Throat Irritation and Blood in Mucus: Causes and Solutions

Nasal and throat issues?

Hello doctor, sometimes when I stay up late at night working on design assignments, I suddenly feel an itch in my throat before going to sleep, so I take throat lozenges and go to bed.
The next morning, when I wake up and touch the area at the back of my throat with my tongue, the saliva I pull out sometimes has a faint trace of blood.
If I apply a bit more pressure, it increases, but after brushing my teeth and drinking water, it usually subsides.
In the morning, I also tend to have more nasal mucus, but it clears up after blowing my nose, and interestingly, there’s no blood when I do that.
This has been happening for about 2-3 weeks, but it doesn't occur continuously; it only happens when I stay up late.
I visited an ENT specialist who said there was inflammation.
I was initially worried it might be nasopharyngeal cancer because of the blood in the phlegm.
I thought I might need a nasopharyngoscopy, but the doctor only used some tools to examine my nose and a small round mirror in my mouth.
After a brief look, he said everything was fine but noted the inflammation and prescribed medication.
After taking the medication, I did feel better and there was no more blood.
The doctor mentioned that my tongue should not reach the nasopharyngeal area and advised me not to worry too much.
He said that generally, persistent nasal congestion and blowing the nose could lead to blood, and that the itchy throat symptom I described is not typical.
He only advised me to go to bed earlier.
I would like to ask if this issue is indeed due to inflammation and if using my tongue to clear phlegm near the throat could cause the blood.
The blood appears red initially, and I sometimes feel a slight sensation in my nose when I pull it, which made me think my tongue might be touching the nasopharynx.
Also, do nasopharyngeal issues typically result in continuous bleeding? Because I only notice it when I wake up and brush my teeth, I’m unsure if the symptoms are the same.
I’m really worried, but the ENT doctor said it was quite normal.
Lastly, I would like to know if there are other ways to help improve this condition besides going to bed early.
Thank you for your help! The ENT doctor mentioned that my tongue cannot reach the nasopharynx due to the curved structure there.
Could you clarify if my bleeding is likely coming from the mucosal area of that curved structure?

Tina, 20~29 year old female. Ask Date: 2021/10/30

Dr. Hong Yuanbin reply Internal Medicine

Hello, it is indeed difficult for the tongue to reach the back of the throat; what you are likely touching is the gums.
Typically, the gums can become more swollen during late nights or periods of high stress.
If you frequently press your tongue against them, it can lead to slight bleeding.
I recommend getting more rest, maintaining a regular schedule, and avoiding pressing your tongue against the gums, which should help improve the situation.
Thank you for your question.

Reply Date: 2021/10/30

More Info

Understanding throat irritation and the presence of blood in mucus can be concerning, especially when symptoms appear intermittently and are associated with lifestyle factors such as late nights and stress. Based on your description, it seems that your symptoms may be related to inflammation in the throat and nasal passages, likely exacerbated by fatigue and possibly environmental factors.

Possible Causes of Your Symptoms
1. Throat Irritation: The itching sensation in your throat could be due to several factors, including:
- Allergies: Seasonal allergies or reactions to dust, pollen, or other irritants can cause throat irritation and post-nasal drip, leading to discomfort.

- Infection: Viral infections, such as the common cold, can cause inflammation and irritation in the throat.

- Gastroesophageal Reflux Disease (GERD): Acid reflux can irritate the throat, especially when lying down after eating or drinking.

2. Blood in Mucus: The presence of blood in your mucus can be alarming, but it is often not serious. Possible causes include:
- Nasal Irritation: Frequent blowing of the nose or irritation from dry air can lead to small blood vessels in the nasal passages breaking, resulting in blood-streaked mucus.

- Throat Inflammation: Inflammation in the throat can also lead to minor bleeding, especially if you are coughing or clearing your throat frequently.

- Infection: Certain infections can cause inflammation and bleeding in the throat or nasal passages.

When to Seek Further Evaluation
While your ENT specialist has reassured you that your symptoms are not indicative of a serious condition, it is important to monitor your symptoms. If you experience any of the following, further evaluation may be warranted:
- Persistent or worsening symptoms.

- Significant amounts of blood in mucus.

- Difficulty swallowing or breathing.

- Unexplained weight loss or night sweats.

Management and Prevention
1. Lifestyle Modifications:
- Sleep Hygiene: Prioritize getting adequate sleep to help your body recover and reduce inflammation.

- Hydration: Drink plenty of fluids to keep your throat moist and help thin mucus.

- Humidifier: Using a humidifier in your room can help keep the air moist, which may alleviate throat irritation.

2. Avoid Irritants:
- Stay away from smoke, strong odors, and allergens that may exacerbate your symptoms.

- If you have allergies, consider using antihistamines or nasal sprays as recommended by your healthcare provider.

3. Throat Care:
- Gargling with warm salt water can soothe throat irritation.

- Throat lozenges can provide temporary relief from discomfort.

Understanding Your Anatomy
Regarding your concern about the anatomy of your throat and nasal passages, the "bump" or "cover" you mentioned is likely the uvula or the soft palate, which separates the oral cavity from the nasal passages. It is normal for the tongue to not reach the nasopharynx (the upper part of the throat behind the nose). The bleeding you observed could be from minor irritation in the mucosal lining of the throat or nasal passages rather than a serious issue.

Conclusion
In summary, your symptoms of throat irritation and blood in mucus are likely related to inflammation, possibly due to allergies or infections, and are not uncommon. Following the advice of your ENT specialist and making some lifestyle adjustments should help alleviate your symptoms. If your symptoms persist or worsen, do not hesitate to seek further medical evaluation. Remember, maintaining good sleep hygiene and staying hydrated are key components in managing your throat health.

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