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Dr Chip (M.D.)
Dr Chip (M.D.), Doctor
Category: Medical
Satisfied Customers: 32187
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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Why do I spit blood in saliva when I wake up in morning?

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I spit blood only when I wake up from sleep even without coughing.

So this is in your saliva or is it that you cough it up? When you wake up normally in the morning, or is this suddenly waking up in the middle of the night? Other medical conditions/medications? Has your doctor had anything to say about this?

Customer: replied 6 years ago.

It is in the saliva and when ever I wake up, even in middle of the night, and in the morning when I spit it is bloody. I am not taking any medications.

And none of your doctors has made any comment? Have you had a CT or MRI of the head?

Customer: replied 6 years ago.

No, why?

Well, first off, have any of your doctors said exactly where they think the blood is coming from. I assume they have ruled out lungs and GI tract and sinuses?

Customer: replied 6 years ago.

No one said exactly from where it is coming. No one ruled out the sinuses, but if it's from the sinuses why is it coming only after getting up from sleep?

Well, the sinuses, when they drain posteriorly, as in post nasal drip, get that drainage mixed in with the saliva. I'm not saying this is just a chronic sinusitis, but I'm saying that if this isn't from the lungs or GI tract, then about all that's left is the upper respiratory tract--the sinuses, the nasal passages, the adenoids, etc. You could also have a polyp in the area. I would suggest you see an ear, nose, and throat specialist for this, because the only areas left to evaluate are above the tonsils, so to speak.

Customer: replied 6 years ago.

When I made the endoscopy, the gastro said there are 2 ulcers in the stomach. Is it possible that it is from those ulcers? If it is sinusitis, why is it only when I get up from sleep?

Were the ulcers bleeding, and how were they treated? Didn't you understand when I said that sinus drainage, especially when lying down, goes backwards into the back of the throat?

Customer: replied 6 years ago.

The ulcers were not bleeding. The Dr. prescribed me aciphex for them. You didn't explain that when lying down blood from the sinuses go to the back of the throat.

Ok. Drainage from the sinuses is into the back of the nasal passages and then it can come out either through the nostrils or it can drain backwards into the back of the throat and then can either be swallowed or mixed with saliva and expectorated. It's possible that the ulcers could be the cause here, but more likely, as I said before, that the problem is in the upper airway. Obviously, when one is lying down, if there is drainage into the back of the nose, it can more easily run backwards into the throat.

Customer: replied 6 years ago.

The first spit after geting up is only very lightly red, every spit after that is more and more bloody. This goes on until I rinse out my mouth very good.

And a thorough examination of your mouth, gums, throat, etc. hasn't revealed any abnormalities? After that, the saliva clears completely?

Customer: replied 6 years ago.


Then all I can say is that the blood must be in the back of your throat, perhaps mixed with mucus and clinging to the pharynx, and, as you spit and salivate, it loosens and is expectorated.

Customer: replied 6 years ago.

Examination didn't reveal anything. After rinsing out my mouth a few times everything is clear.

Ok. What more can I add? It would seem that the source of the blood has to be from the sinuses and/or nasal passages.

Customer: replied 6 years ago.

What kind of treatments are available for this condition?

Well, that would depend on the diagnosis. If this is a chronic sinusitis problem and antibiotics and saline nasal rinses aren't effective, sinus irrigation by an ENT or sinus surgery with debridement of the sinus mucosa may be necessary. I'd start with a CT of the sinuses and antibiotics first.

Customer: replied 6 years ago.

I will make an appointment with an ENT.

Let me know how that goes.
Customer: replied 6 years ago.


Take care. Hope I made everything clear to you.

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