Airway bleeding: Bleeding from the mouth or nose

Bleeding from the Airway. Bleeding from the lining of the upper airway may present in three ways: spitting out fresh blood (or blood-stained mucus) from the mouth, or blood coming from the nose (epistaxis), or blood from both. When such bleeding occurs, it is important to be evaluated thoroughly as bleeding may be a sign of a serious underlying condition such as Head & Neck Cancer (cancer of the mouth, throat or sinuses).

However, there are many other less serious causes of bleeding from the upper airway, such as gingivitis (inflammation of the gums), trauma (injury), fragile blood vessels in the nose or throat, or infection of the nasopharynx (the top part of the throat) or of the sinuses. 

How do we evaluate bleeding from the airway?

People with bleeding from the airway are evaluated by taking a thorough medical history and by performing an examination of the upper airway, including endoscopy. Standard endoscopy of the throat is called laryngoscopy, in which an endoscope (a slim tube with a camera on the end) is passed through the nose using local anaesthetic to examine the airway. A biopsy (a sample of tissue) is performed if any unusual masses or ulcers are found. Additional investigations such as CT scanning may be required.

Bleeding from the airway may be intermittent, and so sometimes, repeated examinations are required to determine the cause of the bleeding.

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