Coughing up blood: what to do

Blood may come from irritated airways after forceful coughing, an infection such as acute bronchitis, or mucus moving from the nose or throat. Conditions such as bronchiectasis, asthma, and acid reflux can also contribute to recurrent cough symptoms. The colour, amount, and pattern matter: bright-red blood, clots, repeated episodes, or blood mixed through mucus deserve clinical attention. A cough with blood does not by itself identify the cause.

Stop strenuous activity and sit upright. Note whether the blood was streaked through mucus or came up separately, how often it happened, and whether you also have fever, chest discomfort, breathlessness, or dizziness. Do not smoke. Avoid taking a cough suppressant or changing medicines without advice, particularly if you use a blood-thinning medicine. Arrange prompt medical assessment even if the bleeding stops, because an examination may be needed to locate the source.

Call emergency services if bleeding is heavy or ongoing, you are struggling to breathe, feel faint or confused, have severe chest pain, or notice a fast worsening of symptoms. Seek same-day care for repeated blood-streaked mucus, a new fever with breathing symptoms, or a history of lung disease. Do not drive yourself if you feel weak, dizzy, or short of breath.

Ask what may be causing the bleeding, whether your medicines could increase it, and which examination or tests are appropriate. Tell the clinician about smoking or vaping, recent infections, travel, nosebleeds, and any previous lung condition.