I am nineteen years old, female, 5 4.75 tall, and 103 lbs. I have had mild to severe gastrointestinal problems for the past two years. I was diagnosed with IBS , lactose intolerance , and likely GERD related to the IBS. I take probiotics and digestive enzymes every day, as well as Lexapro for an anxiety disorder, and iron supplements for anemia. I have also been essentially borderline bulimic for the past year and a half. By this I mean that I may go a month or two without throwing up, but could throw up biweekly for months following that. Today, I self-induced vomiting for the first time in a few weeks, and after doing so, there were traces of blood in my spit. This has happened to me at least 5 times, but it is never a large amount of blood. I am wondering whether this indicates an esophageal tear, or simply irritation due to my acid reflux combined with the vomiting?