Acid reflux and coughing up blood

Reflux can irritate the throat and cause coughing, while forceful coughing can occasionally leave a small streak from irritated tissue. Even so, blood brought up with a cough can come from the airways or lungs, so its source and cause must be checked.

Blood coughed from the airways may be bright red and mixed with mucus. Blood from a nosebleed or bleeding gums can drain into the throat and then be spat out. Vomited blood arises from the digestive tract and may look dark or resemble coffee grounds; this distinction can be difficult without medical assessment.

Bronchiectasis, pneumonia, tuberculosis, pulmonary embolism and lung cancer can present with coughing up blood, among other causes. The symptom does not establish which condition is present. Chest pain, breathlessness, fever, faintness, leg swelling and the amount of blood help determine urgency.

Contact a medical service promptly even if you see only a small streak and feel otherwise well. Note whether the blood followed coughing or vomiting, its colour, its approximate amount and whether it was mixed with mucus or food. If safe, a photograph can help the clinician understand what you saw.

Keep a list of medicines ready, especially blood thinners, anti-inflammatory pain medicines and supplements. Do not stop a prescribed blood thinner on your own, and do not rely on an antacid to explain or manage the bleeding.

Call emergency services now if there is more than a small streak of blood, bleeding continues or returns quickly, or you have trouble breathing, chest pain, a very fast heartbeat, fainting, confusion, marked weakness, blue or grey lips, or cold clammy skin.

Vomiting blood or passing black sticky stools also needs emergency assessment. Sit upright while waiting for help, avoid driving yourself if you feel faint or breathless, and take your medicine list with you.

Ask whether the blood appears to come from the lungs, nose, mouth or digestive tract and which examination or tests can clarify this. Mention recent infection, travel, tuberculosis exposure, smoking history, leg pain or swelling, and every medicine you take.