Waking up in the morning with yellow saliva that has a blood-like taste and a bitter flavor?
I have a history of gastroesophageal reflux and laryngitis, with my first episode occurring a year and a half ago.
After persistent coughing that wouldn't improve, I was referred from the pulmonology department to the otolaryngology department.
The ENT doctor performed a nasal endoscopy and observed gastric acid in my throat, after which I was prescribed medication for gastroesophageal reflux.
Recently, I experienced a new episode where I noticed a blood taste in my throat and coughed up blood-tinged saliva in the mornings (only upon waking).
I underwent another nasal endoscopy, but no abnormalities were found.
When I asked the ENT specialist if gastrointestinal bleeding could cause blood in my saliva, he replied that it was unlikely.
I am very concerned and would appreciate your response.
Thank you for your help.
Tong, 30~39 year old female. Ask Date: 2018/12/21
Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello: The typical symptom of gastroesophageal reflux disease (GERD) is a burning sensation in the upper abdomen that radiates to the throat.
Atypical symptoms may include a feeling of something stuck in the throat, chronic pharyngitis, and asthma-like symptoms.
If there is blood in the sputum when coughing forcefully, a metallic taste in the throat, or blood in saliva, there is a concern for gastrointestinal bleeding.
It is recommended to undergo an upper endoscopy to check for any issues in the esophagus, such as peptic ulcers or gastritis.
Wishing you safety and good health! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.
Reply Date: 2018/12/21
More Info
Morning saliva with blood and a bitter taste can be concerning, especially for someone with a history of gastroesophageal reflux disease (GERD) and laryngitis. Understanding the potential causes of these symptoms is crucial for proper management and peace of mind.
Firstly, it's important to recognize that the presence of blood in saliva, particularly in the morning, can stem from various sources. Given your history of GERD, one possible explanation could be irritation or damage to the mucosal lining of the esophagus or throat due to acid reflux. When stomach acid repeatedly comes into contact with the esophagus and throat, it can lead to inflammation, which may cause minor bleeding. This could explain the blood you notice in your saliva upon waking.
Another potential cause could be related to dental issues. Gum disease or other oral health problems can lead to bleeding gums, which may mix with saliva, resulting in blood being present when you spit. If you have not had a recent dental check-up, it might be worthwhile to consult with a dentist to rule out any oral health issues.
Additionally, the bitter taste you are experiencing could be associated with the reflux itself. GERD can cause a bitter or sour taste in the mouth, especially if stomach contents are regurgitated. This can be exacerbated by lying down or sleeping, as gravity no longer helps keep stomach contents in place.
Regarding your concern about gastrointestinal bleeding, while it is less common for upper gastrointestinal bleeding to present as blood in saliva, it is not entirely impossible. If there were significant bleeding from the upper gastrointestinal tract, it could potentially lead to blood being present in saliva. However, as your ENT specialist indicated, it is unlikely that this is the source of your symptoms, especially if they did not find any abnormalities during the nasal endoscopy.
Given that you have already undergone a thorough examination by an ENT specialist, it may also be beneficial to follow up with your primary care physician or a gastroenterologist. They can evaluate your GERD management and consider additional diagnostic tests, such as an upper endoscopy, to assess the esophagus and stomach for any potential issues that may not have been visible during the nasal endoscopy.
In summary, while the presence of blood in your morning saliva and the bitter taste can be alarming, they may be related to your existing GERD condition or oral health issues. It is essential to continue monitoring your symptoms and seek further medical evaluation if they persist or worsen. Keeping a record of when these symptoms occur, their frequency, and any associated factors (like diet or medication changes) can also provide valuable information for your healthcare provider in determining the best course of action.
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