Every day I cough up what looks like a scab with ugly mucous and blood

Posted by needtoknow @needtoknow, Feb 10, 2016

Every day I cough up what looks like a scab with ugly mucous and tiny amounts of blood. It seems to come from the back of my throat or nose. My doctor has seen the scab but does not see anything wrong. This, to me, seems really odd. Has anyone had this problem?

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I made an account here just for this issue. I have been having this for around 4 years now, weirdly it started after I ate a cup of really spicy cup noodles and felt a burn in my throat. Not sure if it sounds dumb, but maybe the spice made my throat raw, and because throats are always so moist it just never heals? But @ben1985 mine look just like yours, and match all the descriptions. Any resolution for anyone/do you remember around when it started or what may have caused it?

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@jfvero

@klpdx, @reebobbin I have the exact same picture. Thumbnail sized “Scab”, slightly cupped form, with mucus.

I was coughing one up about every 3 weeks. Since having surgery last June to correct a deviated septum, I have great air flow, but am now consistently coughing up one of these scabs every 3 days.

Post surgery I brought this condition to my ENT/Surgeon, which he scoped me and can see the “Crusting”; He reviewed the MRI that I had prior to surgery – No evidence of any abnormality. November he ordered a CT Scan – No evidence of an abnormality/cancer. January he biopsied the nasopharynx where the scab grows – No evidence of cancer… but no conclusion either. I suggested a problem with the adenoids, but he doesn’t think so.

He suggested coming back in 3 months and see if the condition still exists. I’ll be going back late in March … looking forward to hearing if you have any further updates. I plan to share this information with him when I see him next month.

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I have been having these for years, ENT looked through nose to adenoids and said they were scabs on my adenoids, only option was a biopsy and I never went back. He didn't take a sample while he was looking at my adenoids or anything. In a different ENT's office, I actually managed to "suck" one up while he was examining me. For some strange reasons, he looked like he would throw up if he had to look at it. I actually get a sore throat a day or two before the "scab" decides it's time to make me force it up through my throat. Like other posters on here,I hate to show totally gross pictures doctors won't even look at, but I was thrilled to see one on here just like the ones I get up. I have actually put one of these gross things in a little bottle and took it to family doctor who won't even look at it. If they can't stand to look at them, how do they think we feel.

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Just as a follow up to my post of April 25, 2020, as part of my background, I got an airborne mycoplasma pneumonia in December 2012. According to my Lung doctor, this particular mycoplasma bug lies dormant in your system and can re-occur in the lungs, bronchial tubes, sinus, and other places. Since then I have had acute bronchitis a couple of times, sinus infections, and pneumonia one more time. I honestly do not remember whether or not I had these scabs prior to that or if they started out after 2012. There have been times when I've had as many as one a day, or as only a few in a whole week. They do seem to disappear for a short time after being treated with different antibiotics for different upper respiratory infections. But they always come back. Just throwing the mycoplasma bug out there to see if any of you affected with this horrible problem have ever been diagnosed with a mycoplasma infection. There are times when the scabs are so big, I don't think I am going to be able to hack them up. And like some of you said, it's embarrassing if you are out in public and have to cough one of this up. I guess I am just looking for a link that some of us might have that would explain this and why the doctors don't seem to be worried about it. And why nothing we do fixes it?

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Hello @hereforinfo, @jmcgeorge, welcome to Mayo Clinic Connect.
It's definitely frustrating to have these symptoms without knowing what's happening and the solution to it. I'm inviting @jvfero back to the discussion to share his journey of finding diagnosis and treatment for coughing up scabs, and new updates if possible.
@hereforinfo, @jmcgeorge, what have you been doing to help with the symptoms?

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I can’t believe it! I’m not alone! I have been coughing up scabs just about every day for years. Some are tinged with blood, others are covered with mucous. But they always have this in common: they are the same size and shape, and are always hard, flat and disk like. My adenoids were removed 40 years ago, and I’ve always been confused as to what they are and where they come from. Initially I thought they were coming from my lungs because of the amount of effort needed to dislodge them. But now I can almost feel an irritation deep in my throat as soon as I cough one up. Strange little “boogers”. Thanx for all your posts and ideas. I will continue to seek answers.

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@kewpie

I can’t believe it! I’m not alone! I have been coughing up scabs just about every day for years. Some are tinged with blood, others are covered with mucous. But they always have this in common: they are the same size and shape, and are always hard, flat and disk like. My adenoids were removed 40 years ago, and I’ve always been confused as to what they are and where they come from. Initially I thought they were coming from my lungs because of the amount of effort needed to dislodge them. But now I can almost feel an irritation deep in my throat as soon as I cough one up. Strange little “boogers”. Thanx for all your posts and ideas. I will continue to seek answers.

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Welcome to Mayo Clinic Connect, @kewpie. Have you consulted an ENT specialist about this issue?

