Blood in sputum without a cough

A small nosebleed may drain backwards during sleep. Irritated gums, a throat scratch or chronic sinusitis can also leave blood in mucus that is cleared without coughing. Some people with airway inflammation, acute bronchitis, pneumonia, bronchiectasis or COPD produce phlegm and clear it gently rather than with a strong cough. The absence of a cough does not establish the source.

Check for bleeding from the nose or gums, but do not assume that finding one rules out another source. Record what the material looked like and whether you have fever, chest pain, shortness of breath, wheezing or continuing phlegm. Arrange an appointment for unexplained, repeated or persistent blood. Bring a list of medicines and mention smoking or previous lung problems.

Use emergency services for heavy or persistent bleeding, difficulty breathing, chest pain, fainting, severe dizziness or sudden deterioration. Seek same-day advice if you feel very unwell or have a new change alongside significant lung disease or medicine that affects clotting.

Could this be post-nasal drainage or gum bleeding? How can you tell whether the lungs are involved? Should I be examined today? What should I monitor if no cause is found initially?