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What Causes Spitting Up Of Blood Every Morning And Excessive Saliva Secretion?

Posted on Tue, 22 Mar 2016

Question: This is in regards to my 81 years old dad. he is fairly healthy for his age. From the last couple of weeks , when he wakes up in the morning he is spitting little bit of blood in his spit. There is also excessive saliva in his mouth. This symptom is only in the morning. Showed him to the dentist.He did scaling and his gums according to the dentist are fine but he is still spitting the blood only in the morning. He has no cough , never smoker or drinker. Just a spit of blood only in the morning. Not from throat but from mouth. I had an appointment with ENT. All his throat exam was normal. His physician checked his lungs and he thought they were clear. Please advise what it could be. No cough. Attached is a picture of his spit in the morning. Again it is not fro cough but spit in mouth.

Answered by Dr. Saad Sultan (2 hours later)

Brief Answer:
Need workup.

Detailed Answer:
Welcome at HCM
I am DR XXXXXXX XXXXXXX and will be answering your query.
I have gone through your query and being your physician I totally understand your health concerns.
Has he suffered from it before?
Yes , in photograph it appear to be blood .
Blood in sputum need to be investigated. Bronchitis is most common cause which is not a serious condition.
But it would be rather appropriate to deal it in a scientific manner. This blood may come from lungs , blood vessels , outside the lungs from bronchial tree, from the throat and gums.
It was fairly wise approach that you have consulted the ENT surgeon and DENTIST. It has ruled out throat and oral cavity.
Now it is logical to look into lungs and blood vessels for the cause. Sometimes , blood from stomach go into respiratory tree which is later coughed out. Bleeding disorders and anti platelet drugs like aspirin or clopidogrel can also cause this.
If I am your attending physician , after detailed clinical examination , I will get your FULL BLOOD COUNT , ESR , PROTHROMBIN TIME , PARTIAL THROMBOPLASTIN TIME < PTT > and X ray chest. CT chest along with the FIBER OPTIC BRONCHOSCOPY would be subsequent investigations to go with.
If all these come normal then ENDOSCOPY should be done to look for any pathology in stomach too..
Meanwhile stay calm and meet PULMONOLGIST for proper assessment .
Hope your query is adequately addressed , if you still have any feel free to ask anytime.
Regards
Dr XXXXXXX XXXXXXX

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Saad Sultan (8 hours later)

thanks for the response Doc. Today there was no bloo d. So not sure. The ENT doc did say that he has LPR - non acid reflux and gave him the zantac, which has n't started. His blood count and platelet were fine on CBC test, taken a few weeks ago.

As far as pulmonologist, he doesn't have any cough, so his physician is little bit skeptical that it is lung related as the blood just comes from mouth. any further feedback?

Answered by Dr. Saad Sultan (9 minutes later)

Brief Answer:
see pulmonologist only if it become persistent

Detailed Answer:
Welcome at HCM
I really appreciate your followup.
In my opinion you should start zantac to see the response. If it stop coming then no need to worry and just continue with your physician follow up.
If it become persistent and there is weight loss , then in my opinion one should not hesitate consulting pulmonologist.
Hope it helps.
Kindly close the discussion and if you have any query ask me directly by mentioning my name.
Regards
Dr Saad Sultan

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Saad Sultan (31 minutes later)

Last followup, Looks like Zantac has lot of side effects when I read, so didn't start that.. Do you think we should get another alternate medicine for that. Can LPR also cause blood in mouth. Again the point to note is that it is just coming from the mouth but not throat. Can lung related symptoms also cause blood from the mouth ? I thought for lungs , it should actually be coughing up blood but not spitting out blood. He is just spitting and not coughing. Pelase advise.

Answered by Dr. Saad Sultan (9 hours later)

Brief Answer:
continue with medicine prescribed

Detailed Answer:
Welcome at HCM
I appreciate your follow up.
You can use zantac, as far as side effects are concerned , you should not be worried. Every drug has side effects but these are not life threatening and zantac is an old drug and quite safe.
You can replace zantac with Omeprazole 40 mg after discussing with your physician.
LPR is a cause of blood stained saliva, thus it appears like patient is spitting blood.
You should start medicine as prescribed and try to consume food rich in vitamin c.
Lung related problems can be a cause of blood to be coughed out with sputum but not from the mouth
Hope it helps
Regards
Dr Saad Sultan

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Sonia Raina