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I have had the same problem on and off again for the last two years. It has gotten progressively worse. It used to be one a month, since June it has been every three days to everyday. Does not look like anyone has come up with a cure. Most of the time scab comes out with little effort, but there are times it takes a lot of effort and gets stuck. It feels like I'm going to choke. Has anyone in this group had any luck getting the scabs out with a neti pot or Navage?

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@rebeccamcroberts

Hi @needtoknow . How long have you been experiencing this? Do you have a fever or any shortness of breath?

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Hello Rebecca. I've had s similar problem coughing up a scab-like, brown substance from my throat when I first get up and brush my teeth. I also have a thyroid issue as well. If this substance is not coughed up in the morning I will feel it later when I'm drinking coffee. The heat from the coffee loosens the scab enough to expel it. I'm not sure what causes this and no one has ever told me why it's happening.

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Good afternoon everyone! I posted on here a while back about my journey with these frustrating things. The ENT looked into my nasal cavity and noticed they were attached to my adenoid. He scraped it off and said the adenoid underneath looked normal. However, the presence of this clump of mucus was NOT normal. So the ENT had me flush with a nasal rinse twice a day, use Flonase twice a day and added Azelastine twice a day. I did this for almost two months (November - December) last year. It did reduce the frequency of these from about one a day to about one every ten or so days. It also made them a little bit less thick in consistency. Needless to say this did not solve the problem.

When I went back for a follow up my ENT recommended I get my adenoid taken out and have some biopsies done. So we did that at the end of January. My biopsies came back normal however I did have a positive culture for staphylococcus aureus. He prescribed me clindamycin. After some surgery complications and finishing off my antibiotic these things came back with a vengeance and were happening every day again. In fact they were now far larger than before, I am guessing they were filling the area where the adenoid was. So my ENT ordered a CT scan of the sinuses. That too came back normal. The one thing my ENT did say before and after the surgery and CT was that I have an area near my adenoid that sticks out a little. He tried to flatten that out the best he could when he took my adenoid out but couldn't reduce it completely. My ENT also told me that he expected the biopsies were going to come back with some issues. When they were clear he was somewhat surprised as he hasn't seen this kind of thing before. As time went on my scabs got less in frequency and size until they were almost nonexistent. When I went back for a two and a half month follow up my ENT said everything at that time looked good. There was no scab and honestly I hadn't had a scab for a few weeks at that time.

Now fast forward to now. The scabs are back and they occur anywhere from every day to one every few days. They are still alot smaller than what they were when this journey began. I have been racking my mind trying to figure out if there is an environmental connection. I have changed soap, deodorant, toothpaste. I've stopped taking supplements and vitamins for an extended period to see if that did it and so far no connection. The only thing I can think of is that perhaps it is my indoor AC/Heating. I say this because when I had very few scabs for that time period before my follow up...our AC had been off because the weather was nice. With it being much hotter since then...our AC has been on almost every day. So perhaps there is a connection there. We always change our filters and keep our vents clean so maybe it is something else related to the AC?

Here is a little more info that may be related to this and that perhaps might be a common theme amongst all of us? I take the following prescriptions: Pantaprozole (Proton Pump Inhibitor) for GERD since 2007, Nortryptiline for IBS since 2007, and Metroprolol since 2013 for high blood pressure. I am not overweight. I exercise at least four to five times a week; both strength training and cardio. I am in my early forties. I don't smoke and don't drink. I did have a period of almost three years where my liver enzymes were slightly elevated. I went through all kinds of tests, including a liver biopsy and all came back negative. Those values returned to normal about two years ago and the last time I was tested (six or so months ago) one of the values was just a few clicks above normal. So who knows what that is all about or if it even ties in to this...

In short, after all of that, this is what the doctors have concluded at this point in time: THEY HAVE NO IDEA. They have told me the same thing they told me about my elevated liver enzymes...this is a new "normal" for me.

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I get these same things every 3 days, dating back to winter 2019. I’m 28 with no previous surgeries (other than dental) or removals of anything. I will say the most frustrating and tell-tale sign for me is the moment I dislodge the scab on the sliiiightest, or the thick (rather than hardened) mucus starts to become too great, I can tell I have a new one by the unpleasant smell/taste.
I have yet to see a Dr so I have no advice or insight on that but I wanted to pop in and say that I have an impossible time coughing, sucking or clearing my throat to get to this AND I want to avoid this being in my mouth at all costs so I’ve adapted to blowing it out through my nose.
Basically, just create the same pressure one would to get a deep nose blow - but attempt to start the air pressure from the bottom of your throat. I can literally feel the scab dislodge from back up behind the roof of my mouth area and enter my nose to be blown out. It takes 2-3 good pushes, far less noise & awful taste or accidental throat scratching. Also strange - as it comes from my throat it can come out of either nostril so it’s always a toss up.

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