1. < Ear, Nose & Throat (ENT)

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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jfvero | @jfvero | Apr 12, 2022
In reply to @momomouse "Hi jfvero, I posted last night when I ran across this thread and your posts were..." + (show)
@momomouse

Hi jfvero, I posted last night when I ran across this thread and your posts were encouraging. Are you still having problems or doing your routine to prevent? Previously, my research led me to believe that I could have an infection that bounces back after antibiotics due to biofilm. I wasn’t sure how to disrupt the biofilm to the adenoid area so that’s great to hear about the j&j baby shampoo. Hopefully my next ENT can help me pair a new antibiotic with a biofilm treatment routine. Could you pass along the specialist’s info that you saw? I’m in Missouri but I don’t want to sit through another year of arguing the existence of a daily problem with someone who is afraid to admit they don’t know what’s going on.

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Hi Momomouse, I PM'd you with the details of the Dr, in Philadelphia.

Yes, the scab went away for 6-months once, but returned. It seems to flare up when I'm doing woodworking with lots of dust.
It's less often (Once a week) then it was immediately after my nasal surgery, which was every 3 days.

I can't say that I stay on top of the daily regimen. I've become lazy and only do the nasal flush once or twice a week.

While many of the posts here use the nasal flush to dislodge the scab, it’s really the prevention of the biofilm that needs to be focused on. If the scab dislodges, rinse with the saline + J&J to try and defeat the biofilm. See my previous post with picutures - Nov 23, 2020.

Also, from what I was told, it's not really an “infection”, but rather a staph colonization. Yes, it does respond to antibiotics, but the Dr told me not to think of it as an infection.

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jea1 | @jea1 | Apr 26, 2022
In reply to @momomouse "Hi all, I just created an account so I can come back later and read through..." + (show)
@momomouse

Hi all, I just created an account so I can come back later and read through everything. 3-4 years ago I started getting drainage every few days that was difficult to swallow. I never had allergies so I figured it was that. It progressed to last year where I was having issues daily. At some point I realized I could see the mucus at the back of my throat: thick, white, rope-like. I get it periodically through the day now, normally a bit I’m the morning, maybe around 10, then around 2, then always around 5-6, then a couple times in the evening. Now it dries out into large circular clumps, sometimes yellow, or green, or bloody and I can feel it drying out then have to hack and snort until it dislodges and I feel it drop from my adenoids. Sometimes it’s just thick mucus and sometimes it’s dried like a scab. My ENT didn’t believe me about the drainage at first and claimed allergies or acid reflux. Tried treatment and testing for both. He then tried an antibiotic followed immediately by a CT scan. It cleared for a week or two and this the CT was clear. He finally saw it on a scope and saw that it was coming from my adenoids. “Crusted and weeping”. He was very concerned at this point. Tried another antibiotic and a steroid nasal rinse. Very mild relief. He tried to declare me healed when he didn’t see an active drainage event the next time. I kept pushing and insisted on a biopsy (he first suggested it then tried to convince me otherwise the day of the appointment). It showed tissue necrosis due to chronic inflammation and nothing else. No fungal, no viral, no bacterial, no malignancy. I tried prescription strength mucinex and it may or may not help? His suggestion is now adenoidectomy. I am 30, female, very mild allergies (according to testing), wide air passage, normal anatomy, non-smoker, rarely drink, not very active but eat fairly well (have to reduce carbs due to GI enzyme deficiency). 125 pounds, otherwise pretty healthy but history of chronic bronchitis after every cold (probably due to poor sleep hygiene and stress). Rare issues with asthma. Recently diagnosed with sleep apnea. Still have my tonsils, never had issues with them. I have some thyroid cysts/nodules but haven’t grown under observation for a few years. My adenoids are not enlarged, just inflamed.

It keeps progressively getting worse. I often can’t dislodge the mucus plug and end up gagging, dry heaving, coming super close to vomiting. I had to pull of the highway the other day because I couldn’t move my throat muscles without violently gagging. The mucus is incredibly thick and sticky so it sticks to my gag flexes.

I get married at the end of the month and will be spending the day swishing mouth wash to get rid of the mucus smell on my breath. Post wedding, I will select 1 of 2 doctors he recommended for a second opinion.

I work in a very small print shop internal to a business office and live in an 103 yo house but I think these problems first started at my old job and in my old apartment but I don’t want to rule out environmental factors either.

