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Forum Name: Chest symptoms

Question: Bloody Sputum


 baroneb - Sat Jul 30, 2005 3:35 pm

I am a 39 yo male smoker 1 pack per day. I developed a very bad cough over a week ago. The cough was dry at first but became very productive. After a few days I went ot see my family doctor and he gave the usual Robistussin AC and some antibiotics. The morning after taking the medication I woke up in the middle of the night and began hacking up chunks of green yellow gray clear and bloody sputum all mixed together. Needless to say I went straight back to the doctor where he immediately did a chest x-ray blood work and a re-examination. The results all clear no spots on the x-ray blood was perfect. No explanation for the sputum. It happens only in the morning the rest of the day it comes out either clear or greenish but no blood only when I wake up first thing.. By the way I still have a very bad cough. Going on two weeks now. Any answers. Thanks in advance
 BLACKSKULL - Tue Oct 11, 2005 6:29 pm

I hope someone can give you some answers man.....I feel for ya as I have had similar stuff myself with no explanation. I had pneumonia last year...bad cough that didnt go away.... and i only worried cause I started to cough up some bloody sputum in the morning. A trip to the ER showed pneumonia in one lung...no tumors. After a round of antibiotics and 7 days later the blood stopped. 5 months later, another cold, not as bad though. It starts to produce bloody sputum again only in the morning. More Xrays....clear or pneu and tumors....suspected brochitis/infection causing blood. Antibiotics again and it goes away. No more blood till 6 months later...as in now... super bad chest cold with some blood in morning phlegm again. Antibiotics again and it appears to be going away again. I am pretty worried cause like u I smoke and am 37yo. I am trying to quit but am worried about the blood each time I get a bad cold. The rest of the time I have never seen any blood,just with bad chest colds. Anyways, good luck and maybe someone will help us figure it out. I do have asthma (mild) as well.
 Dr. A. De la Guerra - Tue Oct 11, 2005 10:27 pm

User avatar Hi Baroneb and Blackskull. I will try to answer both of you.

Spitting of blood, or coughing out sputum with streaks of blood mixed with it, is called hemoptysis; it refers specifically to blood that comes from the respiratory tract.

There are many causes of hemoptysis (heart problems, trauma, infections, lung disease, etc). Worldwide, tuberculosis is the most common cause of hemoptysis. In the United States the most common causes are bronchitis, bronchiectasis, and lung cancer.

When the amount of blood is small it is considered mild hemoptysis. Blood-tinged mucus is often called hemoptoic sputum (less severe). About 70% of mild hemoptysis have a benign cause which disappears on its own without serious or permanent effects. Indeed, the most common cause of hemoptysis is the least serious, a ruptured small blood vessel caused by coughing and/or a bronchitic infection.

Is different in persons with a history of SMOKING, hemoptysis could be a sign of serious illness, including cancer. Most common causes of hemotysis in smokers are acute and chronic bronchitis, lung cancer, and pneumonia. Lung cancer is strongly suspected in heavy smokers who have hemoptysis and who are ≥40 yr old.

What both of you seem to have is a mild hemoptysis or hemoptoic expectoration due to a bronchitis; I’m not sure if it is acute or chronic bronchitis. But cigarette smoking is the main cause of chronic bronchitis, which is characterized by cough that produces sputum (phlegm), which may be blood streaked, and usually occurs when the person first gets out of bed in the morning. Both of you smoke and have this problems in the morning.

Chronic bronchitis is one form of chronic obstructive pulmonary disease (COPD), and is irreversible.

First of all: stop smoking.
Second, some physicians recommend CTs only when the chest x-ray is abnormal, or the patient is at risk for cancer (40 yr old, smoker). Because of its diagnostic power, others think CTs should always be performed. I’m in the second group, I strongly suggest a CT scan of the chest and a bronchoscopy (the best test to rule out hemoptysis causes).

Sincerely,
Dr_Torax
 BLACKSKULL - Wed Oct 12, 2005 8:37 am

Thank you Dr.Torax for the speedy reply. **Whew** Bronchitis sounds a whole lot better than the big C. I am trying my best to quit smoking and it is definately tough. Hopefully I can quit and let my lungs begin the repair process, whatever level they manage to acheive must still be better than smoking. I've had 4 XRAYS in the year and a half I"ve had these episodes and each one came back "clear". All my hemoptysis seems to only occur after a bad chest cold starts to "break up" and be coughed out. The rest of the time , no blood. Hopefully quitting smoking will help this as well. Thanks again Doc.
 Dr. A. De la Guerra - Wed Oct 12, 2005 6:38 pm

User avatar Hi Blackskull, congratulations for trying to quit, I know it’s really tough. Here are some web sites that can help you:

http://www.smokefree.gov

http://whyquit.com/
http://www.surgeongeneral.gov/tobacco/conspack.html
http://healthed.msu.edu/smoking/
http://www.qualitytools.ahrq.gov/summary/summary.aspx?view_id=1&doc_id=7319&nbr=100854
or download this brochure:

http://www.chestnet.org/downloads/patients/guides/tobacco/tobacco02.pdf

I know you will make it
Good luck
 BLACKSKULL - Thu Oct 13, 2005 9:56 pm

If its a bit of bloody morning mucus only with/after a cold "breaks up" in the chest, can I suppose after 4 xrays clear/uneventfull and my respirologist at the asthma clinic not panicking (unless it doesnt stop) that this is probably not life threatening? I am a hypochondriac sort of. I worry alot about my health and it never seems to turn out to be anything. My friends think I am nuts cause it goes away with the cold......I am panicking a bit with this, but my doctor seems confident its just from my asthma/rad combo with a cold causing this. It goes away till the next chest cold. I know the best thing to do would be a scope and/or CT scan but the docs think its not warrented yet cause it stops after the cold/infection goes away.

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