Hi,

Thank you for your query.

1. A small amount of blood spotting or streaking after coughing up phlegm, especially in the mornings, is not a cause for worry.

2. However, since you also have hives, you should get examined by an ENT , Dental and Skin Specialists.

3. Fresh red colored blood means it has come from the upper gut. Blood from the stomach is dark brown or black due to the action of gastric acid. Meanwhile you may inspect your gums, especially between the teeth, and oral cavity including around and below the tongue for any obvious source of this bleed. This may also be a cause for the hives.

4. Lymphoid tissue is abundant in the throat. It is very delicate and bleeds easily during coughing. Erosive esophagitis or gastritis is another probable cause. Check your detailed endoscopy report. The foreign body feeling in your throat may be due to a post-nasal drip, granular pharyngitis or acid relfux.

4. Your physician may also examine more thoroughly besides endoscopy (which seems to be normal), especially to rule out any growths, conduct scans, dental check-up and blood tests including a coagulogram if this is a recurrent problem.

5. Do you have any other significant past history and are you currently on any medication? Is there any history suggestive of oral injury due to a sharp food item or food contaminant (foreign body)? You need not take any immediate medication if there is no further episode besides medicated gargles and Vitamin C (especially if you have exposure to tobacco smoke).

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards.

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Hi,

Thank you for writing back.

1. Get a video laryngoscopy done. This will help identify any problem in the throat.

2. Get a Chest X-ray and an opinion of a Chest Specialist. You may also get a Sputum examination done for three consecutive days.

It is good to hear that your dental check-up and blood tests are within normal limits.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards.

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Hi,

Thank you for writing back.

1. No, at your age, cancer is very unlikely.

2. Any cancer will show up on regular follow up. Ear detection is the key to a cure.

3. There are many other causes for bleeding from the throat which need to be ruled out first.

4. Cancer cure rates are improving every year with early detection and newer treatment options.

5. This episode would be a good reason for you to give up smoking.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards.

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Hi,

Thank you for writing back.

1. Nasal bleeding may explain why the endoscopy was normal.

2. I was contemplating on mentioning the possibility of a nasal bleed (recommend a nasal endoscopy) and post nasal drip but did not mention it earlier as you had not given any such history.

3. Hence you must now get a check nasal endoscopy done.

4. The hives can be controlled with anti-allergic medication and steroids till the cause is identified.

5. The twitching movement of the eyebrow and lips are not considered significant.

6. If your Chest examination, chest X-ray and Lung Function Tests are normal, the possibility of lung disease at your age is very low.

It is not troublesome at all for me to explain your questions in detail. These are common symptoms and once the cause of your bleeding and hives is identified, they can be cured.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards.

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