I’ve been coughing up blood but doctors can’t find a problem. What do I do?
OUR resident specialist and NHS GP, Dr Zoe Williams, shares her expert advice.
Today, Dr Zoe helps a reader who has been coughing up blood.
Q: I had a health scare in June where I coughed up a blood clot.
I had a fast-track cancer appointment and was investigated.
Nothing was found. Six months on I had another episode.
My GP said to let him know if it happens again with no explanation of why.
A: Coughing up blood from the lungs is called haemoptysis and it’s a symptom that can have several causes.
Lung cancer is one potential cause and the most serious, so unexplained haemoptysis usually triggers an urgent referral for lung cancer to be ruled out.
Other causes include infection (like tuberculosis), a blood clot in the lung (pulmonary embolism), or bleeding abnormality.
And it’s always good to consider if the blood has come from the throat, mouth or stomach and irritated the airway – hence being coughed out.
In women it is possible to get endometriosis when tissue similar to that which lines the womb grows in places it shouldn’t – such as the lungs.
When menstruating, the endometriosis tissue, whether in the lungs or elsewhere, can bleed in the same way the lining of the womb does.
The urgent clinics are just tasked with ruling out cancer, so I suspect your GP wasn’t able to give you an explanation beyond ruling out cancer.
One-off episodes also occur.
But because it has happened again, I’d advise you to return to your GP, so they can take a detailed history and consider any further tests.
You may benefit from a routine respiratory referral for a more comprehensive review, now that cancer is deemed unlikely.