Coughing and throwing up blood: what to know

Blood brought up after a cough is often bright or frothy and mixed with mucus, suggesting the mouth, throat, or airways. Blood brought up with nausea or retching may be darker, clotted, or mixed with food and can come from the upper digestive tract. Irritation after forceful coughing or vomiting can cause small streaks, but other causes include [Pneumonia](/conditions/pneumonia/), [Bronchiectasis](/conditions/bronchiectasis/), [Tuberculosis](/conditions/tuberculosis/), [Lung Cancer](/conditions/lung-cancer/), or a [Pulmonary Embolism](/conditions/pulmonary-embolism/). These possibilities cannot be separated safely by colour alone.

Stop strenuous activity, sit upright, and arrange urgent medical advice. Do not take aspirin or anti-inflammatory pain medicines for this symptom unless a clinician has told you to use them. If possible, keep a sample or photograph, and record whether blood appeared with coughing, retching, or vomiting, along with medicines such as blood thinners. Do not eat or drink large amounts if you are actively vomiting or having trouble swallowing.

Call emergency services immediately for more than a small streak, ongoing bleeding, breathlessness, chest or upper-back pain, a fast or irregular heartbeat, dizziness, fainting, confusion, pale or clammy skin, or black stools. Do not drive yourself if you feel weak or short of breath. Even a small unexplained episode needs prompt clinical review.

Tell the clinician how much blood you saw, its colour and texture, whether coughing or nausea came first, and whether you take blood thinners or have lung disease. Ask what examination or imaging is needed and whether treatment such as [Palliative Radiotherapy](/treatments/radiation-oncology/palliative-radiotherapy/) is relevant to an established cancer diagnosis.