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Haemoptysis (coughing up blood): Treatment, symptoms, advice and help

About haemoptysis (coughing up blood)

Haemoptysis is defined as coughing up blood which can be in the form of flecks or streaks. In rare instances the individual can even cough up massive amounts of blood. This results from bleeding anywhere from lower respiratory tract which includes trachea, bronchi and lungs. Haemoptysis is a symptom rather than a disease. Several underlying causes may be responsible for haemoptysis.

Haemoptysis (coughing up blood): Incidence, age and sex

Haemoptysis is quite commonly encountered in the general population. It may be seen in an individual of any age group. However individuals above the age of 40 years are more frequently affected. Its incidence is more in men as compared with women.

Signs and symptoms of haemoptysis (coughing up blood): Diagnosis

Haemoptysis is itself a symptom and characterized by the presence of blood in the sputum which may be rusty in colour or streaked with bright red coloured blood. Sometimes extensive loss of blood may lead to a significant drop in blood pressure along with a rapid pulse rate. This is a medical emergency and must be immediately handled by medical personnel. Haemoptysis may be associated with other features like persistent cough, fever, night sweats, loss of appetite or loss of weight. The associated features depend upon the underlying disease condition.

A detailed history and comprehensive physical examination including a chest examination is essential. It is advisable to consult a respiratory physician for the same. Investigations like sputum culture, chest X-ray and CT scans may be recommended to establish the diagnosis. Invasive tests like bronchoscopy may be required in some individuals to detect the pathology of the respiratory tract. This procedure requires the use of a flexible tube called bronchoscope which helps in visualising the interior of the respiratory tract.

Causes and prevention of haemoptysis (coughing up blood)

Several causes may lead to haemoptysis, of which pneumonia and chronic bronchitis are most widely known. Other causes include tuberculosis, bronchiectasis, pulmonary oedema and pulmonary embolism. Lung cancer is a rare cause of haemoptysis. Furthermore, generalised cause like clotting disorder of blood may also result in haemoptysis in certain instances. Occasionally violent coughing may cause minor injury of the respiratory passage and result in haemoptysis.

Haemoptysis (coughing up blood): Complications

The most common complication of haemoptysis is acute blood loss which may be seen in occasional circumstances. It may lead to hypovolemic shock which requires immediate fluid and blood infusion. In certain instances, even a moderate amount of haemoptysis may be potentially life-threatening in old-aged individuals.

Haemoptysis (coughing up blood): Treatment

The first step in management of haemoptysis is a complete evaluation of the condition and its underlying cause. Subsequent elimination of the cause of haemoptysis is of essential value to prevent further such episodes. The treatment of haemoptysis depends upon the cause. Persistent or violent cough may need medications which suppress the cough. Antibiotics are the mainstay of treatment in bacterial infections of the lungs. In most of the cases, haemoptysis is mild and may disappear on its own.