Dr. K.K. Pandey
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. The reasons is simple, although tubercular infection leaves the lung after successful treatment, but before leaving, it leaves behind residual wound in the form of big cavities inside the lung. In these hollow spaces of lung, other types of germs especially fungi make their entry and stay there permanently. This condition is called in medical term an ‘aspergilloma’ or ‘aspergillosis’ that is responsible for passage of blood during coughing. Sometimes, the amount of blood coughed- out is so much so that a life-threatening dangerous situation may arise. In our country, millions of patients suffer from the disease of aspergilloma and they due to ignorance keep on trying various types of wrong treatment. On account of this, the remaining healthy part of lung too becomes diseased and then there remains no way out except death.
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. This results into either constriction of branches of windpipes situated inside the lung, or over -inflation of them like a balloon. This condition of windpipes totally obstructs the mechanism of forcing out phlegm from the chest. On account of this, the sputum instead of going normally out of windpipe and then chest, on contrary gets thickened and stays there inside the windpipe permanently. 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. Such patients pass blood during coughing in such a significant amount, that the patients is forced to go to emergency wing of the hospital for urgent blood transfusions, to replenish the lost blood, otherwise the patient may die.
Avoid smoking – it invites lung cancer, the cause of cough with blood
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. Even in villages, the daily group activity of ‘Hukka’ (Hubble-Bubble) smoking in the evening is adding greatly to the number of lung cancer patients. The prevalence of smoking habits among peasants and labourers working in village fields, play a great role in the increased incidence of lung cancer.
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.
If you have been coughing out blood, where to go?
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. It is very essential to investigate the cause of chronic cough and bloody phlegm, because only after treating the cause of it, one can get rid of this problem. 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.
(The author is a Senior Consultant in the Department of Cardiothoracic & Vascular Surgery at Indraprastha Apollo Hospital, New Delhi India.)
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