Brief Answer: see below Detailed Answer: hi, Reflux is most of the time secondary to acid from the stomach. I assume you probably have tried antiacids to block the acid from the stomach (such as omeprazole, esomeprazole, etc). these medications are highly effective in controlling reflux, and if you are not taking them, you should ask your doctor to consider prescribing them for symptom control. These meds are best taken with an empty stomach, and waiting at least 20 minutes before having a meal. If you had a scope about a year ago, I don't think it would be necessary to repeat one. A small hiatal hernia can cause reflux, but it should not get significantly worse in less than a year. Diet is also important, and you should minimize alcohol, smoking, spicy foods, mints, chocolates, caffeine, citrics. In other occasions the reflux is "non-acid", and it could be bile refluxing all the way from the small bowel up to the esophagus. A special test called Manometry with impedance, can be done to check for this. Not every gastroenterologist does this test. Another suggestion, which is sometimes forgotten: lose weight, particularly if you are overweight. Have dinner at least 4 hours before lying flat or going to bed. The red blood in spit is likely from reflux acid irritating the throat / vocal chords, but if it persists, you should seek further medical assistance, and get and close examination. Hope these recommendations help, let me know if i can answer any other questions.

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