Blood in Saliva: Causes and When to Seek Help - Internal Medicine

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Experiencing blood in saliva can be alarming and may indicate various underlying conditions. In your case, the presence of jelly-like blood clots and deep red blood in your mouth, followed by a feeling of something stuck in your throat and subsequent vomiting of blood, warrants immediate medical attention. Here’s a breakdown of potential causes and recommendations on when to seek help.


Possible Causes of Blood in Saliva
1. Gum Disease or Oral Health Issues: Conditions like gingivitis or periodontitis can cause bleeding gums, which may lead to blood appearing in saliva. If you have poor oral hygiene, this could be a contributing factor.

2. Injury or Trauma: Any recent injury to the mouth, throat, or gums can result in bleeding. This could be from biting your cheek, a dental procedure, or even vigorous brushing.

3. Infections: Infections in the mouth, throat, or sinuses can lead to bleeding. For example, a severe throat infection or tonsillitis might cause bleeding that mixes with saliva.

4. Respiratory Issues: Conditions affecting the lungs, such as bronchitis or pneumonia, can sometimes lead to blood being coughed up and mixed with saliva.

5. Gastrointestinal Problems: Conditions like ulcers or esophageal varices can cause bleeding that may be vomited or coughed up. If the blood is dark or has a coffee ground appearance, it may indicate that it has been digested.

6. Blood Disorders: Conditions that affect blood clotting, such as hemophilia or thrombocytopenia, can lead to spontaneous bleeding.

7. Cancer: Though less common, cancers of the mouth, throat, or lungs can cause bleeding.


When to Seek Help
Given the symptoms you described—especially the vomiting of blood and the sensation of something stuck in your throat—it is crucial to seek medical attention immediately. Here are some guidelines on when to see a doctor:
- Immediate Care: If you are experiencing significant bleeding, difficulty breathing, or severe pain, go to the emergency room right away.

- Urgent Care: If the bleeding persists, or if you have other concerning symptoms such as fever, weight loss, or persistent cough, you should see a healthcare provider as soon as possible.

- Follow-Up: After initial evaluation, you may need to see specialists such as an ENT (Ear, Nose, and Throat) doctor for throat issues, a dentist for oral health concerns, or a gastroenterologist if gastrointestinal bleeding is suspected.


Recommended Actions
1. Avoid Irritants: Until you can see a doctor, avoid irritants such as tobacco, alcohol, and spicy foods that may exacerbate bleeding.

2. Maintain Oral Hygiene: Continue to practice good oral hygiene, but be gentle to avoid further irritation or bleeding.

3. Document Symptoms: Keep track of any additional symptoms, such as changes in appetite, weight loss, or changes in bowel habits, which can provide valuable information to your healthcare provider.

4. Seek Professional Evaluation: Make an appointment with your primary care physician or go to an urgent care facility to get evaluated. They may perform a physical examination, order blood tests, or imaging studies to determine the cause of the bleeding.

In summary, blood in saliva can arise from various causes, some of which may require urgent medical intervention. Given the severity of your symptoms, it is essential to seek medical help promptly to ensure proper diagnosis and treatment.