Child coughing up blood (tmi photo warning)

[Checkedrug]

My daughter is 8 and has had a constant cough since about March time. Initially I wasn’t concerned because she has similar the year before so I thought perhaps it was seasonal. Dr gave her a blue inhaler but it made no difference so we went back and got a a brown one and a peak flow meter. We have to see the asthma nurse in 2 months or so as dr thinks it’s probably asthma. The brown inhaler has helped reduce the coughing fits especially at night and the peak flow reading has improved but she still has coughing fits every day which hurt her chest.

today she has spitting out bloody phlegm each times she’s coughed. She’s fine in herself- no temperature or pain and has gone to school and I’ve done an E consult.

im just wondering if anyone has any experience of this. She also has chronic constipation and has done since she was a baby. Additionally she was hospitalised with croup a couple of years ago. She was very prone to bronchiolitis as a baby but her oxygen levels always remained fine. She is tall for her age and on 50th centile for weight. I don’t know if the respiratory issues and constipation are linked and if I should be worried about this coughing up of blood. Any advice or experience of this gratefully received

apologies for the gross picture attached

I don’t have any experience of this but hopefully someone else responds soon with more advice op

thank you.

ED nurse - it fresh/red and quite minimal which is positive so looks like she has maybe coughed so much she has given herself a a little trauma to her throat that being said if it continued it be inclined to get it seen. If she displays any other symptoms excessive tiredness/dark colour blood etc or further shortness of breath I would take her to ED.
Take care, hope she feels better soon!

Thanks so much that’s reassuring. She does have quite big coughing fits so it does sound likely it’s just from the trauma of one. I’ll keep an eye out for any of the other symptoms you’ve mentioned

Small specks of blood like this after coughing are generally nothing to worry about. As another poster says, these are caused by raised pressure in the chest from coughing causing a small tear in little blood vessels. Called a Mallory-Weiss tear and in kids settles on its own normally. If lots of blood or bleeding elsewhere may need a medical review.

I would want my child seen sooner than the asthma nurse appointment as it sounds like her asthma is not controlled. I'd ask for an urgent appointment.

Have you been advised to give any antihistamines? It could be allergy-related with the timings.

The helpline here is very good:
https://www.asthmaandlung.org.uk/

Although DS was considerably younger as it's hard to diagnosis asthma in children I was told children should really be seen by a consultant until there asthma is under control. If she is still having coughing fits at night while taking the brown inhaler the doctors should be increasing her inhaler or giving a different type of inhaler. Our asthma nurse can't change medication so I'm not sure what waiting to see the nurse will achieve. All our nurse does is give advice and do annual checks.

I would make another doctors appointment and ask what needs to be done to get her symptoms under control.

DS has caugh variant asthma it takes a lot of Ventolin (blue inhaler) to help with his coughing. It maybe she's not having enough at a time. Get her seen as soon as possible.

The blood is as others have said probably nothing to worry about, but her symptoms need to be better controlled.

Thanks so much for all the responses. She’s still coughing but no blood today so that’s good news but I have no idea what I’m meant to be doing re the asthma as it’s all new to me. She definitely coughs less but still does have frequent cough attacks. Not as often at night anymore.

@qwertyqwertyqwertyqwerty she doesn’t have any hayfever symptoms that I have spotted but with the timing it could definitely be related- I suffer with hayfever too. I’ll try her with piriton

I have no idea what the purpose of the asthma nurse is- I though she or he was the one to give the official diagnosis- that’s how the dr made it out to me. She does have a blue inhaler and it says to give 2 puffs as and when needed- possibly I should be giving her the puffs after a coughing fit then?

really appreciate all the advice. Thank you

I would be pushing for a chest xray.
TB is making a come back and i would want that ruled out

Do you think she would be more poorly though? She’s fine in herself and the bloody phlegm has stopped today. She’s also had all jabs

I think it would be worth mentioning, its very unlikely but worth asking the GP

Re. symptoms - you said she has regular coughing fits from March onwards? She's still coughing and has recently coughed up blood.

Speak to the doctor about her possible asthma.

Speak to the charity I linked above. They have a helpline staffed with asthma nurses.

I'm not suggesting hayfever, I'm suggesting seasonal or allergy-related asthma.

I think it would be best to consult professionals rather than randomly try drugs yourself. Asthma is serious, whether seasonal or year-round.

I would get her checked out by the GP asap as she may need some different treatment, my son used to need oral steroids