Haemoptysis is the medical term for coughing up blood. Spitting of blood may occur from any slight bleeding from the teeth, gums or a congested throat. Sputum may contain streaks of blood.

When the source of bleeding is lower in the lungs then it could be serious. This bleeding is called haemoptysis, and can be because of the involvement of a blood vessel in an inflammatory process, such as tuberculosis, or a destructive process, such as cancer.

True haemoptysis consists of bright red blood, is a frothy mixture of air from the lungs. Haemoptysis should be distinguished from vomiting blood due to bleeding from the stomach. The blood from the stomach is not bright red, but dark, like coffee, because stomach acid changes the colour. It will not be frothy and have a bitter flavour. It comes with the act of vomiting or coughing. A history of ulcer dyspepsia is usually present.

Causes of Haemoptysis

Tuberculosis of the lungs

This is the most common cause of haemoptysis in India and other developing and third world countries. Tuberculosis is usually described in chronic disease.

Cancer or growth in the lungs
Adenoma and cancer are rare causes of haemoptysis especially in the elderly.

There is a long drawn out history of cough and purulent sputum. Repeated bleeding can occur, but is mostly not dangerous.

Pulmonary embolism
An occasional but serious cause of haemoptysis in patients confined to bed or those who have been subjected to long surgeries or are prone to thromovascular diseases.

Research and Treatment
When haemoptysis occurs, do not panic as the bleeding is unlikely to be severe enough to pose an immediate danger. It is always advisable to Ask a Doctor about the possible causes for the bleeding in your case.  Your doctor will decide if this is true haemoptysis and try to find the cause clinically, and with a series of tests. The first line of investigations is the chest radiograph, complete blood count and ESR, and sputum examination. Additional investigations such as bronchoscopy and bronchography, etc., can be done later if necessary. The treatment always depends upon the underlying condition.

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