bloody sputum
March 3, 2010 | 20,00 EUR | answered by Dr. med. Christoph Schmülling
Hello, I am 24 years old. I smoked for 8 years and quit over a month ago. I have been experiencing mild chest pain and green phlegm for a while. When I quit, after two weeks, I started coughing up a strange brown phlegm with spots. Sometimes it was clear or yellow, but always with brown spots. One day I even noticed blood in my phlegm. I immediately went to the hospital, where they did a lung X-ray and took blood samples. They found nothing in my lungs and my blood tests were normal. I have had the bloody phlegm about 3 times so far, always having to cough it up. Yesterday I saw a pulmonologist, who diagnosed me with chronic bronchitis. I did a lung function test and the doctor said I have a bit too much air in my lungs. He prescribed me a spray (SalbuHEXAL). I asked the doctor for a bronchoscopy, he said it's not necessary but because I am so worried, he scheduled an appointment for me. This morning I had to cough up a little bit of blood again. I am getting impatient as my bronchoscopy appointment is in two weeks. I can't wait that long. I am feeling very hopeless because I don't know what I have. Could I have lung cancer despite my normal lung X-ray? Or could it be something else? Is there any way I can have a bronchoscopy done immediately without waiting? I am really scared. I would appreciate any advice and answer. Thank you.
Dear Seeker,
I can certainly understand your concern, and if I put myself back in the time when I was 24 years old, a medical student filled with medical half-knowledge, I would have had the same worries as you. If the internet had existed back then, the worries would have been even greater, as more half-knowledge often means less real knowledge.
Today, with 30 years of medical experience, I can confidently tell you that the likelihood of bloody sputum in a 24-year-old smoker being caused by bronchial or lung cancer tends towards zero.
Of course, theoretically while jogging through the park, you could be attacked by a guard dog and struck by lightning at the same time, but I have never heard of such a case. Your question is also about probabilities.
The idea of having a bronchoscopy is certainly good, and a diagnosis should be made. However, I am sure that the above-mentioned diseases are not the cause. The most likely explanation at your age is that the cough has led to small vessel injuries, for example in the trachea - the mucous membrane has to withstand considerable pressure when coughing, and small injuries are not uncommon. This can manifest as bloody sputum.
By the way, quitting smoking is a great thing - congratulations on this decision. Since your bronchial mucosa now has the opportunity to become more stable in the long term and heal sustainably, it will also be less likely to bleed. So - go to the bronchoscopy with optimism. I wish you all the best.
Kind regards,
Dr. med. Christoph Schmülling
