Diet taboos for hemoptysis

The core dietary taboos for patients with hemoptysis can be classified into three categories - overly hot and highly irritating foods that must be avoided, hard and scummy foods that are strictly limited in intake, and foods with blood-activating effects that need to be suspended during the acute phase. The specific taboo range will be adjusted according to the cause of hemoptysis and the stage of the disease. There is no unified standard that suits everyone.

When I was rotating in the respiratory ward two years ago, I met an old man named Chen who had been suffering from bronchiectasis for more than 10 years. He finally stopped bleeding and stabilized it for three days. He secretly drank the freshly brewed hot milk tea handed over by his grandson. Later that day, he coughed up two more mouthfuls of blood. When he was treated in the emergency department, he patted his thigh and regretted: "I thought only boiling water can be called hot. This milk tea is warm in my hand. Who knows what could happen?" ”

In fact, the term "over-hot" in clinical practice does not refer to a temperature that can make you shrink your hands. As long as the temperature of food exceeds 45°C, it will cause the blood vessels of the surrounding airway mucosa to expand when passing through the esophagus. The damaged blood vessel wounds that have just condensed can easily rupture and bleed again as soon as they expand. There is also an ongoing controversy here: many schools of traditional Chinese medicine believe that patients with hemoptysis should not be exposed to cold weather and must eat warm food. Now clinical practice generally makes compromise adjustments - if there is fresh hemoptysis within 24 hours of the acute stage, priority is given to liquid food at room temperature or slightly cooled, as long as it is not too cold to irritate the gastrointestinal tract. It is not too late to return to normal warm food after the hemoptysis has completely stopped for more than 3 days.

In addition to the temperature, if the taste is too strong, you have to take it easy. Last month, there was a young man who contracted secondary tuberculosis. While he was in the hospital, he ordered spicy crayfish without telling the nurse. After eating, he coughed so much that he couldn't straighten his waist. The blood that had almost stopped suddenly started to flow again. In addition to chili peppers, alcohol, strong coffee, and particularly sour lemons and grapefruits can either directly stimulate the airway mucosa and aggravate coughing, or excite nerves and accelerate blood flow, which are all hidden dangers for patients who are still hemoptysis. Of course, it doesn’t have to be a one-size-fits-all approach. If you usually drink a glass of Americano every day and don’t cough at all, and you haven’t coughed up blood for a week, it’s not a big problem to drink a few sips, and you don’t have to make yourself too uncomfortable.

Many people ignore hard and scummy food, thinking that hemoptysis is a matter of the lungs and has nothing to do with whether eating scratches the esophagus? Don't forget that the esophagus and airway are closely together. If you eat a dry and hard sesame seed cake and scratch the esophageal wall, or accidentally choke on a small thorn when eating fish, the vibration caused by the severe cough can tear the newly formed blood vessel wounds in minutes. There is also a common misunderstanding in this area: many dietary prescriptions will say that patients with hemoptysis should eat more high-fiber foods to prevent constipation. After all, holding one's breath forcefully during constipation can also induce bleeding. This is actually not contradictory at all. Chop celery into vegetable fillings, boil corn until soft, and boil oats into porridge. This can not only supplement dietary fiber for defecation, but also avoid the risk of scratching the mucosa. There is no need to chew raw celery stalks directly to supplement fiber.

Finally, let’s talk about the most controversial blood-activating food. Many people know that blood-activating traditional Chinese medicines such as safflower and angelica should not be touched, but can red dates and donkey-hide gelatin be eaten? Some people say that the black fungus that they usually eat can also promote blood circulation. Should they also be banned? I met an aunt who suffered from hemoptysis in the late stage of lung cancer. Her family was afraid that she was anemic, so they gave her red ginseng and astragalus soup every day. After drinking it for three days, the amount of hemoptysis doubled, and then it slowly decreased after the soup stopped. The current clinical consensus is that as long as you are still in the acute stage of bleeding, foods that are known to have blood-activating effects, including red ginseng, deer antlers, saffron, alcohol, and even glutinous rice that many people like to use to replenish qi and blood, must be stopped first. However, if the bleeding has stopped for more than a week and you are indeed deficient in qi and blood, you can eat a small amount of donkey-hide gelatin and red dates under the guidance of a doctor. There is no need to avoid these foods for the rest of your life. Malnutrition will be detrimental to wound recovery.

The advice I usually give to patients is not very restrictive. When there is still fresh blood in the first 24 hours, eat some warm lotus root powder and millet porridge. If there is no more bleeding, you can add steamed eggs and soft noodles the next day. After three to five days, nothing will happen, and you can slowly transition to a normal diet. You don’t need to drink white porridge every day to starve your stomach. Only when the nutrition keeps up with the wound will the wound heal quickly.

In fact, you don’t need to be overly nervous when you see the word “taboo”. You don’t dare to eat this or touch that. Just remember a few red lines and don’t touch them. If you are really not sure whether something is edible or not, asking the doctor or nurse in charge of the bed is much more reliable than searching for half-night guides on the Internet.