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What Causes Coughing Up Of Blood?
Question: Hi, I have a history of chronic sinusitis with dry mucosa, some gum problems, a half-reatined wisdom tooth and extreme bruxism. Also suffer from anxiety, especially cancerophobia. I'm able to bring up blood, sometimes by coughing, but mostly not connected to coughing by simply sucking on the roof of my mouth at times. When I first noticed blood after a cough I suffered terrible fear of lung cancer and after 8 months, in May 2013, got a chest x-ray which was all clear. From the on I was sure that the blood came from throat cancer. Took me until january of this year to finally have an ENT exam which also was completely clean and I managed to put my fears of lung cancer or throat cancer to rest.
But 12 days ago I fell sick with a real influenca and had a violent cough for a couple of days which finally lead to some blood again which in turn had me force-cough just to check whether there was blood. The cough is gone since a week but I keep forcing myself to cough and then check the sputum for blood. I even use a camera to zoom in on the stuff and am able to sometimes find some bits of bloody tissue < 1 square millimeter. I feel that all of the coughing and phlegm is based in the throat and I had a very very sore throat for days. I found out that the same stuff somtimes comes out when I blow my nose, though.
The real question I have against this background is basically, what a true hemoptysis from lung cacner feels like. Does hemoptysis trigger a cough? Do you notice that the stuff you're coughing up comes from the lungs? I very seldomly bring up a bit of phlegm from my chest and I notice that the source is in my chest when this happens once or twice a year, would you notice that with hemoptysis as well? Would you taste blood in mouth? I smoked from age 16 to 30 regularily and smoked from 30-40 (current age) 4-5 cigarettes on Friday evenings. That's why I'm terrible scared of lung cancer but I cannot continue force-coughing, spitting the sputum somewhere and examining it with a flash light and a camera. There has to be a better solution...
But 12 days ago I fell sick with a real influenca and had a violent cough for a couple of days which finally lead to some blood again which in turn had me force-cough just to check whether there was blood. The cough is gone since a week but I keep forcing myself to cough and then check the sputum for blood. I even use a camera to zoom in on the stuff and am able to sometimes find some bits of bloody tissue < 1 square millimeter. I feel that all of the coughing and phlegm is based in the throat and I had a very very sore throat for days. I found out that the same stuff somtimes comes out when I blow my nose, though.
The real question I have against this background is basically, what a true hemoptysis from lung cacner feels like. Does hemoptysis trigger a cough? Do you notice that the stuff you're coughing up comes from the lungs? I very seldomly bring up a bit of phlegm from my chest and I notice that the source is in my chest when this happens once or twice a year, would you notice that with hemoptysis as well? Would you taste blood in mouth? I smoked from age 16 to 30 regularily and smoked from 30-40 (current age) 4-5 cigarettes on Friday evenings. That's why I'm terrible scared of lung cancer but I cannot continue force-coughing, spitting the sputum somewhere and examining it with a flash light and a camera. There has to be a better solution...
Brief Answer:
Get done CT thorax and bronchoscopy.
Detailed Answer:
Hello dear, thanks for your question on HCM.
I can understand your situation and problem.
Hemoptysis is coughing out blood. True Hemoptysis carries mucus with it.
Usually either whole sputum is bright red in color or whitish sputum having bright red drops. This is true Hemoptysis.
But the best way to search for the cause and source of the bleeding, is microscopic examination of that sample.
If it is having respiratory epithelial cells along with blood cells then it is 100% from lungs.
And if respiratory epithelial cells are absent then mostly it is from gums.
So better to get done microscopic examination of sample.
Blood in the lungs, definitely irritates mucosa and produce coughing. So Hemoptysis triggers coughing.
And yes, blood gives typical taste in mouth.
Since you are smoker , we need to take this matter seriously. Because Hemoptysis is one of the earliest symptom for lung cancer.
Chest x ray has its own limitations in diagnosis of early lung cancer.
CT thorax with contrast is needed to rule out early lung cancer.
Bronchoscopy is also recommended to rule out any endobronchial pathology like ulcer, nodule, mass etc.
So better to consult pulmonologist and get done CT thorax and bronchoscopy to rule out early lung cancer.
And please quit smoking as soon as possible. It is not at all good habit.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
Get done CT thorax and bronchoscopy.
Detailed Answer:
Hello dear, thanks for your question on HCM.
I can understand your situation and problem.
Hemoptysis is coughing out blood. True Hemoptysis carries mucus with it.
Usually either whole sputum is bright red in color or whitish sputum having bright red drops. This is true Hemoptysis.
But the best way to search for the cause and source of the bleeding, is microscopic examination of that sample.
If it is having respiratory epithelial cells along with blood cells then it is 100% from lungs.
And if respiratory epithelial cells are absent then mostly it is from gums.
So better to get done microscopic examination of sample.
Blood in the lungs, definitely irritates mucosa and produce coughing. So Hemoptysis triggers coughing.
And yes, blood gives typical taste in mouth.
Since you are smoker , we need to take this matter seriously. Because Hemoptysis is one of the earliest symptom for lung cancer.
