21 Possible Causes of Throat Bleeding and When to See a Doctor

Blood in your throat may be caused by infection, anticoagulant medications, certain health conditions, or trauma to the mouth, throat, or chest area. Here’s a summary of possible causes:

Anticoagulant medications typically don’t cause bleeding without an underlying cause. If you experience bleeding while taking an anticoagulant, you should reach out to a doctor.

Injury or trauma to the mouth, throat, or chest could result in blood or sputum in your mouth.

Mouth or throat injury

An injury to your mouth or throat might happen if you bite on something hard. Trauma can also occur if you take a hard blow to the mouth or throat area. This may occur:

• while playing sports
• in a car accident
• due to a physical assault
• due to a fall

Blood in your mouth could also be caused by:

• mouth sores
• mouth ulcers
• gum disease
• bleeding gums
• aggressive tooth brushing or flossing

Chest injury

A blow to the chest can cause a bruised lung (pulmonary contusion). Coughing up blood or blood-stained mucus can occur with a severe blow to the chest area.

Infections occur when a foreign organism — such as bacteria or a virus — enters your body. Some infections can cause you to cough up blood-tinged saliva or mucus.

These can include:

• Bronchiectasis: Bronchiectasis occurs when chronic infection or inflammation causes the walls of your bronchi (airways) to thicken and accumulate mucus. This condition can cause you to cough up blood or mucus mixed with blood.
• Bronchitis: Bronchitis is an inflammation of the lining of your bronchial tubes. Your bronchial tubes carry air to and from your lungs. If your bronchitis is chronic (a constant inflammation or irritation), you might develop a cough that produces sputum streaked with blood.
• Pneumonia: Pneumonia is a lung infection. Its symptoms include a cough that produces yellow, green, or bloody sputum. You may also experience:
  • rapid and shallow breathing
  • fever
  • chills
  • shortness of breath
  • chest pain
  • fatigue
  • nausea
• Severe or prolonged cough: When a cough lasts longer than 8 weeks, it’s considered a chronic cough. A chronic cough can irritate the upper respiratory tract and tear the blood vessels, resulting in coughing up blood or bloody mucus. A chronic cough could be a symptom of an underlying condition, such as:
  • asthma
  • postnasal drip
  • gastroesophageal reflux disease
• Hemorrhagic tonsillitis: Tonsillitis, an inflammation of your tonsils, may occur due to a viral or bacterial infection. In rare instances, a type of tonsillitis called hemorrhagic tonsillitis can cause bleeding. If a doctor removes your tonsils, known as a tonsillectomy, you may also have bleeding after surgery.
• Tuberculosis: Tuberculosis is an infectious lung disease caused by bacteria. It may present with symptoms, such as:
  • a severe and persistent cough
  • coughing up blood or bloody sputum
  • weakness
  • chest pain
  • loss of appetite
  • chills
  • fever

Prescription medications that prevent blood from clotting (called anticoagulants) may cause coughing up blood as a side effect.

Other side effects of anticoagulants may include:

• blood in your urine
• nosebleeds that don’t stop quickly
• vomiting blood

These medications may include:

• apixaban (Eliquis)
• edoxaban (Savaysa)
• dabigatran (Pradaxa)
• rivaroxaban (Xarelto)
• warfarin (Coumadin)

Some health conditions cause coughing. Sometimes, blood or sputum may appear in the throat. Conditions causing bloody sputum may include:

• Chronic obstructive pulmonary disease (COPD): COPD is a group of lung diseases that include chronic bronchitis and emphysema. Symptoms of COPD can include:
  • shortness of breath
  • chest tightness
  • frequent respiratory infections
  • wheezing
  • an ongoing cough that produces a lot of yellowish phlegm
• Cystic fibrosis: Cystic fibrosis is an inherited condition that severely affects the respiratory tract. Symptoms can include:
  • difficulty breathing
  • wheezing
  • frequent chest colds
  • frequent sinus infections
  • a persistent cough with thick mucus
  • digestive issues due to trouble absorbing nutrients from food

