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Bleeding through mouth, sputum had some pus symptoms - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
User :   As soon as I get up in the morning, I have blood in my mouth. it is not that the volume is more but it is been happening for quite some time... I did all the blood tests, Sputum test and chest scan . The sputum had some pus symptoms. But I do know that the blood is coming from the mouth and not from the throat. What may be the reason?
Doctor :   Hi
User :   hi
User :   GM doctor
Doctor :   Pls. give me a few seconds to go through your query.
User :   ok
Doctor :   May I ask you a few more questions to help you better ?
User :   yes sure
Doctor :   May I know your age and gender please ?
User :   29 and male
Doctor :   Ok.
Doctor :   Since when exactly are you facing this problem ?
User :   I had this blood coming from my mouth last month ... so I went to the doctor who is a physician... he asked me to do all the test I mentioned and the result was few pus symptoms in the sputum
Doctor :   Ok.
Doctor :   Is it blood with saliva only or does it have froth ?
User :   it has some froth
Doctor :   Ok.
User :   today I checked
Doctor :   If it is frothy then its origin is from the respiratory system most of the times.
User :   it smells very bad...
Doctor :   Either from the Upper RT or Lungs or Bronchi
Doctor :   It must be some infective cause ?
Doctor :   Do you have any difficulty in breathing ?
User :   No... I do not have difficulty... but sometimes I get breathless when in tension...
Doctor :   I shall mention all the possible causes , but I would go in favour of Respiratory Tract.
User :   One more thing doctor
Doctor :   Blood in the mouth is either coming from the oropharynx (mouth cavity) itself, the GI system (i.e. esophagus and upper GI tract), or the lungs. As you can imagine the list of causes is quite broad.
There can be several directions you can take. If a GI causes is suspected, a GI evaluation can be considered, with an upper endoscopy as the next step.
If there is a lung cause suspected, a pulmonologist can be consulted for lung imaging and possible bronchoscopy.
Doctor :   Yes please go on.
Doctor :   Do you smoke ?
User :   No, i do not smoke at all...
Doctor :   Do you consume alcohol ?
Doctor :   Ok, That is very encouraging .
User :   Yes I do not consume alcohol... but very occassionally
Doctor :   Ok, That is absolutely fine.
User :   I do comsume alcohol
User :   but very occassionaly
Doctor :   No problem about that.
User :   ok
Doctor :   I am Sorry, you were asking me something ?
User :   it looks like I do have some ulcers in my mouth...
User :   I checked my mouth... it is whitish in color
User :   my tongue is blackblue...
Doctor :   As I have mentioned the possiblities, the first is ulcers in the mouth.
User :   Also, I have severe gas problems... the throat becomes bit dry..
Doctor :   Since when have you observed the change in color of the tongue ?
Doctor :   Ok.
User :   yesterday
Doctor :   Ok.
User :   it might be because I spitting out saliva every now and then to check if I am still bleeding from the mouth
Doctor :   For blueblack tongue , there can be several reasons again, most important being Fanconi's anemia.
Doctor :   Or also the coloration of due to blood or any food contents like blue berries .
Doctor :   Dryness in throat is since when ?
User :   please let me know what is fanconi's anemia?
Doctor :   Fanconi's anemia is a disease passed down through families (inherited) that mainly affects the bone marrow. It results in decreased production of all types of blood cells.
User :   it is like I'm trying to let out some gas from the mouth.... tht is the time it is usually dry...
Doctor :   Ok.
Doctor :   There is megaloblastosis,neutropenia and kidney problems and spleenic problems associated with it.
Doctor :   Let me give you a systematic step wise approach to diagnose your problem : User :   ok doctor
Doctor :   As without some more Specific investigations it rather becomes difficult for me to help you ;
Doctor :   1. Endoscopy stomach and intestines and esophagus
User :   ok
Doctor :   As bleeding's primary cause is gastric ulcer or esophageal ulcer .
Doctor :   I would suggest first this test.
Doctor :   2. A thorough dental check up , if you have not done that yet.
Doctor :   It can be caused by chronic vitamin deffieciencies or bleeding gums, sores , etc.
Doctor :   3. An X-Ray chest if these are negative , to investigate your lungs upon.
Doctor :   Have these tests been done previously ?
User :   I have did xray test of the chest which has come out normal
Doctor :   Ok.
User :   I have not done the endoscopy and the dental check up
Doctor :   Please get an Endoscopy done to rule out other complications.
Doctor :   Lets see the report and take it forward.
Doctor :   I strongly feel there might be a gastric/esophageal etiology.
User :   ok doctor... since the blood is coming from saliva.. I mean not from the throat, if I may ask, Is it right to say it is gastric problem... ? just reassuring myselt
User :   myself
Doctor :   As your other symptoms like dryness in throat and bad odour support a GI Cause.
Doctor :   Moreover if it would have been something as simple as oral, the primary would have not missed it.
Doctor :   Usually the mouthe ulcers which bleed are very painful.
Doctor :   Which you have not mentioned in your symptoms.
User :   ok
Doctor :   And hence I feel there might be a GI Cause.
User :   yes doctor... no pain...
Doctor :   Please feel free to ask anything else , if you have any other doubts .
Doctor :   Please get these tests done in a couple of days, please do not delay as it has been already one month.
User :   that shld be fine with me... I would do the endoscopy and get back to you on this... how should I contact you further on this?
Doctor :   You can drop in a mail to YYYY@YYYY with your reports and summary attached.
User :   sure... One more thing... Should I be scared something really bad? I'm actually a bit tensed...
Doctor :   And then get connected to me on the chat window.
Doctor :   No, Not really, it is very common and can be easily treated, please do not panic. Everything will be fine.
Doctor :   Please send a mail at least one hour prior to chat.
Doctor :   Thank you for consulting me, Take care , Dont worry.
User :   ok doctor I will do that... thanks alot for keeping me educated on this... I will surely go for the tests and get back to you
Doctor :   Take care.
Bye for now.
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