Chest x ray has its own limitations in diagnosis of early lung cancer.
CT thorax with contrast is needed to rule out early lung cancer.
Bronchoscopy is also recommended to rule out any endobronchial pathology like ulcer, nodule, mass etc.
So better to consult pulmonologist and get done CT thorax and bronchoscopy to rule out early lung cancer.
And please quit smoking as soon as possible. It is not at all good habit.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dear Dr. Bhavsar,
I have no cough (as I said, I am forcing myself to cough without any need other than to check for blood), have no blood taste in mouth and have this symptoms since more than 2 years, do you still think there's a high likelyhood of lung cancer?
Thanks, best regards.
I have no cough (as I said, I am forcing myself to cough without any need other than to check for blood), have no blood taste in mouth and have this symptoms since more than 2 years, do you still think there's a high likelyhood of lung cancer?
Thanks, best regards.
Brief Answer:
I don't think you are having lung cancer.
Detailed Answer:
Hello dear, thanks for your follow up question on HCM.
I don't think you are having lung cancer.
But, since you are smoker if you want to be 100% sure of not having lung cancer, you need CT thorax and bronchoscopy.
You have asked for better solution in your previous question, so if your CT and bronchoscopy are normal then you can be 100% sure of not having lung cancer.
You can also go for microscopic examination of haemoptysis whenever you have haemoptysis. And if it is not having respiratory epithelial cells then blood is not from the lungs.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
I don't think you are having lung cancer.
Detailed Answer:
Hello dear, thanks for your follow up question on HCM.
I don't think you are having lung cancer.
But, since you are smoker if you want to be 100% sure of not having lung cancer, you need CT thorax and bronchoscopy.
You have asked for better solution in your previous question, so if your CT and bronchoscopy are normal then you can be 100% sure of not having lung cancer.
You can also go for microscopic examination of haemoptysis whenever you have haemoptysis. And if it is not having respiratory epithelial cells then blood is not from the lungs.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Thank you Dr. Bhavsar,
I misunderstood you then :)
There's two things left that I ask myself:
1. I was quite proud of me when I stopped daily smoking 10 years ago and figured I could get away with 3-4 cigarettes stricly only once per week. You as a pulmonologist seem to think differently about it. So 3-4 cigarettes *once per week* still increase lung cancer risk?
2. After clearing my thoughts I'm wondering now whether I really have hemoptysis at all as:
- I can produce blood in my mouth from sucking on my gums or the roof of my mouth at times
- I have no cough on its own at all (I mean nothing makes me cough, I do it myself)
- I see blood only after making myself cough *many* times violently
- the blood I see is never bright red but rather dark red / brown, it has the same color as when I blow my nose
- I only experience blood taste in mouth when I can see my gums or roof oy mouth are bleeding, never after coughing
- I have no sputum apart from post-nasal-drip
Thanks for easing my worries a bit so far :)
Best regards!
I misunderstood you then :)
There's two things left that I ask myself:
1. I was quite proud of me when I stopped daily smoking 10 years ago and figured I could get away with 3-4 cigarettes stricly only once per week. You as a pulmonologist seem to think differently about it. So 3-4 cigarettes *once per week* still increase lung cancer risk?
2. After clearing my thoughts I'm wondering now whether I really have hemoptysis at all as:
- I can produce blood in my mouth from sucking on my gums or the roof of my mouth at times
- I have no cough on its own at all (I mean nothing makes me cough, I do it myself)
- I see blood only after making myself cough *many* times violently
- the blood I see is never bright red but rather dark red / brown, it has the same color as when I blow my nose
- I only experience blood taste in mouth when I can see my gums or roof oy mouth are bleeding, never after coughing
- I have no sputum apart from post-nasal-drip
Thanks for easing my worries a bit so far :)
Best regards!
Brief Answer:
Yes, it increases lung cancer risk.
Detailed Answer:
Hello dear, thanks for your follow up question on HCM.
Smoking is the biggest risk factor for lung cancer. But it is not the only risk factor. Patient can develop lung cancer even without smoking a single cigarette.
So even single cigarette per week is also a risk factor for future lung cancer.
And in my opinion you are not having haemoptysis. Forcefull coughing can itself cause friction and mild bleeding. But this is natural, no need to worry much.
Rather I will advice not to check for this by vigorous coughing.
Better to concentrate on quitting cigarettes.
This will be more beneficial for you.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly / askdrkaushalbhavsar.
Wish you good health.
Thanks.
Yes, it increases lung cancer risk.
Detailed Answer:
Hello dear, thanks for your follow up question on HCM.
Smoking is the biggest risk factor for lung cancer. But it is not the only risk factor. Patient can develop lung cancer even without smoking a single cigarette.
So even single cigarette per week is also a risk factor for future lung cancer.
And in my opinion you are not having haemoptysis. Forcefull coughing can itself cause friction and mild bleeding. But this is natural, no need to worry much.
Rather I will advice not to check for this by vigorous coughing.
Better to concentrate on quitting cigarettes.
This will be more beneficial for you.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly / askdrkaushalbhavsar.
Wish you good health.
Thanks.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
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