Coughing up bloody phlegm, red phlegm or pink phlegm

Overview

Coughing up phlegm that is bloody, red, or pink can be concerning; however, it doesn't always indicate a serious issue. It may sometimes result from mild irritation, while in other cases, it could point to a problem in the airways or lungs. Recognising the colour, pattern, and related symptoms is key to understanding what may be occurring.

What does bloody, red, or pink phlegm look like?

Common appearances include:

• Bright red streaks
• Pink, frothy mucus
• Rusty or dark red mucus
• Small blood spots

Note: The hue and volume can often help indicate the cause.

Causes

Common and less severe causes include:

• Dry or irritated airways (from frequent coughing)
• Upper respiratory infections (like colds, flu, bronchitis)
• Nosebleeds draining into the throat
• Allergies or sinus infections
• Irritation from smoking or vaping

More severe causes include:

• Pneumonia
• Tuberculosis (TB) – less common in Australia, but possible
• Pulmonary embolism
• Chronic lung conditions (COPD, bronchiectasis)
• Heart failure (may cause pink, frothy sputum)
• Lung cancer
• Major trauma to the chest or airways

Comparison table: Mild vs Serious causes

Symptoms to watch for

Other symptoms to be aware of:

• Fever or chills
• Chest pain
• Shortness of breath
• Wheezing
• Fatigue
• Unintentional weight loss
• A persistent cough lasting over three weeks

When is coughing up blood an emergency?

Seek immediate emergency care (call 000 or go to the emergency department) if you experience:

• Large quantities of blood
• Breathing difficulties or tightness in the chest
• Sudden chest pain
• Dizziness or fainting
• Pink, frothy sputum coupled with breathlessness
• A recent long flight, surgery, or swelling in the legs (possible pulmonary embolism)

When to see a GP in Australia

Consider getting a medical evaluation if you notice:

• Blood in phlegm lasting more than 1–2 days
• Recurring blood in mucus
• A fever that does not improve
• A cough persisting for over three weeks
• A history of smoking
• Pre-existing lung issues (COPD, asthma, bronchiectasis)

Diagnosis

Doctors will evaluate your symptoms and may conduct tests to determine the underlying cause. These tests could include:

• Chest X-ray
• Sputum analysis
• Bloodwork
• CT scan
• Bronchoscopy (for persistent or unexplained bleeding)

Treatment options

Depend on the underlying cause

• Infections: antibiotics if bacterial, rest, hydration
• Irritated airways: using a humidifier, throat-soothing remedies, quitting smoking
• Chronic lung diseases: inhalers, airway clearance methods
• Serious conditions: emergency treatment for issues like pulmonary embolism, heart failure, or cancer

Lifestyle and home support

• Stay hydrated
• Avoid smoking and vaping
• Warm liquids
• Monitoring your symptoms

How Hola Health can help

Hola Health connects you with GPs in Australia who can:

• Provide online GP consultations
• Evaluate your symptoms and guide necessary testing
• Prescribe inhalers or antibiotics when needed
• Offer referrals for chest X-rays
• Issue medical certificates
• Advise if urgent care is necessary

Conclusion

Coughing up bloody, red, or pink phlegm can vary from harmless airway irritation to an indicator of a more serious condition. Observing the colour, quantity, and accompanying symptoms can help you identify the potential cause. If the bleeding continues, worsens, or occurs alongside breathing difficulties or fever, consulting a GP or seeking urgent care is crucial for timely diagnosis and treatment.

FAQs

Is the presence of bloody phlegm always a concern?

Not necessarily. Minor irritation or infections can lead to blood streaks, but ongoing or heavy bleeding requires medical attention.

Can COVID or the flu result in bloody mucus?

Yes, severe coughing or inflammation of the airways can lead to slight amounts of blood.

Is it common to cough up blood after smoking?

Occasional irritation can create streaks, but recurring bleeding requires a medical evaluation.

What quantity of blood is considered excessive?

More than a teaspoon at once, or any rapid bleeding, is regarded as urgent.

What tests should I undergo if blood in phlegm is recurring?

A GP might request a chest X-ray, sputum examination, CT scan, or bronchoscopy based on your symptoms.