Dear XXXXXXX

Thanks for your query.

"I have noticed blood while I'm spitting" - here if you meant not coughing out and spitting blood, I believe we are looking at blood stained secretions from the mouth and not lungs or other organs.

Salivary secretions are normally frothy. Presence of blood in the salivary secretions indicates that the source of bleeding is from the oral cavity. The commonest source of blood is gums and teeth. These can be attributed to lack of hygiene or infection/inflammation.
Consulting a dentist and appropriate dental procedures may benefit you.
Twice brushing, daily flossing, regular gum massage, healthy diet containing fruits and vegetables along with multivitamin pills are the treatment options, if this is the cause.

Occasionally a course of antibiotic may be needed if signs of infections are seen.

However, if you are coughing out blood, respiratory infections, gastritis, gastric ulcer or reflux oesophagitis may be the cause.

If you are one who smokes, chews tobacco and consumes alcohol, then quit these activities.

Though malignancy can mimick these symptoms, it is unlikely that you could be suffering from it as your symptoms are not consistent with its features.

I hope I have answered your query. Get back to me, you did meant coughing out blood and not the salivary secretions.

I will be available for to any more of your queries. Get back to me, if you have any more queries.

Regards

---

Dear XXXXXXX
Thought I should add a few points:
1. The commonest cause is Scurvy or Vitamin C deficiency.
2. Vitamin K and Zinc deficiency are the next.
3. Gingivitis, tartar and plaque should be ruled out by a periodontist.
4. Sugary, fizzy drinks and coarse, sharp food like popcorn and chips should be avoided.
5. Other causes are rare. Are you on any medication such as anti-epileptics or anti-coagulants?
6. I would add PT, PTTK, Blood Sugar Level to your tests.
7. Do you suffer from heartburn and acid reflux? Stress increases acid reflux, causing dryness in the throat and worsening a coated tongue.
8. The coated tongue is usually bacterial and fungal overgrowth. Use a Betadine gargle and Candid mouth paint for a week.
9. Cut down on milk and milk products.
10. Clean your tongue regularly. Rule out any dental and sinus disease.
11. How are your bowel movements? Do you suffer from constipation?
Regards

---

Hi and thanks again,

I understand your frustration. I expect the symptoms to be better in 3 weeks. Since it did not you definitely need the evaluation as suggested by your doctor.

Blood workups coming normal rules out hematological conditions that are associated with spontaneous bleeding. That is good news to us.

As far as heart burn is concerned, heart burns present with wide ranges of symptoms. The most often reported symptoms are pain/discomfort of the chest behind the sternum, acidic feeling/irritation in the throat, nausea, vomiting. Other symptoms such as shortness of breathe, abdominal discomfort, bloating and so on may be part of it's symptoms. Throat infections and gingivitis may occur in few individuals having long standing heart burns. Acid suppressing drugs, physical exercises and dietary changes are recommended in treating this condition.

As suggested to you in my previous two answers, in the absence of drug usage and hematological disorders, the 3 most common conditions that needed to be attended here are
1. Nutritional deficiencies
2. Dental problems
3. Posterior nasal / throat problems

So the next step is Nose and throat examination. Hence I agree with your doctor -you will need a dental examination if ENT specialist can't help you.

I also hope your previous doctor has prescribed you multivitamin supplements. Else you could use multivitamins such as 'zincovit' which contain zinc, vitamin b complex and vitamin c in them. They will be beneficial in the current circumstances.

Hope I have answered your query adequately.

Wish you good health and speedy recovery!!

---