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Excessive sputum, foul smell, blood, pus, gum infection

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General & Family Physician
Practicing since : 2005
Answered : 2602 Questions
Age 29/m. height is 5.6' and weight is 72kilos. Its been 3 months since I've noticed blood while I'm spitting in the morning even before having a wash. It smells very routine and everytime I spit, it is with a froth. I think I am losing weight too. I've consulted a doctor and I do not get good answers from them. I went for a chest scan, blood test and it is normal. The sputum has few samples of pus in it. What may be the reason behind me spitting blood in the morning? I have even noticed that my gums are not looking the same, meaning I may be having ulcer like situation and I seen once or twice blood from the tooth /gums.
Thu, 17 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Prasad 3 hours later

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.

Above answer was peer-reviewed by
Follow-up: Excessive sputum, foul smell, blood, pus, gum infection 44 hours later
Thank you for providing me with an answer...

I would like to add that the blood is with the saliva during the mornings... Just spitting from the mouth and not coughing is mixed with the saliva(froth, a mix of yellowish and redish in color, and it does not stop until I wash my mouth with water...Does it mean that it is not serious as I presume it to be? In addition, whenever I touch my teeth / tooth with my toungue I find a rough coating over it... Would this infection happen to come from kissing my partner. who may have tooth or gum problem?

Anyways I'm going for a CBP, ESR, BT/CT, LFT, USG, Abdomin, Platelet count, Serum Creatinine, Blood Urea, HBS AG to ensure nothing is wrong... should I be going ahead with it?

PS: I am a non-smoker and drink very occassionally.
Answered by Dr. Prasad 13 hours later
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?
Above answer was peer-reviewed by
Follow-up: Excessive sputum, foul smell, blood, pus, gum infection 25 days later
hi Doctor,

I've been to a doctor over here and did all the required test I mentioned above and all has come out normal. I've been advised by the doctor here to go for ENT and then if it is still not detected then go in for a dentist check up.

To your fifth query, I am not on any medication as you mentioned out there.

I need understand more of what a heartburn is. I'm actually stressed out a lot these days due to financial, family and work related issues. so, do you think this might be the reason? and if it is, please let me know how to resolve it.

To your last question regarding bowels, I do have constipation time and again and sometimes I might say it leads to piles I suppose. I'm not sure on this. But, now it is controlled on its own and having a free flow here. I even have gastric problems.

I am really confused and finding it frustrating to see blood coming out of the mouth every morning. I hope it gets resolved soon as I'm bit concerned if the infection might get into the blood and create further problems. It happens when the throat gets dried up and all saliva during my sleep comes out during night sleep and then as soon as I get up in the morning I normally spit out saliva with blood mix and acidic in nature.

Answered by Dr. Prasad 5 hours later
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!!
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