I have pretty bad acid reflux, have been treating with natural supplements, then I came down with a pretty bad cold/flu - not sure which one. Last night, after dinner, heartburn got so bad it was causing me to cough and then vomit, Not too unusual for me, but during the last occurrence of vomiting, there was a tiny spot of blood streaked in clear fluid. It was less than the size of the cotton part of a Q-tip, and it was not bright red, rather a more brownish-rusty color. I am not experiencing any abdominal pain and that was the only occurrence. Is it safe to assume that my throat was irritated enough between the acid reflux, coughing and vomiting to cause that? I am familiar with what a Mallory-Weiss tear is, but logically, it would seem if I did have one, it would seem to be not bad enough to warrant yet another trip to the doctor with that small of a spot, and it only happening once. I am a female, age 33, 5'4, 117 pounds and diagnosed (within the last year) with GERD, chronic fatigue/ME and late-onset juvenile diabetes (in 1999) prone to hypoglycemic episodes.