Bleeding when coughing up

The appearance of an admixture of blood in sputum indicates a violation of the integrity of a blood vessel, the localization of which can be located both in the organs of the respiratory tract and in the digestive system. To deal with the source of bleeding, you need a complete examination, including laboratory and instrumental diagnostics. So when is blood from the throat observed?

First, we will differentiate between gastric and pulmonary bleeding.

Causes of hemoptysis

All the reasons that cause bleeding can be divided into several groups:

• pathology of the bronchopulmonary system;
• diseases of the nasopharynx / oropharynx;
• oncological processes;
• vascular diseases.

Among the diseases, the localization of which is in the respiratory system, it is worth highlighting:

• bronchitis, especially atrophic form. Hemoptysis with bronchitis is mostly minimal. In the sputum, bloody streaks and purulent discharge are noted. Profuse bleeding is recorded when a blood vessel ruptures with a strong cough.
• bronchiectasis is characterized by persistent coughing with purulent sputum. With "dry bronchiectasis" hemoptysis is noted.
• tuberculosis is manifested by severe malaise, prolonged cough with scanty sputum, subfebrile hyperthermia, profuse night sweating and weight loss. Often, an admixture of blood is found in the fibrous-cavernous type.
• pneumonia, provoked by pneumococcus / staphylococcus / pseudomonads, are manifested by the release of "rusty" sputum. When infected with Klebsiella, the sputum resembles "currant jelly."
• a pulmonary abscess is characterized by hemoptysis, febrile fever, cough with purulent sputum, and severe intoxication syndrome.
• parasitic (echinococcosis, ascariasis) and fungal (aspergilloma) damage to the lung tissue also leads to hemoptysis.

If blood is diagnosed on the back of the throat, the causes may be damage to the blood vessels in the nasopharynx, for example, due to injury, after surgery in the nasal area or removal of tonsils.

In the case of ulcerative tonsillitis, when ulcerative defects form on the surface of the tonsils, an admixture of blood may appear in the sputum. The cough appears reflexively when blood enters the bronchi. In addition, when trying to remove plaque from the tonsils with diphtheria, the surface also bleeds for a long time. As a result, a wound is formed, which predisposes to infection.

As for oncological diseases, the cause of hemoptysis can be:

• lung cancer, which is manifested by hemoptysis, weight loss, poor appetite. Often, an admixture of blood in sputum is recorded with a central type of tumor.
• adenoma of the bronchus is characterized by hemoptysis, cough, shortness of breath, increased severity of respiratory failure as the tumor grows and the lumen of the bronchi decreases.
• tumors of the larynx, nasopharynx, paranasal sinuses can also provoke hemoptysis when blood enters the bronchi.

Bleeding of the tumor is noted during its disintegration, which indicates the progression of the disease and the severe stage of the disease.

Separately, diseases of the cardiovascular system in adults should be highlighted:

• pulmonary hypertension due to mitral stenosis, cardiomyopathy and other cardiac pathologies leads to hemoptysis after exercise. The person is worried about severe shortness of breath, dizziness and angina pectoris. Hemoptysis is observed due to a violation of vascular integrity with an increase in pressure in the pulmonary bloodstream.
• pulmonary edema is manifested by the release of foamy sputum with a bloody impurity, which stains the sputum pink.
• pulmonary embolism is accompanied by hemoptysis, severe shortness of breath and chest pain.
• increased fragility of blood vessels in vascular diseases of autoimmune origin.

After exposure to a traumatic factor, the appearance of blood streaks in the throat is characteristic. Throat can be struck by chemicals (burns of the mucous membrane), solid food or laryngoscopy. In addition, hemoptysis is also possible after bronchoscopy, transbronchial biopsy, percutaneous pulmonary puncture, or pulmonary artery catheterization.

When a lung is injured, ribs are broken, and the chest is bruised, a bleeding vessel appears, provoking the appearance of hemoptysis. To a lesser extent, blood impurity in sputum is observed with cystic fibrosis, hypoplasia of pulmonary vessels, hereditary hemorrhagic telangiectasia, Wegener's granulomatosis, lupus, Goodpasture's syndrome or sarcoidosis.

Diagnostic measures

If in the morning and during the day a person is worried about sputum with blood impurity, you should consult a doctor to establish the true cause.

Hemoptysis is a serious symptom of many diseases that, if untreated, can lead to fatal complications.

At the doctor's appointment, anamnestic data is first analyzed. The person talks about the presence of diseases, contact with sick people, injuries suffered, operations and the peculiarities of the appearance of an admixture of blood in sputum. During a physical examination, the doctor performs auscultation (listening) of the lungs, heart, examines the skin and examines the throat.

For diagnostic purposes, it is assigned:

• chest x-ray, which is performed primarily for hemoptysis. This image makes it possible to visualize the lung tissue, blood vessels, bronchi and heart. The study is carried out in two projections for a clearer definition of the localization of the pathological focus.
• the back wall of the throat and larynx are examined during pharyngoscopy, which makes it possible to establish the disease of the tonsils, detect neoplasms and the source of bleeding.
• bronchoscopy is performed to assess the bronchial patency and sampling of material for histological analysis. Thanks to the study, it is possible to verify the oncological disease.
• computed tomography makes it possible to accurately examine pathological foci.

From laboratory methods, a clinical blood test, a coagulogram, the determination of antibodies, tumor markers and other studies are used. When diagnosing tuberculosis, parasitic pathologies, sputum analysis should be carried out to establish the cellular composition.

Treatment

Therapeutic tactics depend on the cause provoking the appearance of blood in the sputum. With a tumor process, depending on the stage of the disease, surgical intervention can be prescribed to remove the primary oncological focus, radiation or chemotherapy. If the malignant conglomerate is inoperable, palliative surgery is performed, in which only part of the tumor is removed.This makes it possible to somewhat improve the patient's quality of life and increase the survival rate.

As for conservative therapy, it may include hemostatic drugs, for example, ethamsylate, calcium chloride, aminocaproic acid, and other drugs. In the treatment of the underlying disease, antibacterial, antimycotic agents, mucolytics, hormonal and vascular drugs can be prescribed.

Diseases are treated by a pulmonologist, oncologist, otolaryngologist, rheumatologist or phthisiatrician. It is especially important to timely diagnose an infectious disease (tuberculosis). This will help not only prevent the development of complications, but also protect people around from infection. Do not postpone the visit to the doctor and at the first appearance of blood in the sputum, you must go to the hospital.