Coughing Up Blood With Bronchiectasis

Bronchiectasis (bron-kee-eck-tuh-sis) is a chronic lung condition that causes the airways (bronchi) to widen abnormally, resulting in mucus buildup and frequent lung infections. For individuals with bronchiectasis, coughing up blood (hemoptysis) can be a rare but alarming symptom.¹
In this article, we’ll explore what causes hemoptysis, the risks associated with it, and how to manage your bronchiectasis to reduce the chances of it happening.

Can Bronchiectasis Cause Coughing Up Blood?

The airways in those with bronchiectasis are damaged and inflamed because of repeated infections, mucus accumulation, and the body’s attempts to clear out all of this excess mucus. Over time, this damage can weaken the blood vessels lining the airways. As the airways become more fragile, small blood vessels may break or get damaged, leading to hemoptysis or blood in the mucus.²
Several factors can contribute to coughing up bloody mucus with bronchiectasis:

• Chronic Infection. Frequent lung infections, such as viral or bacterial bronchitis, increase inflammation, which can damage blood vessels.³
• Excess Mucus. Mucus buildup creates an environment where bacteria thrive, worsening infections and inflammation.
• Bronchial Wall Damage. Structural damage to the airways over time makes them more prone to bleeding.
• Exacerbations. Episodes where symptoms worsen, usually triggered by infections or irritants, can lead to increased airway inflammation and bleeding.⁵

To Read: How Serious is Bronchiectasis?

Types of Hemoptysis in Bronchiectasis

Hemoptysis can vary in severity, from small streaks in the mucus to larger amounts of blood being coughed up. It is generally classified based on the volume of blood loss. If you have bronchiectasis and notice blood in your sputum, assess the amount and the frequency:

• Small amounts of blood (mild hemoptysis). Blood-streaked sputum or small amounts of blood. This is the most common and less concerning. Monitor the situation and consult your healthcare provider. It may be a sign of an underlying infection or irritation.
• Persistent or worsening blood production. Seek medical attention immediately; this could indicate a more serious issue, such as a severe infection or worsening lung damage.
• Large amounts of blood (massive hemoptysis). Blood expectoration from the lower respiratory tract totaling 300–600 mL over 24 hours.⁶

A massive hemoptysis can lead to airway obstruction or severe blood loss and can often be life-threatening. If you or a loved one cough up large amounts of blood in a 24-hour period or experience shortness of breath, seek emergency care immediately.

How Do You Treat Bronchiectasis Bleeding?

Treatment for coughing up bloody mucus with bronchiectasis depends on its cause and severity:

• 
  Antibiotics. Infections are a common trigger for bleeding, so antibiotics may be prescribed to control bacterial growth.⁷
• 
  Airway Clearance Therapy. Airway Clearance Systems can help manage excess mucus and reduce the risk of infections and flare-ups. By clearing mucus more effectively, these therapies may also decrease the likelihood of airway damage and hemoptysis.
• 
  Bronchial Artery Embolization (BAE).⁸ In cases of severe or recurrent bleeding, a procedure called BAE can be performed. This involves blocking the blood vessels responsible for the bleeding to prevent further hemoptysis.

If you have bronchiectasis, coughing up blood should be carefully monitored. Even mild hemoptysis should be evaluated by a healthcare provider to determine the cause and prevent further complications.

Preventing Hemoptysis

While not all cases of coughing up blood can be prevented, there are steps you can take to reduce the risk:

1. Regular use of airway clearance therapy devices can help prevent mucus buildup and reduce infections that can lead to hemoptysis.
2. Early intervention for lung infections can help prevent exacerbations and further airway damage.
3. Quitting smoking, avoiding certain foods, staying hydrated, and avoiding respiratory irritants can all help manage bronchiectasis and minimize lung damage.

How SmartVest Can Help

Managing symptoms and triggers can potentially mitigate coughing up bloody mucus with bronchiectasis. Stay proactive by managing infections promptly, working closely with your healthcare team, and using effective airway clearance techniques. That’s where Smartvest comes in. This inflatable vest allows those with bronchiectasis to perform airway clearance therapy at home with greater ease and comfort.
Request a free informational packet to learn more about using SmartVest at home. The packet includes information on its innovative features, proven results, and a prescription form for your healthcare team. We also handle the reimbursement process, so you have one less thing to worry about.

Resources

[1] National Library of Medicine. “Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Chapter 39 Hemoptysis” Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK360/
[2] Cleveland Clinic. “Bronchiectasis” Retrieved from https://my.clevelandclinic.org/health/diseases/21144-bronchiectasis
[3] National Library of Medicine. “Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Chapter 39 Hemoptysis” Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK360/
[5] National Library of Medicine. “Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Chapter 39 Hemoptysis” Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK360/
[6] BMC Pulmonary Medicine. “A retrospective study on the management of massive hemoptysis by bronchial artery embolization: risk factors associated with recurrence of hemoptysis.” Retrieved from https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-023-02371-1
[7] National Heart, Lung, and Blood Institute. “Bronchiectasis Treatment.” Retrieved from https://www.nhlbi.nih.gov/health/bronchiectasis/treatment
[8] National Library of Medicine. “Bronchial Artery Embolization for Hemoptysis: A Retrospective Observational Study of 344 Patients” Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC4837820/