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

routine

Searchingforrelief -- I private messaged you the contact information several weeks ago ... checking to see if you were able to make contact

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That's tough when you've been to the doctor so many times and you still don't have a solution.

May I ask if you went to the same ENT each time or did you see second opinions?

Hello everyone, thank you for the replies, I just wanted to provide an update. Since posting, I've had a biopsy of my nasopharynx where the andenoids are. I was told there is no cancer, but my tissue tested positive for a bacteria called Eikenella Corrodens. My ENT told me this diagnosis is perplexing to him because many people normally have this specific bacteria in the nose naturally, but not necessarily in the actual tissue (from the sample of skin he took out). I have already taken a round of clindamycin for 10 days due to my crusty phlegm sample testing positive for heavy growth staph areus. Now, my ENT says he thinks he'll prescribe me a second round (now a month later) because the Eikenella is resistant to Clindamycin and I'll now be taking Augmentin. I don't know if perhaps this is a co-colonizatiom between the two bacterias? Or, all part of normal flora and is just a coincidence and I just a nasal irrigation issue... or both. Since my biopsy, I have only coughed up just 1 phlegm which was super bloody from the biopsy but it's been a week and nothing since. I plan on waiting till I cough up another one and then start the 2nd round of antibiotics while starting nasal irrigation twice daily as many of you have recommended. Thank you all for the feedback, please let me know if any of you have a similar diagnosis or thoughts about the Eikenella in the nasal tissue! I am also scared to take antibiotics because clindamycin is strong and that was just a month ago so I might wait a little....

I have had the exact same issue consistently for 2 years straight. I've had it off and on for several years before that, usually a lingering side effect from a cold or strep throat, but it would effectually go away. Not this time. I have no sinus issues, but I no longer have tonsils and get strep throat every few years (my doctor thinks one of my kids is a carrier). I have not been on antibiotics for over 3 years, so i can't rule out a long term bacterial issue. (Not even sure if they can linger that long?).

I am convinced my Silent Reflux is the current cause of my excess mucus. I also think those of us that have this dried plug form have a particular spot to harbor it, that maybe others don't. It's a bit of a perfect storm, which is why it may not be as common as it should be. I plan to see a Naturopath about my reflux, as i don't want to use the medication.

One tip i wanted to share is an easy way to dislodge the scab/ plug. Gargling! I lean my head waaaay back and gargle with warm water, almost swallowing it at the end. This could mean my "spot" where the scab forms is lower than other people's spot. Mine is right at the very bottom of the nasal cavity, right around the eustachian tube oriface. Hacking doesn't work (that brings stuff UP)... it needs to be brought down with a snort, and then coughed up. It almost feels like i just need to get it around a "corner" - like it's forming on a ledge. And it's attached to the ledge with very thick, sticky mucus, like glue! It's no wonder it can be hard to dislodge! But the gargling works. And so much relief afterwards! Until 2-3 days later when another one forms.

Interestingly, when I talk a lot - like in the phone, it dislodges itself! So the response to larynx activity suggests that it could be forming on, or very close to, my larynx. Sometimes it's slid down my throat, because I'm unable to get to a bathroom to cough it up. That is not fun!

Anyway, I'll post again after I've been to a Naturopath. I hope the gargling helps some people!

Hello @pokee and welcome to Mayo Clinic Connect. Thank you for joining this conversation and providing support to others who have similar experiences and for the offer to come back and provide an update following your Natropath appointment.

How can members support you best?

Reply to pokee : you wrote the most accurate description I've seen. It does feel just as you describe. I too sense there is a spot, crevice that it accumulated in. One ent dr told me it looked like i had something called a thornwall (sp?) cycst, he said maybe accumulated there. (A small pocket in the nasal area, can look it up) It shows in x-ray, but I couldn't tell if the location was quite where I sense it to be, just as you described. Gargling does help it, other times it loosen without warning. sometimes when talking, i also have it happen while eating. Yuck. I always keep napkin/tissue near by. I've learned to live with it, although can't stand it. but would be great if anyone ever figured it out for sure! I think it may be like you said, some people have this area it gets stuck, others don't. Or if some others do, they don't happen to create as much nasal drainage. It seems combination of extra more frequent drainage and a place it gets built up. Excellent description you gave!

@jea1 Yeah, I used to have that many times per day. Then a doc decided he should find out, so he wanted to cut off a sort of cyst or macular skin from my larynx. Then I learned I have Barrett's Esophagus (genetic), which should not have cause the growth on the larynx. We decided not to operate on the Barrett's, and the surgery on the voice box seemed more urgent, and turned out to be Amyloid on the larynx, as well as the Barrett's. Then Mayo took out most of my Thyroid, so I started taking levothyroxine. Anyway, nothing is simple any more. The Barrett's is still growing, but I should be dead before too many more years, anyway. I am 81, with several fatal diseases.

I haven’t had any improvements with my nasal scabs. I posted here back in 2019. It looks like people have had some success with regularly blasting their noses full of saline solution. Will try that and report back.

Navage 1-2 times daily and a nasal emollient daily - Ponaris is what I use. It's a question of maintenance forever I'm afraid, if you suffer from it. Totally worth the effort/cost though. I used to live in fear of one of those things dislodging in front of other people!!