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Swollen and puffy esophagus. Took medicine. Coughed up phlegm and blood. Now? - Online Doctor Chats

Date : 01-Mar-2013
User rating for this question
Very Good Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2009
Answered : 983 Questions
Doctor:please proceed with your query
Doctor:Please go ahead
User:i have been having issues swallowing.......ent doctor thought it was from gerds as the opening into my esphogus is swollen and puffy looking..........have been being treated with nexeum for three months not better than this morning i coughed up phlem and had some blood in it
User:one more small amount about thirty minuts later than nothing more until after lunch today then i felt need to cough and there was more blood in the phlem, inbetwen the phlem was clear
User:i use a cpap and oxy at night
Doctor:oh, I see
User:am i just getting over concerned
Doctor:from your description, I feel the blood that was in the sputum seems to be originating from lungs
Doctor:the possibility of it just being from the inflamed esophagus/pharynx can not be ruled out completely at this point
User:had chest x XXXXXXX in sept all was good...............had a bronscopy about 18 months ago was all ok
User:i am on plavix
Doctor:so, the best way forward would be get a HRCT(High resolution CT scan) of the lungs
User:ok, but i cant use contrast due to kidney issues
Doctor:since you do have a problem with lungs, it goes more in favor of a lung pathology than a benign pharyngeal condition
Doctor:HRCT can be done without a contrast.
User:ok so chest x XXXXXXX is not adaquete that is what they are talking about having me do
Doctor:It is just plain CT scan with a little more exposure and slices taken much thinner
Doctor:Any day, a CT scan is far superior to an X-ray
User:ok dcotor thank you for you help.............i will pursue this avenue with my doctors here
Doctor:If I may, could you please tell me your age and occupation
Doctor:and since how long you have been having these issues with your breathing and lungs?
User:68 years old, i am in industrial sales primarily inside administrative type work
User:i am obese and have had the sleep apnea for several years................of late due to addtional weight gain the cpap alone was not getting suffient oxy to me at night when i am asleep, during the day i am fine
Doctor:okay, I would also like to point out the fact that, an appearance of blood in sputum would also warrant a sputum culture and examination under microscopy for the acid fast bacili
Doctor:and if required special culture to look for the acid fast bacilli
User:lung doc says my lungs are fine except for the apnea, i will bring this up with my respiratory doc's nurse as my doctor is out of country until end of month
Doctor:okay, in your condition, CPAP does help a lot and oxygen is a good adjunct
Doctor:please do that.. I know tuberculosis is not so common in the USA, but considering your age, it needs to be ruled out nevertheless
User:ok thanks doctor i will follow up, i had this bleeding issue about 18 months ago never found cause then it stopped..................until this morning............they did the lavage in the lungs and went in and scopedd them all was good nothing to be seen, all cells in fluids they removed were clear
Doctor:as far as your GERD is concerned, I would recommend adding a prokinetic agent(Medicines that improve gastric emptying time) to your regimen along with choosing a better PPI
Doctor:The newer proton pump inhibitors show promise in dealing with this issue.
Doctor:Is there anything else you would like to discuss Mr. Blakeway?
User:very good thanks again for your help and all of the information
Doctor:You are most welcome.
User:bye bye
Doctor:Thank you for consulting me. Have a good day sir.
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