diving, flying, etc.
• Sinusitis inflames the paranasal sinus lining, and this swelling is caused by viruses, bacteria, and allergies.
• Using inhaled drugs or constant exposure to cleaning products can cause nose bleeds and blood in the phlegm.
• Bronchiectasis is another chronic condition that is linked with permanent dilation of the bronchi and can lead to excessive phlegm production.
• Bronchitis can cause blood in the phlegm.
• Pulmonary edema develops due to fluid accumulation in the lungs, which makes phlegm red or pink.
• Lung-related ailments like Pneumonia, cystic fibrosis, and COPD can also be the cause.

Risk factors of blood in sputum 

However, there are many other risk factors for blood in sputum other than the common causes, including respiratory infections. These risk factors are :

• Cystic fibrosis
• Lung cancer
• Pulmonary embolism
• Vasculitis
• Family history of clotting disorders
• Tuberculosis
• Recent surgery, cancer, or other illness
• HIV
• If you are above 40 years of age and a regular smoker
• If you see the medications that suppress the immune system.

Blood in phlegm, no cough, or cough are both scary for many, and you are confused about whether to seek medical help or not. It is vital to get yourself checked as soon as you find blood in sputum with or without a cough. Schedule your appointment with the doctor immediately without any delay to get yourself checked and to get proper treatment.

Symptoms of blood in sputum 

Blood in sputum is defined as a Haemoptysis, which is when you cough up blood that comes from the lungs or airways. Depending upon the cause, you may experience the symptoms listed below. Symptoms of the condition can range from mild to severe, and you need to understand them well and contact the doctor immediately when you cough blood :

• Bright red blood
• Streaks of blood
• Bloody mucus
• Bubbly blood or mucus
• Coughing more than a few teaspoons is alarming
• Chest pain
• Blood in urine or stools
• Feeling dizzy
• Fever
• Shortness of breath

Diagnosis for blood in sputum

If you cough up little blood, then there is no matter of concern. You may notice blood in sputum in the morning when clearing your throat, and you may also see blood streaks in mucus from respiratory infection as we do; that is normal. However, if you notice more blood consistently, then it can indicate and show the signs of more serious medical issues that may need medical attention. The doctor may need many tests to find the cause and the treatment options. However, the doctor will choose suitable diagnostic methods based on the various causes of your condition. Some are listed below:

• Medical history and physical exam to know about the amount, frequency, and duration of the condition
• Chest X-Ray
• CT scan
• Bronchoscopy
• Complete blood count to know signs of infection
• Sputum culture is used to determine the cause, whether it is due to a virus or bacteria.
• Coagulation test
• Pulmonary arteriography
• Urinalysis

Treatment of blood in sputum 

The first step is to determine when to seek medical help when you notice blood in the sputum and to know the amount and persistence of the blood in the cough. If the amount is small, then it does not need instant help, but if the amount of blood is excessive, recurrent, and comes along with other symptoms listed above, then there will be a need for immediate assistance from a doctor. Thus, If blood in phlegm is accompanied by other symptoms like fever, unintentional weight loss, weakness, fatigue, night sweats, or a persistent cough lasting more than three weeks, it is time to get medical attention from a lung doctor. The treatment of blood in sputum mainly depends upon the causes of coughing up blood, and after the cause is determined and the results of the tests, the lung specialist will develop an individualised treatment plan. Some treatment options include:

• Medications 

The doctor prescribes these medications because an infection causes the blood in the phlegm. These antibiotics will help when lung conditions like bronchitis are also present and are helpful in managing symptoms.

• Surgical options 

It is needed in axes where a tumour is present or else if there is any abnormality that is accusing the blood in phlegm.

• Supportive care

It is necessary as well, irrespective of the cause of the condition, as it can help manage symptoms and promote healing; these measures include staying hydrated, proper rest, and avoiding irritants.

Why Blood in Sputum Sometimes Shows Up Only in the Morning

One pattern worth paying attention to is blood that appears only immediately after waking, while the sputum remains clear for the rest of the day. This differs from blood that continues to appear throughout the day and may indicate a different, sometimes less concerning, set of causes.

During the night, mucus in the nose, throat, and upper airways can accumulate because normal swallowing and coughing occur less frequently. Dry air, mouth breathing during sleep, and exposure to air-conditioned environments can dry out and irritate the lining of the nose and throat. In some cases, this irritation can cause minor bleeding, resulting in blood-streaked mucus during the first cough or throat-clearing episode of the day, even when the lungs are not the source.

Postnasal drip can contribute to a similar pattern. Mucus from the sinuses may drain down the back of the throat during sleep and accumulate there. Clearing the throat in the morning can bring up blood-streaked mucus originating from the nose or throat rather than the lower respiratory tract.

Another possible cause is mild nighttime coughing associated with acid reflux or a lingering respiratory infection. Even occasional coughing during sleep can irritate the throat lining, with small streaks of blood becoming noticeable upon waking.

However, blood in the sputum should not be ignored simply because it appears only in the morning. Although faint streaks that resolve quickly and occur without other symptoms may be less concerning, medical evaluation is advisable if the bleeding persists, recurs, or increases in amount. Seek prompt medical attention if it is accompanied by a persistent cough, chest pain, unexplained weight loss, or breathlessness. Depending on the symptoms and examination findings, a doctor may recommend a chest X-ray, CT scan, or other investigations to identify the source of the bleeding.

If blood-streaked sputum has been occurring for some time and does not improve with simple measures, consulting Dr. Arvind Kumar can help determine the underlying cause and establish whether further investigation or treatment is needed.

Conclusion

Blood in sputum in small amounts may not be a cause for immediate concern, but you must understand the symptoms and risk factors that may require prompt intervention. To get any underlying medical condition, have a chat with one of the lung doctors in India, Dr. Arvind Kumar, experienced in the field. He has experience performing more than 15,000 chest surgeries, including about 8,000 minimally invasive and robotic procedures, with more than 40 years of experience in chest and lung surgery, including robotic thymectomy.