GERD and coughing up blood: what should you know?

Reflux can irritate the throat, but visible blood in coughed-up mucus may come from the nose, throat or lungs. Forceful coughing can also irritate small blood vessels. Other possibilities include Bronchiectasis, Pneumonia, Tuberculosis, Lung Cancer or Pulmonary Embolism, and these cannot be sorted out safely from symptoms alone.

Tell the clinician whether the blood was streaked through mucus or more substantial, how often it appeared, and whether it followed vomiting rather than coughing. Mention fever, breathlessness, chest pain, smoking history, recent travel, leg swelling and medicines that affect clotting.

Contact a healthcare service promptly even if the amount seems small, particularly if the episode is new or recurring. Do not take someone else’s reflux or cough medicine to mask the symptom. If possible, note the colour and amount without delaying care, and bring a list of medicines and relevant medical conditions.

Call emergency services for more than a trace of blood, ongoing bleeding, severe breathlessness, chest or upper-back pain, fainting, confusion, a very fast heartbeat or marked weakness. These signs can indicate serious bleeding, infection or a clot and require immediate assessment.

Could the blood be from my throat, stomach or lungs? Do I need chest imaging or other tests? Could any medicine increase bleeding, and what should I do if it happens again?