Hemoptysis and aspirin

Posted by happy2023 @happy2023, 3 days ago

I have been wondering if taking aspirin might bring on an episode of Hemoptysis. The doctors I have asked seem not to know.
If aspirin can make the stomach bleed, can it do the same thing to the lungs?
I noticed this past April 2024, after taking alka seltzer (which contains aspirin) for a few weeks, that I began coughing up small amounts of blood in my mucus.
By May I had that scary episode of Hemoptysis, coughing pure blood, not a lot, maybe 2 or 3 tsp, and continuing with bloody mucus for days after.
I've been switching between Tums and alka seltzer for about a week now and notice spots of blood in my mucus, so quite afraid I'm heading for another episode of Hemoptysis.
Does anyone know if there could be a correlation between Hemoptysis and aspirin?

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

@happy2023 Hemoptysis is not uncommon in people with Bronchiectasis, especially during exacerbations or with a current active infection.
In answer to your question about aspirin can bring on an episode, the answer seems to be a little murky...even with a dive into Google Scholar, I found no definitive studies - just a lot of case reviews.
The consensus from those reviews was that aspirin, other antiplatelet meds and anticoagulants does cause hemoptysis in some patients, especially with underlying conditions like Bronchiectasis - and that if not being used for prevention of cardiovascular events, should be avoided.

I did find this article:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9703373/
which included this discussion:
"Therefore, we suggest in patients with low thrombotic risk who present not life-threatening hemorrhage temporary discontinuation of antiplatelet therapy (either dual or single) and consider re-administration of a single antiplatelet agent (Fig. 5). In cases with high thrombotic risk and not life-threatening hemorrhage, we suggest continuing single antiplatelet therapy with close monitoring of the patient and follow the hemoptysis algorithm until cessation of bleeding..."

So clinicians do recognize a connection between antiplatelet therapy (this includes aspirin) and hemoptysis.
I would suggest that you talk to your primary doctor about the underlying condition that has you using AlkaSeltzer and Tums, and see if there is a better choice for you. Neither of these is intended to be a long-term treatment of "heartburn" or o9ther gastric issues.

Sue

REPLY

Thank you so much, Sue. I did have a barium swallow test at National Jewish Health to check for GERD. The test revealed a minimal amount of acid reflux.
Like my father, I did not take any heartburn medication until my 70's. I will be especially careful about the AlkaSelter. Apart from that, I do not take any aspirin.
It seems that with my Bronchiectasis, I cannot overly fill my stomach, or else I cough and produce mucus. And of course, if I eat too late in the day, I get heartburn.

REPLY

It does for me. I avoid advil the best I can as it also increases my creatine level in the CMP. I must avoid Tylenol as it increases my alkaline phosphate level in my CMP. I take as few advil or somed advil dual as humanly possible but sometimes I just have to

REPLY

If I were to take an aspirin or tylenol I am pretty certain I would get hemoptysis. In fact anything that significantly thins the blood will do it for me. Otherwise I rarely get hemoptysis.

REPLY

I wonder why doctors, and most especially pulmonologists, are not aware of even a remote possibility of hemoptysis and aspirin interaction.
National Jewish does research into lung conditions. It would be great if I could find an avenue to communicate with them about this one concern with aspirin, especially with Dr. Daley, head of ID or Dr. Griffith, ID doctor.
I also wonder if combining inhaled tobramycin with one or more medications could knock out Pseudomonas, or even alternating oral antibiotics as a therapy. Sometimes it takes 2 or 3 courses of or even switching out oral antibiotics to get rid of a mere chest infection, let alone Pseudomonas.
NJH prefers to keep my asymptomatic Pseudomonas knocked back with good airway clearance, with my pulmonologist saying it is hard to get rid of this bacteria, and if rid of it, it often comes back.
Thank you all for your replies.

REPLY
@happy2023

Thank you so much, Sue. I did have a barium swallow test at National Jewish Health to check for GERD. The test revealed a minimal amount of acid reflux.
Like my father, I did not take any heartburn medication until my 70's. I will be especially careful about the AlkaSelter. Apart from that, I do not take any aspirin.
It seems that with my Bronchiectasis, I cannot overly fill my stomach, or else I cough and produce mucus. And of course, if I eat too late in the day, I get heartburn.

Jump to this post

Does a barium swallow test accurate? My GI doctor said to get an accurate result, I need to do endoscopy to see if I have reflux and GERD. I will ask my pulmonologist about the test you mentioned. Thank you.

REPLY
@happy2023

I wonder why doctors, and most especially pulmonologists, are not aware of even a remote possibility of hemoptysis and aspirin interaction.
National Jewish does research into lung conditions. It would be great if I could find an avenue to communicate with them about this one concern with aspirin, especially with Dr. Daley, head of ID or Dr. Griffith, ID doctor.
I also wonder if combining inhaled tobramycin with one or more medications could knock out Pseudomonas, or even alternating oral antibiotics as a therapy. Sometimes it takes 2 or 3 courses of or even switching out oral antibiotics to get rid of a mere chest infection, let alone Pseudomonas.
NJH prefers to keep my asymptomatic Pseudomonas knocked back with good airway clearance, with my pulmonologist saying it is hard to get rid of this bacteria, and if rid of it, it often comes back.
Thank you all for your replies.

Jump to this post

i think some people with Bronchiectasis can take aspirin without issue. I just know I cannot and that it will cause bleeding. Or if I take Omega 3's. Anything that really thins the blood. But not everyone has that reaction. And it might be a nose bleed or hemoptysis.
Combining Tobramycin with Cipro or Levo is done all the time by some Pulmos. if the person is symptomatic with Pseudo. Toby alone is also used to keep it at bay (two weeks on two weeks off). But not treating it unless symptomatic seems to be what the experts are doing.

REPLY
@sweethighland

Does a barium swallow test accurate? My GI doctor said to get an accurate result, I need to do endoscopy to see if I have reflux and GERD. I will ask my pulmonologist about the test you mentioned. Thank you.

Jump to this post

This thing about GERD is interesting. The GI doctor at National Jewish Health spoke at their last Lecture Series (it was available nationwide online, all you had to do is register and pay a small amount to do so, and they have this informative series every year). He explained there are certain things you can do to avoid acid reflux, like not lying down after you eat, eating smaller meals, avoiding foods that aggravate your stomach.
An endoscopy sounds like another one of "those" tests that a doctor might order. I don't know anything about this test.
I don't know how accurate a barium swallow test is, but my pulmonologist seems to be satisfied with my minimal acid reflux, and thank goodness because that barium swallow test was over $700 and even though insurance covered a good deal of that, out-of-pocket cost was a good bit of pocket change for me.
It seems we continue to navigate a lot, what doctors say, how we must take care of our health in light of opinions, medical and otherwise, a whole myriad of information from which we glean knowledge that will help us in our journey with Bronchiectasis, a disease which is not addressed, nor even understood,
as much as we would like in the medical world.
Mayo Clinic Connect has been a godsend, and I'm so grateful we can be a part of it.

REPLY
@irenea8

If I were to take an aspirin or tylenol I am pretty certain I would get hemoptysis. In fact anything that significantly thins the blood will do it for me. Otherwise I rarely get hemoptysis.

Jump to this post

I have gastritis so only take tylenol. I too haave to watch my alkaline phosphatase and need to use it sparingly since I started Ethambutol + Azithromycin which are liver toxic.
Alka seltzer and pepto bismol have aspirin. Be careful with stomach upset

REPLY
Please sign in or register to post a reply.