Respiratory Disorders Expert Forum
coughing bloody mucus
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coughing bloody mucus

I've had a cough for a year now.Diagnosed and treated for asthma and acid reflux.Cough much better but still producing some thick clear mucus every day or so.

A week ago, I coughed up some bloody mucus for the first time. The first episode was a small amount of bright fresh blood with some phlegm and on two subsequent occasions,the same day, the blood was darker and more integral with the phlegm. They were very small amounts each time. Today, a week later, there was again some phlegm which seemed to come from deep down and it had brown mucus with it. Could this simply be old blood, the residue from the original bleed or is it a sign of continued bleeding?

I feel well, no fever etc. I had clear chest x ray and HRCT 8 months ago and had a further clear CXR and clear CT with contrast three days ago.. However, I remain very worried that I may have a serious condition, as yet undetected. My respiratory consultant says he is not looking at anything sinister and that the most likely cause is a blood vessel ruptured by coughing. It just seems too simple, that after a year of coughing, I suddenly produce blood and it is explained away so easily. Should I ask for further tests?
I am 65 and have not smoked for 17 years.

I am at my wits' end and don't know where to turn.
Any help would be greatly appreciated.
242587_tn?1355427710
The recently performed normal chest X-ray and CT Scan are very reassuring but these normal/negative tests do not explain the recent cause of blood in your phlegm and your continuing concern is warranted.  Your respiratory consultant may be right that the blood is from the rupture of a small blood vessel, associated with coughing, but I believe that it would be inappropriate to make that assumption.  The blood might be from anywhere in your respiratory system from the sinuses, to the throat itself, to your larynx and surrounding structures, to the trachea and even the gastrointestinal tract (the pharynx or upper esophagus) and not be evident on a Chest CT.  

I suggest that you speak to your primary care physician and/or the respiratory consultant to request direct examination of these possible sites of bleeding.  Direct examination of your throat, larynx and trachea by the respiratory doctor would be a reasonable place to start.  

Yes, brown mucous could be from residual blood but it is the bright red blood that is of concern and the brownish mucous only a reflection of that.

If your physicians are reluctant to conduct further testing, my suggestion would be that you seek a 2nd opinion.

I hope that the bleeding is not a sign of serious disease.

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