14 Reasons for Coughing Up Blood

2. Internal Injury

An internal injury can cause you to cough up blood if it damages your lungs or airways. This may happen after a chest injury, such as a vehicle accident, a fall, or being hit in the chest. When tissues inside the chest bleed, some of that blood can move into the airways and come out during a cough.

You might also notice other signs like chest pain, shortness of breath, or dizziness. Even a small amount of blood in your sputum could indicate internal bleeding that needs medical care. The blood may look bright red or rusty depending on when the bleeding started.

A health provider can check for these problems using tests such as a chest X-ray or CT scan. These images show whether blood is pooling inside the lungs or chest cavity. In some cases, procedures like bronchoscopy help identify where the bleeding starts.

3. Throat Injury

A throat injury can cause bleeding inside the airway, which can cause you to cough up small amounts of blood. You may notice bright red blood mixed with saliva or mucus. The bleeding might start soon after the injury or appear later as swelling develops.

Injuries often happen when your neck or throat gets hit, squeezed, or punctured. Even if the skin looks normal, tissues inside can be bruised or torn. Damage to blood vessels or the windpipe can make breathing painful and may trigger coughing that brings up blood.

Common causes include sports accidents, choking, or any strong pressure on the neck. Some people may also get throat injuries from objects stuck in the throat or intense coughing that strains delicate tissues. Symptoms that can follow include soreness, hoarse voice, difficulty swallowing, or a feeling of tightness in your neck. You might also notice bruising, swelling, or a raspy sound when you talk or breathe.

4. Ribcage Injury

A ribcage injury can cause blood to appear when you cough, especially if the injury affects the lungs or blood vessels inside the chest. You might bruise or fracture a rib after a fall, blow to the chest, or even from repeated strong coughing. The pain often feels sharp and worsens when you breathe deeply, laugh, or move.

If a broken rib presses on your lung, air or blood can leak into the chest cavity. This can cause shortness of breath, chest tightness, or coughing up small amounts of blood. Sometimes, air gets trapped under the skin, creating a crackling or bubbly feeling when touched.

Most minor injuries heal on their own within a few weeks, but rest and pain relief help you recover faster. Using an ice pack can reduce swelling in the first few days. Breathing normally, even if it hurts a bit, prevents mucus buildup that could lead to infection.

5. Collapsed Lungs

A collapsed lung, also called a pneumothorax, happens when air leaks into the space between your lung and chest wall. This air keeps the lung from expanding normally when you breathe. The collapse can be partial or complete, depending on how much air is trapped.

Common signs include sudden sharp chest pain and shortness of breath that worsen with deep breaths or coughing. A collapsed lung may happen due to chest injury, lung diseases such as pneumonia, medical procedures, smoking, or other respiratory conditions. In some cases, the cause is unknown.

Diagnosis usually involves a chest X-ray. Treatment depends on the size of the collapse; small pneumothoraxes may heal on their own, while larger ones often need a chest tube to remove trapped air. Restoring lung expansion improves breathing and lowers the risk of complications.

6. Valve Issues

When your heart valves do not open or close as they should, blood may not flow normally through your heart and lungs. This can raise the pressure in the blood vessels that connect your heart and lungs. If that pressure becomes too high, small blood vessels in your lungs can break, causing you to cough up blood.

Valve problems include two main types: narrowing (stenosis) and leaking (regurgitation). In stenosis, the valve becomes stiff and does not open fully, making it harder for blood to pass through. In regurgitation, the valve does not close tightly, allowing blood to flow backward. Both can strain your heart and damage the lungs over time.

You may notice symptoms such as shortness of breath, chest discomfort, tiredness, or swelling in your ankles or feet. In more serious cases, the pressure from poor valve function can cause fluid to back up into your lungs. This can make breathing difficult and may lead to spotting or streaks of blood in your cough.

7. Severe Lung Infection

A severe lung infection can cause you to cough up blood when your lung tissue becomes inflamed or damaged. Infection can irritate small blood vessels in the airways or fill tiny air sacs in the lungs with fluid. As the infection worsens, blood vessels may break, and blood can appear in mucus.

Two common causes are pneumonia and tuberculosis. Pneumonia fills one or both lungs with pus or fluid, which makes breathing difficult. Tuberculosis develops more slowly but can destroy parts of your lungs if it is not treated. Both conditions need prompt medical care to prevent serious harm.

Severe infections can also result from bronchiectasis, where the airways widen and trap mucus. This trapped mucus makes it easy for bacteria to grow and causes repeated infections. Over time, it can lead to bleeding during coughing fits.

Symptoms of severe lung infections often include a persistent cough with thick or bloody mucus, chest pain or pressure, shortness of breath, and fever or chills.

8. Stomach Ulcer

A stomach ulcer happens when a sore forms in the lining of your stomach. You might feel a burning or aching pain in the upper part of your belly. The pain can come and go, and sometimes feels worse at night or after you eat.

When an ulcer bleeds, you may notice blood in your vomit or dark, sticky stool. This bleeding can cause you to cough up blood if blood travels up from your stomach into your throat or mouth. Medical attention is important if this occurs.

