Distinguishes vomiting blood and coughing up blood

The discharge of blood from the mouth can make everyone panic and worry about their health condition. Especially if enough blood comes out. However, there are fundamental differences that you need to understand beforehand; is the blood drained when coughing or vomiting? Even though it looks the same, it turns out that the mechanisms for coughing up blood and vomiting blood are much different. How to distinguish a cough accompanied by blood from vomiting blood?

Different sources of blood

By definition, coughing up blood and vomiting blood are differentiated based on where the blood comes from. Coughing up blood (hemoptysis) is the discharge of blood from the respiratory tract. Blood that comes out of the respiratory tract indicates irritation or injury to the airway. Causes of cough with blood are usually related to infectious diseases of the respiratory tract, such as pneumonia, bronchitis, and tuberculosis.

While vomiting blood (hematemesis) is the discharge of blood from the upper digestive tract, namely the esophagus (esophagus), duodenum, and pancreas. Reporting from the Cleveland Clinic, the conditions that cause vomiting of blood are mostly serious digestive disorders that require medical attention as soon as possible. Diseases that cause vomiting of blood are generally irritation or swelling in the esophagus, inflammation of the stomach or gastritis to damage to liver function,

The initial symptoms of coughing up blood and vomiting blood are different

Symptoms that appear before bleeding from the mouth can also distinguish coughing and vomiting blood. In coughing up blood, it usually begins with a persistent cough that has lasted several days or even weeks (chronic cough), chest pain, shortness of breath, and sore throat. Whereas in vomiting blood, the symptoms that appear are related to the digestive tract such as abdominal pain, swelling of the stomach, and nausea.

The time of discharge

Blood that comes out of the airways usually comes out with the coughing process. However, often blood from the airway can come out mixed with vomit or food waste that comes out of the digestive tract. This is because the blood is accidentally swallowed and causes a nauseous sensation when coughing so that the patient vomits.

Whereas in vomiting blood, blood is usually vomited first before the food vomits. Indeed vomiting blood can also be accompanied by coughing, but this condition is rarely found.

The blood characteristics of coughing and vomiting are different

Because they come from different sources, the blood that is produced is different. If you pay attention, the blood that comes out of a cough is usually mixed with foamy or frothy sputum. Blood was also seen clotting. Meanwhile, when someone vomits blood there is usually no phlegm.

In addition, the difference in the blood that comes out from coughing and vomiting can also be seen from the color. Coughing up blood comes from the respiratory tract where along the passage there are no areas that produce enzymes or acids. Therefore, the color of the blood is usually a fresh red and may be accompanied by clots.

Whereas in vomiting blood, the blood is dark red or thick because it has been mixed with stomach acid. When it comes from a ruptured blood vessel in the esophagus, the color of the blood is less dense than that of the stomach. However, vomiting of blood that is fresh red in color is rare.

Different blood components

This one difference can be seen when the blood sample has been examined further in the laboratory under a microscope. The different components of the blood can be clues as to where the blood is coming from.

Blood originating from the respiratory tract usually consists of blood cells (erythrocytes, leukocytes, hemosiderin), immune cells (macrophages), and microorganisms. However, the blood that comes from vomit will be accompanied by food scraps that have not been processed by the stomach.

Blood from coughing and vomiting has a different pH

The respiratory tract area is more alkaline, so when litmus paper is attached to the blood sample that comes out, the paper will turn blue.

Conversely, the blood that comes from the digestive tract has mixed with stomach acid so that the blood is acidic. When we stick litmus paper on the blood that comes out, the paper turns red.

There are symptoms of anemia

In coughing up blood, usually the amount of blood that comes out is not too much so that symptoms of anemia or lack of blood rarely occur. However, if you cough up blood continuously (massive), you may experience symptoms of anemia.

Coughing up blood can be said to be massive if it meets the following criteria:

• If you cough up more than 600 cc of blood in 24 hours and the bleeding doesn't stop.
• If you cough up blood> 250 cc in 24 hours with an Hb level of less than 10 g%, while coughing up blood is still ongoing.
• If the patient coughs up blood> 250 cc in 24 hours with an Hb level of less than 10 g%, but during the 48 hours observation accompanied by conservative treatment the coughing of blood does not stop.

The difference is, vomiting blood usually causes anemia more quickly. Symptoms of anemia that arise due to vomiting of blood include pale skin and eyes, fatigue, lethargy, palpitations, and shortness of breath.

Different stool colors

In coughing up blood, blood production does not affect the formation of stool. Conversely, in vomiting blood, apart from leaving the mouth, blood can also be carried up to the large intestine where feces form.

Therefore, to distinguish vomiting blood from coughing up blood can be done from the color of the stool which turns black. This is because the feces have mixed with blood from the digestive tract.

Those are some things that can be used as a guide to recognize the difference between coughing up blood and vomiting blood.

If you are still in doubt, immediately consult a doctor for further tests so that you can get the right treatment. The reason is, if it is not immediately addressed, both coughing and vomiting blood can both have serious health impacts.