Bleeding throat?? Worried, please help

For the last week, I have been waking up in the middle of the night, feeling as though I am choking and when this wakes me up, my throat feels sore and heavy. I immediately go to the bathroom and spit into a tissue and there is blood in my saliva . I spit and clear my throat a few times just to clear it (sorry to be gross) until it lightens up and can hardly see it. It doesnt happen every night but I would say most mights this week. I have been having throat problems for many years and I went to see an ENT in January 2011 who looked at my throat and did a Laryngoscopy. He didnt see anything other than inflammation and did not recommend me to come back. However, at the time I was not having any blood. The ENT Doctor said that if I keep having problems to go and see a Gastroenterologost as it may be acid reflex causing my throat problems. However, I am taking the GERD medication and now this is happening. Because of the soreness on one side of my throat and the blood I am starting to think it may be something else. I also have a bit of soreness in my ear (the same side of my throat that hurts)  My doctor is reluctant to send me back to the ENT but I think I should go. Any ideas what could cause your throat to bleed at night with a sensation of choking/gagging and soreness until it clears? Any help would be greatly appreciated. Thanks

[David Tinkelman, M.D.]

Your being seen by an ENT physician was a good decision and the recommendation that you see your primary care physician or a Gastroenterologist (GI) is sound.  Your symptoms do have the earmarks of GERD or acid reflux and the apparent non-improvement with your taking “GERD Medication” does not rule-out that diagnosis.  Such medication is often, but not always, effective in the treatment of GERD.  In addition, you do note that the ENT “..didn’t see anything other than inflammation.”  That he did see inflammation is important, calls for an explanation  of the inflammation, and would be consistent with the diagnosis of GERD.

I favor your seeing a GI doctor in consultation and, if not done at the time of the original ENT assessment, that you check with the ENT about the possible value of a CT scan of the nose and sinuses.  At that time, I would also ask the ENT if he/she might specify other (than GERD) possible causes of the “laryngeal inflammation.”  That inflammation could well be the source of blood in your saliva/sputum and just not have been bleeding at the time of the laryngoscopy.

One other possibility could be that your esophagus, inflamed by GERD or not, could be the source of bleeding and exam of the esophagus would be a logical other place to look if no other source is demonstrated.

Good luck