GERD, cough and blood: what to know

Acid reflux can irritate the food pipe, throat and voice box, causing a dry cough, throat clearing, hoarseness or a sour taste. Irritation from reflux does not by itself explain blood in coughed-up mucus. Blood may come from the nose, mouth or irritated airways, and causes include infections, asthma, bronchiectasis or other lung conditions. A nosebleed that drains backward can be mistaken for blood from the chest. Note the colour, amount, clots, and whether it appeared with mucus or vomiting. These details help a clinician locate the source.

Arrange a same-day medical review if you have seen blood when coughing. Do not assume reflux is the cause or start extra medicines without advice. Until assessed, avoid smoking and strenuous exertion, and record any medicines that affect bleeding. If reflux symptoms are also present, smaller meals, avoiding food close to bedtime and raising the head of the bed may reduce nighttime irritation, but these measures do not replace assessment. Information about [Acid Reflux](/conditions/acid-reflux/) and [Chronic Cough](/conditions/chronic-cough/) may help you prepare.

Call emergency services or go to an emergency department if bleeding is heavy or recurring, breathing is difficult, chest pain is present, you feel faint or confused, or your lips look blue. Seek urgent help as well if you are vomiting blood, passing black stools, or take blood-thinning medicine. Do not drive yourself if you feel weak or short of breath.

Ask: Could the blood be from my nose, throat, stomach or lungs? What examination or imaging is appropriate? Could my medicines increase bleeding? Which reflux measures are suitable while this is being investigated?