Suggest ways to rule out esophagitis and gastritis
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I am a Gastroenterologist and would be answering your query.
Bloody in sputum is also referred to as hemoptysis in medical terms.Most common Causes of bloody sputum include lung infection with pneumonia, bronchitis, tuberculosis, chest trauma etc but as in your case there are two likely possibilities.
1) Get a PT/INR done again Asap.Coumadin is a abticoagulant and strict PT/INR monitoring is to be done to avoid bleeding which is the most common side effect of this therapy.
Even slight change is doses can increase INR by many times.
2) As you have history of GERD and esophagitis.Most likely cause of bleed in your case is reflux disorder only.See when acid refluxes back into your esophagus it erodes the layer covering esophagus termed medically as mucosa layer.
This erosion leads to inflammation and mild bleeding from site of mucosa erosion.
Initially i would suggest you to go for an endoscopy to rule out site of bleeding.
However just 2 tsf of blood with sputum is not suggestive of any major problem but as you are on a anticoagulant PT/INR should be checked asap.
If reaching hospital is a problem rigt now then you can just wait and watch in case episode repeats itself go for PT/INR asap.
Hope i was helpful.
Follow up suggestions.
Hi again Dear,
Have gone through your details.
See just on the basis of history its very difficult to say whether its gastric or from lungs.However as you are a diagnosed case of erosive gastritis most likely possible source of bleed is either your esophagus or stomach(can be ulcers also).Bleeding is difficult to quantify clinically. Its very difficult to distinguish whether you are throwing up, coughing, or spitting out bloody material.
However to rule out lung at least X-ray of chest should be done initially along with auscultation of chest(examining by stethoscope).Historic clues are however suggestive of gut as primary source of disease.
PT/INR ideally should be around 1-2.So i would consider 2.5-3(to be on higher side).
See if the episodes repeat itself and bleed volume is more then 15-20 ml then go to emergency room other wise my initially suggestion is take Antacids along with proton pump inhibitors for few days. If blood stops this means that it was due to erosion of esophagus.
Please mention is there any history of recent respiratory tract infection or cough cold coryza etc?
"please see above..I typed in wrong box. thankyou..and yes,I was satisfied w the doctors response".-Can't get what you mean to say dear.
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