Spitting blood is the presence of blood when coughing, spitting, or clearing the throat. It can appear as small streaks in saliva or mucus, or as more significant amounts. While unsettling, its origin and severity vary widely, stemming from different parts of the body.
Causes Originating in the Mouth and Throat
Blood in saliva often originates from the mouth or upper throat, frequently due to common, less severe issues. Gum disease, such as gingivitis or periodontitis, is a frequent cause, where inflamed gums bleed easily during brushing or flossing due to plaque buildup or aggressive brushing.
Nosebleeds can also lead to blood being spit out. Blood from the nasal passages may drain down the back of the throat and mix with saliva, especially if an individual leans their head back or lies down. Dry air, frequent nose picking, or certain nasal sprays can irritate nasal blood vessels, making them prone to bleeding. Minor irritations or small cuts within the mouth, such as from biting the cheek or tongue, or from consuming hard foods, can also result in blood mixing with saliva. Additionally, certain oral infections, like oral thrush, may cause localized bleeding and soreness.
Causes Originating in the Lungs and Digestive System
Blood originating from the lower respiratory or upper digestive tract often signals more significant conditions. Respiratory infections like bronchitis, pneumonia, or tuberculosis can cause blood-streaked sputum due to airway inflammation. Persistent or severe coughing can also rupture small blood vessels in respiratory passages, resulting in blood in mucus. Conditions like bronchiectasis, involving permanent airway widening, can also lead to coughing up blood or blood-mixed mucus.
Blood originating from the digestive system typically comes from the esophagus, stomach, or upper small intestine. Conditions such as acid reflux (GERD), esophagitis, or stomach ulcers can irritate the lining of these organs, causing bleeding that may be vomited or spit out. This blood often appears darker, sometimes resembling coffee grounds, due to exposure to stomach acid. A Mallory-Weiss tear, a tear in the esophageal lining often caused by forceful vomiting or coughing, is another potential source.
More serious lung conditions can also cause blood to be coughed up. A pulmonary embolism, a blood clot in the lung, can cause bleeding, presenting as blood in sputum. This condition is often accompanied by sudden shortness of breath and chest pain. Lung cancer, while less common, can also manifest with coughing up blood, even in small amounts, particularly as the disease advances. Certain medications, especially blood thinners (anticoagulants) or some nonsteroidal anti-inflammatory drugs (NSAIDs), can increase the likelihood of bleeding from various sources.
Knowing When to Get Medical Help
Any unexplained instance of spitting blood warrants medical evaluation. The volume and frequency of blood are important indicators; if the amount is more than just streaks, is persistent, or increases rapidly, medical attention is advisable. For instance, coughing up more than a few teaspoons of blood should prompt immediate medical care.
Associated symptoms provide additional clues about potential severity. Shortness of breath, chest pain, dizziness, unexplained weight loss, fever, or night sweats accompanying blood in sputum suggest prompt medical assessment. The blood’s appearance also offers insights: bright red or frothy blood often indicates a respiratory origin, while dark, coffee-ground-like blood points towards a digestive source. If there is any uncertainty about the origin or if the blood is accompanied by vomiting, seeking immediate care is recommended. Individuals with existing risk factors, such as a history of smoking, chronic lung disease, or other serious medical conditions, should be particularly vigilant.