You Coughed Up What? Watch For Signs Of A More Serious Health Problem
Coughing can be normal, but coughing up things like vomit and blood should be looked into quickly
Key takeaways:
- Coughing can be a normal way our body protects your lungs and airways from irritants.
- But if you cough up thick mucus, vomit or blood, it could be a sign of something serious. You should see a health care provider quickly.
- Vaccines and good hygiene can help prevent illnesses that bring about coughing fits.
Fall and winter could be renamed “coughing season” with seasonal illnesses in the air. But there’s more to coughing than the brief but annoying impact on your day.
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Some coughing is normal. But you should see a health care provider quickly when you cough up things you shouldn’t.
The basics: Why do you cough?
Aminat Ogun, MD, a family medicine physician at OSF HealthCare, says coughing is one way your body protects your lungs and airways from irritants. You expel the bad stuff out of our system, she says.
Some everyday things that can make you cough: breathing in smoke, allergies and mucus dripping down to your throat and irritating it. Or, you may just wake up in the morning and cough a few times to lighten your chest. These shouldn’t alarm you, Dr. Ogun says.
“We have cough receptors in our airways and lungs,” Dr. Ogun explains. “If we have mucus or an irritant, there’s a signal sent to our brain. The brain activates those receptors to have the cough action happen. So that’s why you clear your throat or cough in the morning. You’re trying to clear out your airways.”
If your cough is associated with an illness (like a cold, flu, RSV, COVID, bronchitis or pertussis, also called whooping cough) or a chronic condition (like asthma or COPD), you should be seeing a provider as often as needed to learn how to manage things.
Coughing up things you shouldn’t
Watch for signs that your cough may be linked to a more serious problem, Dr. Ogun says.
- Mucus: Our airways produce mucus to trap irritants, Dr. Ogun says. So it’s not out of the ordinary to cough up mucus from time to time. But if the mucus is thick or a different color (green or yellow), it could be a sign of pneumonia or bronchitis.
“When it’s persistent [cough with mucus] and it’s affecting your breathing, you definitely want to be seen [by a provider,]” Dr. Ogun says.
- Vomit: Dr. Ogun says sometimes, you just cough hard enough to bring up some vomit. If it’s a “one-off,” as she calls it, you should still see a provider, but it may not be cause for great concern. But persistent vomiting while coughing could be a sign of whooping cough, acid reflux or aspiration (when food or drink gets into the lungs).
- Blood: Coughing blood brings a high level of concern, Dr. Ogun says.
“Sometimes you have the common cold, you’re coughing for a long period and you irritated your airways. Maybe you nick the capillary artery [leading to coughing blood.] That’s fine,” Dr. Ogun says. “But more serious conditions would be a blood clot in the lung or tuberculosis.”
Heart failure, lung cancer or infections are also associated with coughing up blood.
Diagnosis and treatment
When you see a provider for an abnormal cough, they’ll ask about your health history, specifically about your cough. How long have you been coughing? Did something trigger it? What are you coughing up? Do you have other symptoms, like a fever?
“Then the provider could do a physical examination. They look at the back of your throat. They listen to your lungs to see if they hear anything concerning. Depending on what they find, they could order a chest X-ray or a CT scan to see what’s going on inside your chest,” Dr. Ogun says.
Treatment will depend on what the provider finds. For example, acid reflux can be tamped down by an antacid or a proton pump inhibitor (PPI). For an infection like pneumonia, you’ll get an antibiotic. If it is just an irritating tickle in your throat, you may get a steroid like Flonase.
What you can do
Some advice from Dr. Ogun to ensure coughs don’t derail your health:
- Parents should keep a close eye on kids and their coughing.
- No matter the age, don’t shake off one instance of a bad cough and assume things will go back to normal. See a provider right away.
- While vaccines don’t prevent coughing, Dr. Ogun says they are critically important to stomp out the illnesses associated with coughing. Talk to your health care provider about when you’re due for flu, COVID, RSV, pneumonia and Tdap (tetanus, diphtheria and pertussis) vaccines.
“Pertussis is dangerous in immunocompromised people and kids,” Dr. Ogun warns. “RSV is highly contagious, as well. It’s life-threating in infants and older adults.
“What vaccines do is help prevent getting to the very severe stage [of an illness,]” she adds. “You’re trying to prevent ending up in the hospital. You’re also reducing the risk of infection. And you’re protecting people around you who may be sicker than you.”
- Daily hygiene habits also go a long way. Sneeze or cough into your elbow or a tissue. Wash your hands often. Stay home and away from others when sick. Again, these don’t prevent coughs. But they can help prevent the spread of illness that brings those rough coughing fits.
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