you know, i don't have alot of ideas, but that is scary...i know some things that might cause that, but i doubt that you haven't heard of them already...if you have, then atleast this post will bump up your topic
tuberculosis last stages are marked by excessive blood and mucous expectorating
sometimes with stomach problems such as ulcers or lesions the bleeding in the digestive tract can get coughed up
also, if he keeps coughing and coughing and coughing, then chances are the bleeding is caused by the irritation in his system from coughing, which causes more blood, which creates a need to cough more, which makes more blood, and the cycle goes on
however, the other two ideas at the top are generally life-threatening, and since he's had this for four years, there probably not the problem, but, just thought i'd give all i could think of!
rachael
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Thought This Might Be of Use...Since Alot of Others Have It:
Updated on 6/18/02
August 1999: diagnosed with GERD and IBS...put on zantac, then aciphex
Spring 2000: diagnosed with TMJ...have lower splint
September 2000: hospitalized for failure to thrive due to malnutrition and dehydration; fed with ng tube for 3 months, put on prilosec
2001-02: developed chronic sinusitis/rhinitis from NG tube, put on nasonex and allegra
January 2002: switched GI's, diagnosed with hiatal hernia, switched to nexium, added peppermint oil, put on bentyl PRN for pain, zoloft for nausa
March 2003: IBS getting worse, switched PRN bentyl to BID levbid ER
May 2003: diagnosed with asthma from GERD, put on advair and singulair, albuterol PRN
May 2003: back pain and limited mobility, caused by 2002 car accident and dance injury, unidentified
April-June 2003: minor ear irritation and hearing problems, and extra sinus swelling, unidentified
May-June 2003: heartburn recurring even with meds!- GI put me on 40mg Pepcid Rx in the morning and at bedtime...Seems to be holding over till August... 
July: chest x-ray came back, found mild thoracic scoliosis, and small "heart shadowing", EKG results are coming...
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