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Blood in Phlegm

Blood in Phlegm

If you have been coughing up phlegm with blood, then it's time to find out what's wrong. Undermentioned are the various causes and treatment options for the same.
Dr. Sumaiya Khan
Last Updated: May 19, 2018
If it wasn't bad enough that you are coughing up phlegm, it's only worse to see that the phlegm has streaks of blood in it. A variety of lung conditions can be the reason behind it. It can be spotted in different forms: bright red, pink and frothy, or mixed with mucus. Its presence in the phlegm -- also called hemoptysis -- could be quite alarming, even if found in a small amount. However, observing a tinge of blood is a common sight and isn't of grave concern.
What Causes Blood in Phlegm
Phlegm is produced as a natural response by the immune system to any kind of irritant in the body. As the phlegm passes through the respiratory tract, it may get tinged with blood if there is any lung infection. However, this could occur anywhere along the entire length of the respiratory tract. Hence, this is a symptom that is not adequate to base a diagnosis on; it is merely an indicator of something being wrong somewhere along the respiratory tract.
Blood coming from elsewhere, like the stomach can mimic the condition that arises from the respiratory tract. Hence, it is necessary to examine, or ascertain the site of bleeding, and then find out the reason for its presence.
Respiratory Conditions
Bronchitis: This condition caused by a bacterial, or viral infection is an inflammation of the airways of the respiratory tract. In this condition, the blood found in the sputum is due to the rupture of small blood vessels during the inflammatory process.

Lung Fibrosis: When excess of fibrous connective tissue (fibrosis) breaks up the integrity of a lung vessel that carries blood, it might escape into the air sacs (in the lungs) and cause coughing that releases blood in the mucus.

Pneumonia: It's a lung infection that mainly affects the alveoli or air sacs and is caused by bacteria, viruses, and fungi. When pneumonia is caused by Klebsiella, it causes bloody phlegm, apart from other symptoms, like cough, fever, and breathing trouble.

Bronchiectasis: This condition is a destruction and widening of airways in the lungs, leading to mucus production in excess. Typically, small amount of blood is coughed up from an inflamed airway.
Lung Abscess: This is an acute/chronic lung infection marked by inflammation, pus collection, and tissue destruction. As the illness progresses, about 75% patients tend to cough up phlegm with blood.

Cystic Fibrosis: Caused by a defect in a single gene, the lungs, intestines, and pancreas become congested with thick mucus. As the condition aggravates due to filling up of the air passages (with mucus), complications occur with one of them being bloody phlegm.

Chronic Obstructive Pulmonary Disease (COPD): Smoking is the major reason behind COPD. This respiratory disorder includes emphysema (damages lung tissues) and bronchitis (airway inflammation). Expulsion of phlegm with blood occurs during stage III of this disease, wherein weight loss, breathing trouble, and shortness of breath are also observed.

Tuberculosis: Usually caused by M. tuberculosis, it is a severe lung infection with bloody mucus (caused by damaged blood vessels) as a symptom, along with night sweats, fever, weakness, malaise, and weight loss.

Pulmonary Embolism: In this condition, a blood clot that develops elsewhere in the body travels through the blood before it finally gets stuck in the arteries. Cough experienced during this condition may bring up the blood-tinged phlegm.
Lung Cancer
Lung cancer, a major cause of death, is observed in people, who indulge in long-term smoking. One of the first few symptoms of lung cancer is expelling bloody phlegm. However, unlike the other cases, the phlegm is extremely thick, which may even cause difficulty in breathing while coughing it up. Hence, when you notice such phlegm being given out, you should immediately contact the doctor.
Heart Disorders
Certain cardiovascular diseases can also show symptoms of bloody phlegm. These include valvular heart diseases, like mitral stenosis or mitral regurgitation, congestive heart failure, arteriovenous malformation, etc. When phlegm with blood is noticed in the morning, it could signal the risk of an underlying heart disease.
Miscellaneous Conditions
There are certain miscellaneous conditions that may lead to phlegm with blood in it, like sarcoidosis, amyloidosis, lymphatic disorders, reactions to certain medications, coagulation disorders, like thrombocytopenia, thrombotic thrombocytopenic purpura, bleeding disorders, like hemophilia, etc.
What You Need to Do
If you have a viral cold and notice blood spots in your phlegm, then you should stay open-eyed. If it gets worse, it's time you see a doctor.

Don't self-prescribe an over-the-counter cough suppressant to repress your blood-tinged mucus. Rather, it's better your physician examines you and prescribes one.

If you spit up a lot of bloody cough, you can take a sample along for testing. Preferably, cough up in a container, so that you can retrieve it.
Call Your Doctor ...
If you notice spots or streaks of blood in your phlegm in the absence of a cold, or flu.
If you notice more than a few teaspoons of blood.
If you also come across symptoms, like fever, chest pain, and shortness of breath.
If you pass out while coughing.
As such, the entire treatment of blood-tinged phlegm in the chest will depend on the underlying condition that is causing the person to cough up the phlegm. It is extremely important that the person takes this symptom seriously and contacts the doctor. Normally, medical tests, like blood and sputum examinations, ECG, CT scan, and X-rays of the chest are done to determine, or distinguish the ailment behind phlegm expulsion. Only after that can a detailed treatment plan be chalked out.
Curing the expulsion of phlegm (with blood) begins with treating the underlying cause. If the patient is suffering from cystic fibrosis, or an acute lung infection, prompt treatment needs to begin to diagnose and cure the problem. Accumulation of phlegm in young children could pose a problem and hence, should be attended to, on time.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical professional.