What should you know about a bleeding cough?

A pink streak in phlegm may occur after forceful coughing or inflammation from acute bronchitis, a common cold, or allergic rhinitis. Blood can also come from the nose or gums and then be cleared by coughing. Longer-lasting cough, repeated bleeding, wheeze, chest discomfort, or frequent chest infections needs a clinician’s review. Bronchiectasis can produce recurrent phlegm and bleeding, while asthma or bronchiolitis may cause breathing difficulty; the blood itself does not establish any one diagnosis.

Tell the clinician whether the blood is bright red, mixed through mucus, or more substantial. Also mention fever, breathlessness, chest pain, smoking or vaping, recent illness, and medicines that affect clotting.

Sit upright, avoid strenuous activity, and record how often you cough blood and what it looks like. Do not suppress a substantial bloody cough with someone else’s medicine. Arrange medical advice for any unexplained episode, even when you feel otherwise well; treatment depends on the source, which may be the nose, throat, or lower airways.

Call emergency services for heavy or continuing bleeding, difficulty breathing, blue lips, severe chest pain, faintness, confusion, or a fast worsening cough. Prompt assessment is also needed for fever with marked weakness, or blood after a chest injury. Keep any tissue or sample available to show the clinician if practical.

Ask where the blood is most likely coming from, whether your breathing and chest need testing, and which warning signs require emergency care. Ask how to manage your cough while the cause is being checked.