• Granulomatosis with polyangiitis: Granulomatosis with polyangiitis is a rare disorder that can be fatal if not treated. Symptoms can include:
  • coughing (sometimes with bloody sputum)
  • pus-like drainage from your nose
  • sinus infections
  • nosebleeds
  • shortness of breath
  • fatigue
  • joint pain
  • fever
• Lung cancer: Lung cancer includes cancer that originates in the lung. Cancers from other areas of the body can also spread to the lungs. Symptoms of cancer affecting the lungs may include:
  • a persistent cough
  • chest pain
  • coughing up blood or bloody sputum
  • shortness of breath
  • fatigue
  • hoarseness
  • loss of appetite
  • persistent infections
• Mitral valve stenosis: Mitral valve stenosis involves a narrowing of the heart’s mitral valve. Symptoms can include:
  • shortness of breath
  • chest discomfort
  • fatigue
  • dizziness
  • heart palpitations
  • coughing up blood
• Pulmonary edema: Caused by excess fluid in the lungs, pulmonary edema is a medical emergency typically associated with heart problems. Symptoms typically include:
  • frothy sputum with blood
  • severe shortness of breath
  • heart palpitations
  • anxiety
• Pulmonary embolism: Typically caused by a blood clot, a pulmonary embolism is a blockage in a pulmonary artery in your lungs. Symptoms may include:
  • chest pain
  • shortness of breath
  • a cough that produces blood or bloody mucus
• Bleeding esophageal varices: Bleeding esophageal varices can happen when swollen veins, or varices, in your lower esophagus rupture and bleed. Symptoms may include:
  • vomiting blood
  • stomach pain
  • lightheadedness or fainting
  • rectal bleeding or, in severe cases, bloody stools
• Goodpasture syndrome: A rare but potentially life threatening autoimmune disease, Goodpasture syndrome causes a buildup of autoimmune proteins in your kidneys and lungs. This can lead to bleeding of the lungs or kidneys. Symptoms may include:
  • fatigue or weakness
  • nausea or vomiting
  • loss of appetite
  • paleness
  • coughing up blood
  • difficulty breathing
  • blood in your urine
• Nosebleed: If you experience a nosebleed, whether due to injury or another reason, you may later cough up additional blood.

If you’re coughing up blood, a doctor must quickly determine where the blood is coming from and why. First, they’ll identify the site of the bleeding and then establish why you’re coughing up blood.

If there’s blood or sputum in your mucus when you cough, the blood is most likely coming from your respiratory tract. The medical term for this is hemoptysis. If the blood is coming from your digestive tract, it’s called hematemesis.

Doctors may be able to determine the location of the bleeding by the color and texture of the blood:

• Hemoptysis: With hemoptysis, the blood is typically brighter red and frothy as it hasn’t been exposed to digestive enzymes. Sometimes it’s mixed with mucus.
• Hematemesis: With hematemesis, the blood is usually dark. Sometimes it’s mixed with traces of food.

If you’re coughing up blood, your treatment will depend on the underlying condition causing it. Depending on the cause, treatment may include:

• cough suppressants for a prolonged cough
• surgery to treat a blood clot or tumor
• antibiotics for infections like bacterial pneumonia or tuberculosis
• steroids to treat an inflammatory condition behind the bleeding
• antivirals to reduce the severity or duration of a viral infection
• chemotherapy or radiation therapy to treat lung cancer

If you’re coughing up large amounts of blood, treatment may first focus on stopping the bleeding and preventing blood and other material from getting into your lungs (aspiration).

Doctors can focus on treating the underlying cause when the symptoms are stable.

Unexplained coughing up of blood can be serious. You’ll want to make an appointment with a doctor for a diagnosis and treatment recommendation.

It’s especially important to see a doctor if the blood in your sputum occurs with the following:

• a loss of appetite
• unexplained weight loss
• blood in your urine or stool

If you don’t already have a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.

If you cough up blood, you may think your throat is bleeding. However, the blood may be coming from your respiratory or digestive tract.

An occasional, small amount of blood in your saliva is usually not a cause for great concern.

But you may want to consider talking with a doctor if:

• You have a medical history of respiratory problems.
• You smoke or have a history of smoking.
• The frequency or amount of blood increases, consider talking with a doctor.