Bloody sputum? Ignorance may cost you your life

Dr KK PANDEY Senior Thoracic & Cardiovascular Surgeon Indraprastha Apollo Hospitals New Delhi

In our Indian subcontinent, innumerable persons of all age groups do suffer from cough at various stages of their lives. Sometimes frequency of cough suddenly increases with the onset of winter and dry cough gets converted into wetly one with white secretions. Recurrent episodes of even non-stop dry cough should be a cause for worry, let alone passage of blood during coughing. Coughing out blood poses a serious as well as a dangerous problem. The negligence  in such a situation is tantamount to an open invitation to death. Always remember, one should take the problem of blood in your phlegm very seriously and promptly consult a thoracic surgeon, otherwise a precious human life may be lost due to ignorance.

Why does blood come out during coughing?

There are multiple reasons for passing out blood during coughing. In our country the most important cause is the tubercular infection. When a tubercular infection due to lack of proper care and treatment reaches a fulminant stage, a sufferer starts coughing out blood. Sometimes, bleeding happens to be so severe that a tubercular infected person dies instantaneously within hours, due to exsanguinations and flooding of opposite normal lung with blood.

Quite frequently it has been observed that even after successful treatment of tuberculosis, though tubercular infection is brought under control, but the victim continues to pass blood during coughing. This condition is called in medical term an ‘aspergilloma’ or ‘aspergillosis’ that is responsible for passage of blood during coughing.

Avoid recurrent infections of lung

The second important reason of cough with bloody phlegm is the disease of bronchiectasis. In this disease the wall of the wind pipe get severely damaged due to persistent swelling and inflammation brought on by repeated infections of wind pipe. The blood pipes adjacent to branches of windpipes get thinned-out and become dilated. Because of all these changes, these blood pipes burst out due to increased internal pressure brought on by coughing and the sufferer starts passing bloody sputum from his mouth. A patient suffering from bronchiectasis should consult a thoracic or a chest surgeon and get the damaged part of lung removed as early as possible; otherwise the remaining healthy part of lung too will get diseased.

Avoid smoking - it invites lung cancer, the cause of blood sputum

In our country, the third important cause of passage of bloody sputum during coughing is the cancer of lung. In small as well as big cities, due to increasing trend of smoking among youths, the number of patients suffering from lung cancer is steadily rising.

The habit of smoking not only causes cancer of lung but also leads to narrowing of blood pipes, which supply pure oxygenated blood to various organs of body. This results into loss of lung as well as their limbs too. If a chronic smoker passes bloody phlegm during coughing, the possibility of lung cancer cannot be ruled out.

Lung abscess too causes bloody phlegm

The fourth important reason in our country of coughing with bloody sputum is the collection of pus inside the lung, which is called commonly as lung abscess. On account of severe infection, the blood pipes become weak and burst open due to sudden and temporary rise in pressure and this results into spitting of blood during coughing.

Other factor for bloody sputum

Sometimes there is some fundamental deformity in the anatomical architecture of blood pipes situated inside the lung, among young males and females since birth. In this deformity, the blood pipes, before supplying the lung are found inter connected since birth. This deformity of blood pipes is called pulmonary arterio venous fistula (P.A.V.M.)

CHEST INJORY MAY ALSO RESULT INTO A BLOODY SPUTUM

Sometimes it has been observed after road traffic accident due to old chest injury, pus is collected inside the chest and due to this collection; the windpipe existing inside the lung gets connected to the outer surface of the lung. This condition is called in medical term a broncho pleural fistula. In this dangerous situation when the patient coughs, blood may possibly be spitted out along with phlegm.

Where to go if you have been passing  out bloody sputum?

If you suffer from chronic cough and at the same time you pass bloody phlegm, please do not sit idle and consult without delay a thoracic surgeon instead of a general surgeon. A patient suffering from this problem should go to a hospital where a full–time thoracic surgeon is available and the surgery of lung as well as heart is done routinely. For determining the cause and extent of the problem, some modern investigations like bronchoscopy, thoracoscopy CT-guided biopsy and Para sternotomy are required. This facility of angiography comes in handy in an emergency to save the life of a patient, if a life-threatening bleeding erupts.

What to do, when you cough out bloody sputum?

When you cough put bloody phlegm, consult a thoracic surgeon at the earliest. If any part of a lung is completely destroyed due to infection, try to get rid of that damaged part of lung as early as possible. This is the only way to control the bleeding problem permanently. Another advantage of this removal is that the adjacent healthy portion of remaining lung is saved from destruction.      

If a lung cancer happens to be the cause of bloody sputum and cough, the removal of whole lung harbouring cancer is the only alternative to save the life of such patient, and this also prevents the spread of cancer to the lung on the other side.

You can live normally with a single lung?

Generally, the people have apprehension whether a person after removal of one lung will survive or not. This is only a misconception. One should know a person after he has donated one of his two kidneys, does live normally, like wise one can live normal life after one lung has been removed. Therefore one should not hesitate to get rid of destroyed part of lung fast, as this is the only way out to save the life of a patient. An experienced thoracic surgeon should always do the lung surgery.