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thanks for posting that you got a dr to "biopsy" it, (i assume you meant they examined the discharge/scab, or did the dr. actually biopsy tissue from your nasal passage?)
i feel for everyone here. i've had this for at least 20 years, and wondered about it for as long. I only found this thread a year ago, and was hopeful to get some shared experience, find some answers. I saw ent today, and after he did the camera in and down the nose, right after i hacked the thing up. I mentioned this web forum, and told him how strange this issue is, etc. .. he had no interest at all. i guess to them they just think it's another regular nasal "snot". To all of us here we know how annoying it is, and as you mentioned when it gets stuck, you gag yourself almost to death trying to dislodge it. 🙁 Also I've lived and worked many different places in the 20 + years I've had this. i thought environmental issue too possibly , and it may still be, but i didn't have much change from place to place. For my case it seems to get better or worse of it's own accord. best wishes to everyone here. maybe some dr someday will have a better approach to this issue and give all of us some clarity on why it happens.

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vcoufal | @vcoufal | Apr 28, 2022
In reply to @needtoknow "Hi rebecccamcroberts. No fever or shortness of breath. It has been going on for over 6..." + (show)
@needtoknow

Hi rebecccamcroberts. No fever or shortness of breath. It has been going on for over 6 months. I have gone to several ENT doctors and to walk-in clinics. No one seems to be able to offer me a cause or solution. I have taken antibiotics, used nasal wash, Mucinex, etc. I need to find a doctor who can examine me and find out why this is happening.

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@needtoknow I was kind of happy to see your remark, as I have been suffering from this for a couple of years. 2 to 3 At least. I've never been able to find any information about it or anyone else who's ever experienced it, and like you none of my doctors have made any comments even though I have sent them pictures. asked about it a 100 times To every doctor I've seen for any reason I never get any response, any input, any opinion, nothing.

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1 reply
needtoknow | @needtoknow | Apr 28, 2022
In reply to @vcoufal "@Needtoknow I was kind of happy to see your remark, as I have been suffering from..." + (show)
@vcoufal

@needtoknow I was kind of happy to see your remark, as I have been suffering from this for a couple of years. 2 to 3 At least. I've never been able to find any information about it or anyone else who's ever experienced it, and like you none of my doctors have made any comments even though I have sent them pictures. asked about it a 100 times To every doctor I've seen for any reason I never get any response, any input, any opinion, nothing.

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I sympathize with you. It is very annoying and frustrating. I feel as though I have to constantly be clearing my throat which is exhausting at times. I told myself I will go to one more ENT doctor about this problem and if he/she has no solution, I will just have to give up. I will post my results of this last try to find the problem. It will probably be in two months or so as it is very difficult to get appointments with doctors these days. Will be thinking of you and hoping you find someone who cares enough to find out what is causing this problem for you.

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am31 | @am31 | May 3, 2022

Hi all, I am writing this post in the hope that it may bring some of you hope and hopefully even relief. I had this issue of bringing up thick phlegm (like some of you have shared in photos) on a daily basis for over three years. I tried different types of antibiotics, I saw an ENT, I tried dietary changes in case it was caused by reflux, I tried Nexium and Pariet, I tried going dairy free in case it was an allergy, the list goes on. Just when I had almost given up, I thought I’d try going off my birth control pill to rule that out. To my amazement, within weeks/days after going off my birth control pill, the phlegm problems stopped. I asked my doctor to prescribe me a different type of birth control pill (albeit more expensive) and I am now feeling my healthy self again! I wanted to share this as I found comfort in finding this forum and I really hope this may bring some of you comfort and relief too.

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1 reply
searchingforrelief | @searchingforrelief | May 5, 2022

I hope this continues to be a successful solution!

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searchingforrelief | @searchingforrelief | May 5, 2022
In reply to @hayroe "I have learned that if you have a divit in your nasal passage where bits can..." + (show)
@hayroe

I have learned that if you have a divit in your nasal passage where bits can collect, they will. As most nasal cavities have staph, a pool of infection grows and gets too large for the space & breaks off. There is no way to remedy the situation. The nasal wash can help, but not much. I have noticed that through the pandemic and with mask wearing I've been free from this twice weekly event for almost two years.

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How did you learn about this? From and ENT?

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Moderator
Colleen Young, Connect Director | @colleenyoung | May 6, 2022
In reply to @am31 "Hi all, I am writing this post in the hope that it may bring some of..." + (show)
@am31

Hi all, I am writing this post in the hope that it may bring some of you hope and hopefully even relief. I had this issue of bringing up thick phlegm (like some of you have shared in photos) on a daily basis for over three years. I tried different types of antibiotics, I saw an ENT, I tried dietary changes in case it was caused by reflux, I tried Nexium and Pariet, I tried going dairy free in case it was an allergy, the list goes on. Just when I had almost given up, I thought I’d try going off my birth control pill to rule that out. To my amazement, within weeks/days after going off my birth control pill, the phlegm problems stopped. I asked my doctor to prescribe me a different type of birth control pill (albeit more expensive) and I am now feeling my healthy self again! I wanted to share this as I found comfort in finding this forum and I really hope this may bring some of you comfort and relief too.

