Blood in the Mouth: Causes, Symptoms, Complications, Diagnosis and Treatment

It can be alarming for many people, but it may or may not be associated with a serious illness.

People can spit blood, cough up blood, or even vomit blood, and the causes of this are very varied.

Blood in the mouth can come from the gastrointestinal tract or the respiratory tract, and the severity can vary depending on the cause.

Some people taste blood in their mouth every day. Consequently, they can no longer taste the food they are actually eating.

This condition continues for long periods until they lose their appetite.


The blood that appears in saliva usually comes from the mouth, nose, and other parts of the gastrointestinal and respiratory tract.

The gastrointestinal problems can cause coughing up blood, and these conditions include:

  • Inflammation of the esophagus
  • Inflammation of the stomach lining or gastritis.
  • Inflammation of the gums or gingivitis.
  • Ulcers in the mouth
  • Erosions in the lining of the stomach and small intestine or peptic ulcers.
  • Recent tooth extraction or dental work.

Bleeding can also come from respiratory tract problems, leading the person to find blood in saliva, such as:

  • Nose bleed.
  • Inflammation of the large airways or bronchitis.
  • Congestive heart failure, which causes blood to leak through the lungs.
  • Lung infection with pneumonia .
  • Pneumothorax .
  • Lung infection with tuberculosis.

There are less common, but more serious and life-threatening conditions that can cause blood to be found in saliva, such as:

  • Cancer bleeding in the mouth.
  • Bleeding from esophageal cancer.
  • Bleeding from esophageal varices, which are swollen veins in the esophagus that have ruptured.
  • Stomach cancer bleeding.
  • Bleeding from lung cancer.
  • Nasopharyngeal cancer bleeding.
  • Bleeding from stomach or intestinal ulcers, or perforated peptic ulcer.
  • Internal trauma and bleeding involving the gastrointestinal or respiratory organs.
  • Fluid build-up in the lungs (pulmonary edema) as a result of congestive heart failure.


There are several symptoms that can accompany blood in the mouth and depend on the cause.

Symptoms of the taste of blood in your mouth can be signs of some underlying health problems that need to be addressed immediately.

Symptoms related to gastrointestinal causes of spitting up blood include:

  • Abdominal cramps or pain
  • Bloating, bloating.
  • Bloody stools, which may appear red, tarry, or black.
  • Diarrhea.
  • Bleeding from the rectum
  • Vomiting of bright red blood or black “coffee grounds” material.

Other symptoms include:

  • Dizziness or vertigo
  • Fast pulses.
  • Lethargy, fainting, or changes in levels of consciousness.
  • Fatigue.
  • Pale skin
  • Soft spot.

Life-threatening conditions can be accompanied by serious symptoms, such as:

  • Loss of consciousness and lack of response.
  • Dizziness.
  • Breathing problems such as shortness of breath and wheezing.
  • Suffocation.
  • Severe abdominal pain
  • Soft spot.


Complications from the presence of blood in the mouth are usually the result of serious conditions, and these include:

  • Very low red blood cell count or anemia.
  • Circulatory shock
  • Need for blood transfusion.
  • The cancer has spread and invaded other organs.
  • The infection has spread.


The physical examination is oriented in the search for:

  1. Blood or bruises in the mouth (from the gums, tongue, etc.).
  2. Bright yellow or needle-sized spots on the tongue, under the tongue, on the roof of the mouth, and / or on the inside of the cheeks.
  3. Blood coming out of the mouth.

The doctor will try to find out if the blood is really coming from the airways or the lungs.

It should be checked if it is a hematemesis, that is, when the blood rises, you vomit, but vomiting can cause you to cough when vomiting or a pseudohaemoptysis, that is, when the blood comes from somewhere in the mouth or the nose and down the back of the throat, causing a cough.

For example, from a nosebleed or a sore throat. By clarifying that the blood is true hemoptysis and the cause is unclear, the doctor may order one or more tests.

Tests that are commonly done after unexplained hemoptysis include one or more of the following:

Chest x-ray

An ordinary X-ray is a quick and easy test. It may be all that is needed to diagnose or evaluate various problems. However, an ordinary radiograph has limited use.

Other tests may be needed if the diagnosis is not clear on a common X-ray image.

Computed tomography

A CT scan is a specialized X-ray test.

It can provide good images of soft tissues in the body that do not show up well on normal X-ray images.


A bronchoscopy is a procedure that involves the large airways (the trachea and bronchi). A fiberoptic bronchoscope is the most commonly used device.

This is a thin and flexible telescope, it is almost as thick as a pencil. The bronchoscope is passed through the nose or mouth, down the back of the throat, into the windpipe, and into the bronchi.

The fiber optic allows light to shine around the curves in the bronchoscope and thus the doctor can see clearly into the airway.

Blood test

A variety of blood tests can help diagnose various conditions.

Other tests

Several more sophisticated tests and scans may be recommended if the diagnosis or extent of the problem is unclear despite the above tests.

Gastrointestinal tract bleeding can be diagnosed by inspecting the organs using an endoscopic technique, where a minimally invasive device that has a camera is passed from the mouth to the esophagus and stomach.

When the underlying cause of bleeding is identified in any part of the digestive tract, treatments can be applied using the same endoscopic technology.

Infections such as tuberculosis in the lungs can be treated with antibiotic medications.

Coughing up blood from the respiratory system can also be examined and treated through an endoscopic technique called bronchoscopy.


Occasional bleeding from the mouth and gums can be treated with proper oral hygiene. However, more serious causes require more intensive medical attention.

Active bleeding in the upper GI tract can be controlled by using heat to cauterize, injecting chemicals directly into the site with a needle, or cutting a bleeding blood vessel through the endoscope.

If bleeding cannot be controlled with this technique, surgery may be required. Recurrence of bleeding can be prevented by taking prescription drugs.

A bleeding bronchial artery can also be blocked using metal coils or other substances in a technique called embolization.

Severe bleeding in the lungs may require lung resection or pneumonectomy.

Cancer in the respiratory or gastrointestinal tract can be treated medically or surgically, and may also require chemotherapy with or without radiation therapy.

Inflammatory conditions may also require steroid therapy.

People who lose large amounts of blood may need blood transfusions or other special medications to reduce blood loss.