Spitting Blood

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What is spitting blood?

Spitting up blood indicates the presence of bleeding that may originate in the digestive tract or in the respiratory system. Spitting blood may be caused by many different conditions, and the severity varies among individuals. Spitting blood may accompany vomiting if it is from a gastrointestinal source, or it may occur with coughing if it is from a respiratory source.

Common gastrointestinal causes of spitting up blood are inflammation and infections, such as the stomach inflammation called gastritis. Conditions of the mouth such as gum disease and tooth extraction may cause spitting blood. Spitting blood that comes up with a cough is commonly associated with lung cancer, bronchitis, and pneumonia. These may cause spitting up of bright red blood, rust-colored mucus, or mucus that contain streaks of blood. Pulmonary edema, congestive heart failure, or a perforated or collapsed lung (pneumothorax) from trauma may be associated with spit-up or coughed-up blood that appears bubbly because it is mixed with air and mucus.

The frequency of spitting blood and the amount of blood produced vary greatly, depending on the source of the bleeding. Symptoms of blood loss include lightheadedness, dizziness, fainting, or difficulty breathing. It is rare for spitting blood to be so severe as to lead to serious complications, such as shock. However, people with significant blood loss from severe spitting blood may have serious medical conditions that require emergency hospitalization and treatment.

Left untreated, severe spitting blood can result in a life-threatening loss of blood. Seek immediate medical care (call 911) for serious symptoms, such as pale skin or pallor and difficulty breathing, severe abdominal pain, vomiting blood or black material, or change in level of consciousness.

What other symptoms might occur with spitting blood?

Spitting blood may accompany other symptoms, which vary depending on the underlying disease, disorder or condition.

Gastrointestinal symptoms that may occur along with spitting blood

Spitting blood may accompany other symptoms affecting the gastrointestinal system including:

Other symptoms that may occur along with spitting blood

Spitting blood may accompany symptoms related to other body systems including:

  • Dizziness

  • Fainting or change in level of consciousness or lethargy

  • Fatigue

  • Pale skin or pallor

  • Weakness (loss of strength)

Serious symptoms that might indicate a life-threatening condition

In some cases, spitting blood can be a sign of a life threatening condition. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Change in level of consciousness or alertness such as passing out or unresponsiveness

  • Dizziness

  • Respiratory or breathing problems such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

  • Severe abdominal pain

  • Vomiting blood or black material resembling coffee grounds

  • Weakness (loss of strength)

What causes spitting blood?

Spitting blood can be the result of any condition of the digestive or respiratory tracts. Common digestive causes of spitting blood include inflammation or infection, internal injuries caused by trauma, and underlying disease processes such as cancers. Respiratory causes of spitting blood include pneumonia, lung cancer, tuberculosis, and trauma.

Gastrointestinal causes of spitting blood

Spitting blood can be caused by gastrointestinal causes including:

Other causes of spitting blood

Spitting blood can be caused by other conditions including:

Serious or life-threatening causes of spitting blood

In some cases, spitting blood may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Esophageal cancer

  • Esophageal varices (swollen veins in the esophagus that have the potential to rupture)

  • Internal injury from trauma to either the lungs or gastrointestinal organs

  • Lung cancer

  • Nasopharyngeal cancer

  • Oral cancer

  • Perforated peptic ulcer (bleeding stomach or intestinal ulcer)

  • Pulmonary edema (buildup of fluid in the air sacs of the lungs)

  • Stomach cancer

Questions for diagnosing the cause of spitting blood

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your spitting blood including:

  • When did you first notice that you were spitting blood?

  • Can you see blood when you cough up something?

  • Is there blood in your stool?

  • Do you have any other symptoms?

  • What medications are you taking?

What are the potential complications of spitting blood?

Because spitting blood can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 8
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Gastrointestinal bleeding. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003133.htm
  2. Coughing up blood. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003073.htm