Blood-tinged Mucus Flowing from Nasopharynx to Throat

Blood-tinged mucus draining from the nasopharynx into the throat?

In October and November, I experienced blood streaks flowing down from my nasopharynx.
I visited two ENT clinics, and both doctors performed nasal endoscopy.
They noted that the microvessels inside my nasal cavity were more prominently dilated, which is likely the source of the bleeding.
They confirmed that there were no issues with the structures from the nasopharynx to the vocal cords.
The doctors advised me to have regular follow-ups every six months and to maintain nasal moisture.

Additionally, after both endoscopy procedures, I noticed some cold symptoms a few days later, including post-nasal drip with slightly yellow mucus and a bit of throat discomfort.
Why is this happening? I would like to ask if further examinations are necessary regarding the bleeding, or if regular follow-up is sufficient.
Should I be concerned about the possibility of malignancy?

Guang, 30~39 year old female. Ask Date: 2020/11/13

Dr. Ji Zhaoyun reply Otolaryngology

There are many causes of nosebleeds, with the most common being thin nasal mucosa resulting from forceful nose blowing.
However, other potential causes include nasopharyngeal or nasal cavity tumors (such as nasopharyngeal carcinoma), sinusitis, fungal infections, allergic rhinitis, hypertension, coagulopathy, and nasal trauma.
It is advisable to consult an otolaryngologist if there are any concerns.
If oral medication is ineffective, consideration can be given to cauterizing the frequently bleeding nasal blood vessels using medication or laser treatment.
Wishing you peace and good health.

Reply Date: 2020/11/13

More Info

Blood-tinged mucus flowing from the nasopharynx to the throat can be concerning, especially when it occurs repeatedly. Based on your description, it seems that you have already consulted with two ENT specialists who performed nasal endoscopy and found that the microvasculature in your nasal cavity is more prominent, which could explain the bleeding. The fact that both doctors did not find any structural issues with your nasopharynx or vocal cords is reassuring.

The presence of blood in mucus can often be attributed to several benign causes, including nasal dryness, irritation, or minor trauma to the nasal mucosa. Given that you have been advised to maintain nasal moisture and follow up every six months, it seems that your doctors are taking a cautious yet reasonable approach. Keeping the nasal passages moist can help prevent further irritation and bleeding. You might consider using saline nasal sprays or humidifiers, especially in dry environments, to help with this.

Regarding your recent symptoms of a mild cold, yellow nasal discharge, and throat discomfort, these could be indicative of a viral upper respiratory infection or sinusitis. Post-nasal drip, where mucus flows down the back of the throat, can lead to throat irritation and discomfort, which may explain the pain you are experiencing. The yellow color of the mucus suggests that your body is fighting off an infection, which is common and usually self-limiting.

As for your concerns about the possibility of malignancy, it is understandable to be anxious about such symptoms. However, the fact that two specialists have examined you and found no alarming signs is a positive indicator. Blood-tinged mucus due to prominent blood vessels is typically not associated with cancer. Nevertheless, if you notice any changes in your symptoms, such as increased bleeding, persistent pain, or any new symptoms, it would be prudent to seek further evaluation.

In terms of further investigations, if your symptoms persist or worsen, you might consider discussing additional tests with your doctor. This could include imaging studies like a CT scan of the sinuses or a referral to a specialist for further evaluation. However, if your symptoms are mild and manageable, regular follow-up as advised by your ENT specialists may be sufficient.

In summary, while the presence of blood-tinged mucus can be alarming, it is often due to benign causes, especially when no structural abnormalities are found. Maintaining nasal moisture, monitoring your symptoms, and adhering to follow-up appointments are key steps in managing your condition. If you have any further concerns or if your symptoms change, do not hesitate to reach out to your healthcare provider for guidance.

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