If you feel unwell and are struggling with a respiratory illness, you may cough up red mucus. Red phlegm or mucus is a sign that blood has been mixed in with your sputum.
This is a common occurrence in many mild respiratory illnesses including upper respiratory infections such as bronchitis or asthma. It can be alarming to see blood in your mucus, especially if there is a lot of it. In most cases, a small amount of blood in your mucus is nothing to worry about. Coughing up or vomiting large amounts of blood can be a sign that you have a more serious health condition that needs medical attention.
In this article, I’ll help you understand where the blood in your mucus might be coming from, and what could have caused it. I’ll tell you how it’s treated, and when you should see a medical professional about blood in your mucus.
Where is the Blood in My Mucus Coming From?
Blood in the sputum typically comes from the lungs, but in some cases, it may also originate in other parts of the body, such as the stomach or digestive tract.
It can be brought on by a range of factors.
- From the lungs (hemoptysis): Bright red, frothy blood that may be mixed with mucus is usually caused by persistent coughing or a lung infection.
- From the digestive tract (hematemesis): In less frequent circumstances, blood in the mucus can originate in the stomach or digestive tract. A clear indication of this is if you cough up dark blood that contains traces of food. Blood that comes from your stomach or digestive tract could be a symptom of a more serious health condition that requires medical attention.
Common Causes of Blood in Mucus
Common causes of blood in mucus include:
Not only is a persistent cough frustrating, it can also be damaging to your respiratory tract. A severe cough can tear the blood vessels in your upper respiratory tract, resulting in blood in your mucus.
There are a host of reasons why you might get a nosebleed. Common causes include nasal dryness, nose-picking, or injury.
This can lead to a loss of blood from the tissue that lines the inside of your nose.
Coughing up blood is a common symptom of chronic bronchitis.
This upper respiratory infection involves persistent or recurring inflammation of the airways. The inflammation causes persistent cough and the production of sputum.
Serious Causes of Blood in Mucus
Larger amounts of blood in your sputum, and coughing it up regularly, can be a warning of a more serious health condition. These include:
Pneumonia is caused by an inflammation of the lung tissue from a bacterial or viral infection.
The air sacs fill with pus and may become solid. People with pneumonia may cough up blood and experience chest pain when breathing or coughing.
They may also experience fatigue, fever, sweating, and chills.
A contagious infection that usually targets your lungs, tuberculosis is caused by harmful bacteria that can spread from person to person in direct contact.
A person with tuberculosis will often experience symptoms such as a fever, sweating, chest pain, pain while breathing or coughing, and a persistent cough that can result in expelling red mucus.
A pulmonary embolism is a blood clot in one artery of a lung. It can cause chest pain (usually made worse by breathing), sudden shortness of breath, and coughing up blood.
This is a condition where a person accidentally inhales food, liquids, saliva, vomit, or an object into their windpipe and lungs. This can result in coughing, difficulty breathing, discomfort, and in some cases, choking.
The aggravation of the windpipe could damage the tissue lining which results in blood in the sputum.
Pulmonary edema is a condition caused by excess fluid in the lungs. This makes it difficult to breathe.
It is most common in people with heart conditions. Symptoms include coughing up pink and frothy sputum, severe shortness of breath, and, for some, chest pain.
Lung cancer is a common side effect of prolonged cigarette smoking, particularly prevalent in smokers over age 40. Symptoms include a cough that does not go away, blood in the mucus, shortness of breath, chest pain, and sometimes bone pain or headaches.
Cancer in the throat, larynx, or windpipe can cause swelling or a sore that does not heal. If throat cancer spreads to the lungs, it may result in coughing up blood.
An inherited, life-threatening disorder that attacks the lungs, digestive system, and other parts of the body, cystic fibrosis is an illness with no cure. This is often diagnosed in childhood.
Those who have cystic fibrosis often have shorter life spans and battle daily with the overproduction of mucus. Coughing up blood in mucus is a common occurrence for those with cystic fibrosis.
Anticoagulants are blood-thinning medications that prevent blood clotting.
A side effect of taking anticoagulants is bleeding gums, which can cause you to cough up sputum that contains blood.
Diagnosing Why There is Blood is in Your Mucus
A healthcare provider will usually diagnose why blood is in your mucus by first reviewing your medical history and conducting a physical examination. During the examination, your doctor may ask you to cough, as well as check the nose and mouth for sites of bleeding. In some cases, additional tests may need to be done to determine the cause.
If your doctor suspects that you have a more serious health condition that is causing you to cough up blood, they may request a chest X-ray. This test will show a clear image of your lungs and can detect lung cancer, infections, or air collecting in the space around a lung.
CT scans use a combination of X-rays and computer technology to provide detailed images of any part of the body, including the bones, muscles, fat, organs, and blood vessels.
They can help doctors rule out more serious causes of coughing up blood.
A bronchoscopy involves an endoscope (a camera at the end of a tube) being inserted into the airway through the nose or mouth. This can help your healthcare provider get a clearer idea of what is causing your symptoms.
Some can stop bleeding, and others can remove a blood clot.
In some cases, your doctor may take samples of your blood or sputum for testing. This can help them detect viral or bacterial infections.
A biopsy is a sample of tissue that is taken from the body for testing. Your doctor may require a biopsy to determine if the blood in your mucus is the result of a disease.
Treating Blood in Mucus
Treatments for stopping blood in mucus will vary depending on the underlying cause.
Possible treatments include:
- Antibiotics: Antibiotics treat bacterial infections. Your doctor may prescribe antibiotics if you have pneumonia or tuberculosis.
- Blood product transfusion: When coughing up blood is due to thin blood or coagulants, or if there are clotting problems, your doctor may suggest a blood product transfusion.
- Chemotherapy or radiotherapy: These treatments may be used to treat lung cancer.
- Embolization: An embolization may be recommended if a major blood vessel is causing blood in the sputum. This process involves inserting a catheter into the vessel where bleeding is, and a metal coil, chemical, or fragment of gelatin sponge is used to seal it off.
- Steroids: Steroids can help with inflammatory conditions that are causing bleeding.
- Surgery: In rare cases, surgery may be carried out to remove a damaged or cancerous portion of the lung. This is usually only when bleeding is severe and/or persistent.
When to See a Medical Professional
If you are coughing up large amounts of blood frequently, speak to a medical professional.
Those who experience any of the following additional symptoms with blood in mucus should seek medical attention:
- Blood in the urine or stools
- Chest pain
- Dizziness or lightheadedness
- Loss of appetite
- Unexplained weight loss
- Worsening shortness of breath
In the event you are coughing up dark blood that contains food particles, go to the hospital immediately.
This is usually a sign of a severe health problem in the digestive tract.
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Frequently Asked Questions
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Approach to Hemoptysis in the Modern Era. (2017).
Bronchial Artery Embolization for the Treatment of Acute Hemoptysis. (2017).
Severe hemoptysis: From diagnosis to embolization. (2015).