Coughing up bloody phlegm, red phlegm or pink phlegm

Summary: Coughing up blood, also known as haemoptysis, can range from mild irritation to a sign of a serious medical condition. It may result from infections like pneumonia or bronchitis, chronic conditions such as tuberculosis or lung cancer, or less common causes like autoimmune diseases, pulmonary embolism, or certain medications. While small traces of blood in phlegm might not always be alarming, persistent or heavy bleeding, especially with symptoms like chest pain, shortness of breath, or unexplained weight loss, requires urgent medical attention.

Coughing up phlegm is a common bodily function, usually indicating that your body is clearing out irritants, infections, or other foreign particles from your respiratory system. While most phlegm is either clear or lightly coloured, noticing red, pink, or bloody mucous can be concerning. This type of phlegm can happen for various reasons, some minor, while others may point to a more serious health problem. Let’s look into the possible reasons for coughing up bloody or coloured phlegm, the symptoms associated with it, and the steps you should take if this happens.   

What is coughing up blood?

Coughing up blood, also known as haemoptysis, refers to the presence of blood in mucous from the respiratory tract. While small amounts may result from minor causes such as throat irritation, it can also indicate serious lung or cardiovascular conditions requiring prompt medical evaluation.  

Common causes of coughing up blood

Coughing up blood can be caused by various reasons. Some common causes include: 

• Pneumonia: A bacterial or viral infection in the lungs that leads to inflammation, coughing, chest pain, and sometimes blood in the phlegm. The infection can irritate blood vessels, resulting in bleeding.  
• Bronchitis: Inflammation of the bronchial tubes, often due to infection or chronic irritation (like smoking), can lead to coughing up blood-tinged mucous, especially if the airways are severely irritated.  
• Tuberculosis (TB): A bacterial infection that primarily impacts the lungs. Tuberculosis can cause coughing up blood or blood-tinged mucous as the infection damages lung tissues and blood vessels. 
• Lung Cancer: A malignant growth in the lungs can lead to blood in the mucous due to tumour-related bleeding or erosion of blood vessels. 

Less common causes of coughing up blood

Coughing up blood, though often linked to infections or lung conditions, can sometimes have less common causes. Understanding these rarer possibilities can help determine when urgent medical attention is needed. 

• Pulmonary embolism: A clot in the lungs may result in sudden episodes of coughing up blood, accompanied by chest pain and breathing difficulties.   
• Lung abscess: An infection within the lung can cause bloody mucous, fever, and a chronic cough.   
• Autoimmune diseases: Conditions like lupus or vasculitis can cause inflammation and bleeding in the lungs.   
• Endometriosis-related lung bleeding: In rare cases, endometriosis may impact the lungs, causing blood to be coughed up during menstrual periods.   
• Foreign objects in the airway: Foreign objects inhaled can lead to irritation, infection, and bleeding. 
• Certain medications: Medications such as anticoagulants (blood thinners) can increase bleeding tendencies, which may contribute to haemoptysis in patients with underlying lung conditions. Certain chemotherapy drugs may also cause lung inflammation or damage, leading to blood in the mucous.  

Also read: Coughing up brown phlegm: Causes, symptoms and when to see a GP 

Is coughing up blood serious?

Coughing up blood can vary in severity from mild to potentially life-threatening, based on its underlying cause. Minor irritation, infections, or bronchitis may result in small amounts of blood in mucous that are usually not serious. However, ongoing or significant bleeding may suggest serious health issues such as tuberculosis, lung cancer, or pulmonary embolism. If you notice heavy bleeding, along with chest pain, shortness of breath, dizziness, or unexplained weight loss, it's important to seek medical help right away. Even small amounts of blood in the mucous should be evaluated by a doctor, as it may be an early sign of a serious condition such as tuberculosis, lung cancer, or pulmonary embolism. 

Tests that may be needed

If you're coughing up blood, your doctor may order tests to determine the cause and severity. These tests help diagnose infections, lung conditions, or other underlying health issues. 

• Chest X-ray: Aids in the detection of infections, lung tumours, or other abnormalities in the lungs. 
• CT scan: Offers a comprehensive image of the lungs to detect blood clots, tumours, or pulmonary diseases.   
• Bronchoscopy: Involves inserting a slender tube equipped with a camera into the airways to investigate sources of bleeding or obstructions.   
• Sputum test: Examines mucous to identify infections such as tuberculosis or pneumonia.   
• Blood tests: Checks for infections, clotting disorders, or underlying conditions. 
• Pulmonary function test: Measures lung capacity and performance to determine chronic diseases like COPD.   
• Echocardiogram: Assesses the heart's functionality when a heart-related problem is suspected. 

Also read: Coughing up black phlegm: What it means & what to do

Contact GP if:

Consult a general practitioner if you have been coughing up blood for several days, or if the quantity increases over time. It's important to seek medical help if the blood is bright red, foamy, or mixed with mucous, particularly if chest pain, shortness of breath, dizziness, or unexplained weight loss are experienced. Other concerning symptoms include fever, night sweats, or a cough that persists without improvement. If you have a history of lung issues, are a smoker, or have a compromised immune system, getting an early assessment is essential. For any sudden or severe bleeding, obtain urgent medical assistance without delay. 

Coughing up bloody, red, or pink phlegm can be caused by numerous issues, from minor irritation to serious conditions like lung cancer. If you experience persistent symptoms or other signs like chest discomfort or difficulty breathing, it’s important to consult a healthcare professional for proper evaluation and treatment. Prompt action can help manage the condition and improve your health. Online GP chat available 24/7 mostly offers rapid access to medical guidance, sick leave certificate or telehealth medical certificate, making it a practical choice for addressing thrush without requiring an in-person appointment.   

Hola Health offers a fast and convenient way to access healthcare with doctors on demand anytime, anywhere in Australia. Whether you need a night doctor or a quick consult during the day, Hola Health connects you with AHPRA-registered Australian GPs within 15 minutes: 

• Online doctor appointment: Speak to an Australian GP or an after-hours GP for immediate advice and treatment options via telehealth Australia. 
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With Hola Health’s web doctor service, you can book telehealth appointments 24/7, ensuring quick and reliable care when it’s needed most by home doctors. Trusted by thousands of Australians, Hola Health makes healthcare accessible and stress-free via 24-hour doctors.