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@am31, I can imagine your delight that the phlegm issue was resolved by changing prescriptions. What led to your asking your doctor to try a different birth control pill?

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bblank0025 | @bblank0025 | May 13, 2022

I am looking for answers in any possible way so I appreciate you reading this post. In February 2020 I started to cough up stick and rubberily mucus, like snot. In May 2020 I started to cough up the strands you see in the photo. Since then I cough up two to three of these PER DAY. Between May 2020 and January 2021 I had more than 20 different tests performed to find the issue/source. In January 2021, a Gastroenterologist told me the source was my stomach because there was a hiatal hernia preventing the "flap" to function. The doctor recommended a Nissen Fundoplication or a gastric bypass. The gastric bypass was an option due to being overweight and could solve other medical issues like HBP, pre-diabetes, and sleep apnea.

In June 29, 2021 I had a gastric bypass weighing in at 294#. My weight in January 2021 was 331#. I had zero (0) instances of mucus strands being coughed up from the date of survey until January 31, 2022. Nothing that I can control changed yet these strands came out of no where. Today I am coughing up at least two per day. My weight loss has stabilized and I weigh 192# today.

The doctors are starting to perform more tests and, honestly, I'm tired of the tests and exhausted at many levels. I can't be the only person in the world to have this experience.

Below is a summary of tests completed in 2020, 2021, and 2022.

Link to other photos-these are pictures of what was coughed up so far in 2022 (you will need to copy/paste the link:
drive.google.com/drive/folders/1lQOo84um1edxAexekWXRHtEQJj6Ym6Ih?usp=sharing

Anyone have any insight? Thank you for your time.

Tests/Procedures Completed in 2020
1. ENT (March 5)
2. Pulmonology (May 6)
3. X-ray Chest Frontal & Lateral (May 18)
4. X-ray Esophagus (May 20)
5. D-Dimer Test (June 19)
6. 1st Upper GI (July 6)
7. CT Chest #1 (July 23)
8. Allergy testing (July 23)
9. PFT (August 4)
10. ENT (October 8)
11. CT Sinuses (October 22)
12. 2nd Upper GI with Bravo pH monitoring (Oct 22)
13. CT Chest #2 (November 13)
14. Bronchoscopy (November 20)
15. Pathology Tests (November 20)
16. Manometry/ Esophageal Motility (Dec 8)
17. Blood work (December 21)

Tests/Procedures Completed in 2021
1. Blood Work (January 25)
2. Autoimmune Disease Panel (March 3)
3. ER Visit (March 2021)
4. Blood Work (March 23)
5. Blood Work (March 26)
6. Blood Work (April 2021)
7. GI Pathology (April 2021)
8. Rheumatology (March 3)
9. Blood Work (May 2021)
10. Blood Work (June 2021)
11. Roux-en-Y Gastric Bypass (June 2021)
12. Blood Work (July 2021)
13. Blood Work (September 2021)
14. Blood Work (December 2021)

Tests/Procedures Completed in 2022
1. Sleep Neurologist (February 2022)
2. Polysomnogram (February 2022)
3. Upper GI and Bravo (May 2022)
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noblelife | @noblelife | May 27, 2022

Hey Everyone! I posted awhile ago about this happening to me for now the last 2 years. I as well had posted some information about Thornwaldt cyst/disease crusting type. So I ended up bringing this to my ENT and he agreed it sounded like that could be the problem. I was excited as the fix seemed fairly simple. We did the MRI and unfortunately it did not show a cyst, but my adenoids (Yes I still had mine) were inflamed so he suggested taking them out. Im pretty against removing adenoids but I went for it just bc this "thing" is literally ruining my life. Once I healed from the surgery the issue persisted and to some degree seems to have gotten worse. So back to the ENT I went... that's when he did actually see the opening (Cyst) he was able to suck the stuff "Scab" out of the hole and I had relief immediately. (I have some symptoms that dont seem to bug some of y'all with this tho.. Occasional pain in the area of the "scab", I can feel the opening, severe anxiety/panic Once the scab comes up it stops for a bit, and sometimes the "scab" will be stuck up there for weeks and I can physically feel it up there it just won't come up no matter how hard I try to get it up) He needed to speak with some other people so he put me on a steroid nasal rinse for 3 weeks and I will return on Tuesday to see what he thinks. He does not know why it didn't show on the MRI. He was a little perplexed at the time so I have a lot of questions for him on Tuesday. I'll let y'all know on Tuesday what he is thinking.

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