Two main causes of stomach ulcers are infection with Helicobacter pylori bacteria and frequent use of anti-inflammatory pain medicine. Smoking and high alcohol use can also increase your risk. Treatment often includes antibiotics to eliminate bacteria and acid-reducing medicines to promote healing. Managing discomfort may involve eating smaller meals, limiting spicy or greasy foods, and reducing caffeine and alcohol intake.

9. Bronchitis

Bronchitis happens when your bronchial tubes, the airways that carry air to your lungs, become inflamed and filled with mucus. You may notice a deep cough that lasts weeks, sometimes with mucus streaked with blood. The irritated airways may break small blood vessels during strong or frequent coughing.

Acute bronchitis often follows a cold or the flu. Viruses are the usual cause, though sometimes bacteria can also be responsible. If you smoke or are exposed to dust, fumes, or pollution, your risk increases. The coughing can feel worse when you lie down, exercise, or breathe in cool air.

Common symptoms include chest soreness, wheezing, mild fever, and shortness of breath. Your cough may start dry and later bring up phlegm that looks clear, yellow, or green. In rare cases, the mucus may contain small amounts of blood from irritated tissues. Treatment focuses on rest, fluids, and over-the-counter fever reducers or pain relievers. Breathing steam or using a humidifier can help loosen mucus.

10. Pneumonia

Pneumonia occurs when an infection fills your lungs with fluid or pus. This condition makes breathing difficult and leads to a cough. The cough may produce mucus that contains streaks of blood. Bacteria, viruses, or fungi can cause pneumonia, with bacterial infections being the most common.

Symptoms include coughing, chest pain, fever, and shortness of breath, and older adults may feel confused or weak rather than develop a high fever. The cough often brings up yellow or green mucus, sometimes with small amounts of blood due to irritation or broken blood vessels.

Diagnosis involves a physical exam and imaging tests such as chest X-rays. Treatment varies based on the cause and includes antibiotics, antivirals, or antifungal medications. Rest, hydration, and avoiding smoking aid in recovery. In severe cases, hospital care with oxygen therapy or other treatments is necessary to support lung function.

11. COPD

Chronic Obstructive Pulmonary Disease, or COPD, narrows your airways and damages your lungs, often after years of irritation from cigarette smoke or pollutants. You may develop a long-term cough that produces mucus because your lungs try to protect damaged airways. In advanced stages, coughing can break small blood vessels. This may lead to traces of blood appearing in the phlegm.

Shortness of breath, wheezing, frequent chest infections, and excess mucus are common signs. As COPD worsens, you might experience chest pain or tiredness. Additionally, the airway damage can make breathing progressively more difficult, resulting in shortness of breath even during mild physical activities. Managing COPD often involves medication, lifestyle changes, and pulmonary rehabilitation to improve quality of life.

Doctors use breathing tests to confirm COPD and prescribe medications like bronchodilators or corticosteroids to open your airways, while some people may need oxygen therapy later on. Lifestyle changes such as quitting smoking, staying active, and eating a balanced diet can help improve strength.

12. Illicit Drug Use

Illicit drug use irritates or damages your airways and lungs, which can cause you to cough up blood. Inhaling or injecting certain drugs harms blood vessels in your lungs or triggers bleeding in airway tissue. Drug addiction raises this risk, with some narrowing blood vessels and causing tissue injury.

Smoking or inhaling substances can burn or inflame your respiratory tract. This damage may cause rust-colored or bright red blood to appear in mucus because the airways become irritated or injured.

Using multiple drugs together increases the chance of severe complications such as sudden bleeding or respiratory failure. Impure or contaminated drugs may also injure your lungs. Continued exposure weakens blood vessel walls, leading to repeated bleeding and permanent lung damage.

Long-term use can lead to chronic respiratory issues and significantly impact overall lung function. Consequently, individuals may experience persistent shortness of breath and decreased exercise tolerance.

13. Medications

Certain medicines can make you cough up blood by thinning your blood or irritating your lungs. Blood thinners reduce your blood’s ability to clot, so even small injuries inside your airways bleed more easily. Some anti-inflammatory drugs also increase the risk of bleeding, especially in your stomach or throat. If bleeding travels upward from your airways, it can appear as blood in your cough.

Medicines that affect your immune system or treat infections may irritate or injure your lungs, causing slight bleeding that mixes with mucus. Groups of medicines sometimes linked to coughing up blood include blood thinners used to prevent clots, anti-inflammatory pain relievers, certain antibiotics, immune-suppressing drugs, and cancer treatments that may irritate lung tissue.

If you take these medicines, new or unusual symptoms may occur. Coughing up blood, especially if the amount increases or shortness of breath develops, is important to mention to your healthcare provider.

14. Lung Cancer

Lung cancer can cause you to cough up blood when a tumor irritates or damages blood vessels inside your lungs or airways. The blood may appear as small streaks in your mucus or as a larger amount mixed with phlegm. Even a small amount should be taken seriously because it could signal bleeding from cancerous tissue.

You might notice other signs before or along with coughing up blood, such as a cough that will not go away, chest pain, shortness of breath, or unexplained tiredness. Some people lose weight without trying or feel a drop in appetite. If the cancer spreads to other parts of your body, symptoms may depend on where it goes, such as headaches, bone pain, or swelling in the face or neck.

Both smokers and non-smokers can develop lung cancer, although smoking remains a major risk factor. Breathing in secondhand smoke, exposure to harmful chemicals, and a family history of lung cancer also increase your chances.