Haemoptysis (Blood in Sputum/Cough)
Finding blood in your phlegm or spit can be a distressing experience. In the medical world, coughing up blood from the respiratory tract is known as haemoptysis.
While it can sometimes be caused by something minor, like a forceful cough or a nosebleed, it is a symptom that should always be evaluated by a healthcare professional to rule out serious underlying conditions.
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Identifying the Source
The first step is determining where the blood is coming from. True haemoptysis comes from the lungs or bronchial tubes.
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Haemoptysis (Lungs): The blood is usually bright red, frothy (mixed with air and bubbles), and mixed with mucus. It typically follows a cough.
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Pseudo-haemoptysis: Blood that comes from the nose, mouth, or throat but is "spit out."
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Haematemesis (Stomach): Blood that is vomited up. This is usually darker (like coffee grounds) and may be mixed with food particles.
Common Causes of Haemoptysis
The severity of the symptom often depends on the underlying cause. Common triggers include:
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Bronchitis: Acute or chronic inflammation of the airways can cause small blood vessels to break.
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Pneumonia: A lung infection that can cause chest pain, fever, and bloody phlegm.
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Tuberculosis (TB): A serious bacterial infection; persistent cough and weight loss are common accompanying symptoms.
Infections (Most Common)
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Bronchiectasis: Permanent scarring and enlargement of the airways, often leading to recurrent bleeding.
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COPD: Long-term lung damage that can make the airway lining fragile.
Chronic Lung Conditions
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Lung Cancer: A primary concern in long-term smokers or those with persistent symptoms.
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Pulmonary Embolism: A blood clot in the lung that requires immediate emergency care.
Serious Concerns
Symptoms to Monitor
When discussing your symptoms with a doctor, pay attention to these details:
Symptom Feature
Volume
Color
Duration
Triggers
What to Note
Is it just streaks of blood, or a significant amount (teaspoon or more)?
Is it bright red, pink and frothy, or dark/rusty?
Is this a one-time occurrence or has it happened for several days?
Does it happen only during a violent coughing fit?
Accompanying "Red Flag" Symptoms
If you are coughing up blood, seek medical attention immediately—especially if you also experience:
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Shortness of breath or gasping for air.
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Chest pain.
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Fever and night sweats.
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Significant, unintended weight loss.
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Coughing up more than a few tablespoons of blood (Massive Haemoptysis).
How Is It Diagnosed?
Because haemoptysis is a symptom and not a disease itself, doctors use several tools to find the "why":
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Chest X-ray or CT Scan: To look for infections, masses, or fluid in the lungs.
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Bronchoscopy: A thin, flexible tube with a camera is used to look directly inside the airways.
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Sputum Culture: Testing the phlegm for bacteria or infections like TB.
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Blood Tests: To check for inflammation levels or clotting issues.
Summary
Most cases of blood-streaked sputum are due to common infections like bronchitis, but because the lungs are vital organs, any instance of haemoptysis deserves a professional opinion. Early diagnosis is the most effective way to ensure a quick recovery.
About the Service Provider
Dr. Smaran Cladius - MD Respiratory Medicine, Fellowship in Interventional Pulmonology, Certificate in Allergy Testing & Allergen Immunotherapy
Pulmonologist | Chest Physician | Allergy & Sleep Specialist
Dr. Smaran Cladius is a pulmonologist specializing in the diagnosis and management of respiratory diseases, including chronic cough, asthma, COPD, respiratory allergies, tuberculosis, interstitial lung diseases and sleep-related breathing disorders.
Medically reviewed and Last updated: July 2026
This information is for general educational purposes only and is not a substitute for professional medical advice. Read our full Medical Disclaimer →