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

I have the same thing occasionally, but mine comes out of my sinuses when I blow my nose.
I was never too alarmed over it. I figured it was a dry patch on the membranes that came off eventually. Could be wrong.

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Hello! I just found this thread today & created an account so I could comment. I’m wondering if what I’m experiencing is the same or at least similar to others here. I’ve read through the whole thread and it sounds like the chief complaint is having to dislodge/hack out a scab from the adenoid area every couple of days. I also seem to have a mucus-y clump that dislodges every week or so, but usually it’s relatively small and I can’t cough it out of my mouth— it just goes down my throat. In case anyone can bear to read a long story, I’ll explain my situation from the beginning.
On a day in late October 2020, I was out and about and suddenly felt like I was having a hard time getting air— almost like I was congested. I thought it might be Covid so I went to my physician and was tested and it came back negative. Because it wasn’t Covid they thought it might be heart burn, so I tried taking heart burn medication which didn’t relieve the breathing issue. After 2 more visits to my physician, some blood work, and a chest X-ray later, my physician said she thought it might be anxiety and that I should consider taking medication for it. I felt like my physician was wrong, so I visited an ENT (April 2021). My ENT used a laryngoscope to look into my nose and she said she was seeing adenoid hypertrophy and nasal turbinate hypertrophy. She believed I had an adenoid infection. She prescribed an antibiotic (clarithromycin), an antibiotic ointment (mupirocin), an antihistamine (azelastine), Flonase, Claritin, and a daily nasal saline rinse (NeilMed). I didn’t think my issues were allergy-related because I’ve never had allergies, so I didn’t take the Flonase or Claritin. I did use the other things prescribed, but nothing fully resolved my issue. I went back to the ENT (June 2021) a couple months later and she once again used a laryngoscope and saw minor improvements in the adenoid and turbinate hypertrophy, but there were still there. She also dislodged a mucus clump with the scope during the visit. She suggested I visit an allergist to see if allergies were the cause. I followed her recommendation to see the allergist and it came back with zero allergies. I also did a lung function test which came up clear as well. The ENT mentioned that if I was still having problems in 3-4 months, that I should visit her for an adenoidectomy. I’m pretty opposed to having surgery for something that I don’t even know what the problem is, so I haven’t gone back.
Since my last ENT visit in 2021, I haven’t seen anyone for the issue. Day to day, I’ve gotten used to the feeling of mild congestion and find myself swallowing a mucus clump that comes from my adenoid area about once every one to two weeks. Whenever I’m getting the mucus clump, I have little red dots on the roof of my mouth. I also have started to have minor headaches from time to time or just twinges of head pain pretty much daily. I’ve started to just feel generally unwell. My symptoms seem to improve and get worse and then improve again and the cycle continues. I’m considering seeing another ENT because I really want to figure it out once and for all.
I’m not sure if my symptoms line up exactly with what people here are experiencing, but I’ve never heard anyone talk about the mucus-y clump before so I thought it might be similar.

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I have been getting the same thing for years and I finally found an ENT who correctly diagnosed me. It’s coming from your adenoids. He looked in my sinuses with a scope and showed me a picture of it. Adenoiditis is what it’s called and that dried up mucus thing is dried up pus because your adenoids are infected. He put me on antibiotics and a short term steroid. Hope this helps.

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@fcleaner1 @beebuzz @needtoknow Hey guys, pardon the totally gross pictures, but I thought it might be helpful to make sure everyone has the same issue in mind. The photo is of the afore mention snot crusts. I’ve been definitively diagnosed with chronic adenoiditis, and will soon be having them removed. Currently, I have to clear one of these bad boys out more or less daily, and at times, it can be annoyingly difficult, painful, and embarrassing to try and “cough it up.” Basically, you sound like you’re trying to (pardon me) “hawk up” a stubborn loogie (sp?). I encourage anyone with similar symptoms to gather the evidence: save/document a series of crusts (to show your provider), study nasal anatomy/read about chronic adenoiditis, and perhaps most important: find an ENT who listens to you, and agrees to perform an internal laryngopharyngeal exam with a flexible fiber scope.

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Hi all, I am a doctor (Internal Medicine, not an ENT), not affiliated in any way with Mayo. Sharing my experience because I too have been dealing with similar symptoms for almost 10 years now. I've had these same sort of dark yellow - light brown crusts, concave shape often with a "tail" of moister mucous (see photos), that seem to form on a regular basis, perhaps more often in drier environments, that feel like they are coming from midline pharynx (back of nose, upper throat). When they do fall off, I notice an unpleasant almost "yeasty" odor. Saline sprays and nasal irrigation help when it's close to falling off but is stubbornly stuck. From what I've recently read, this seems like a pretty close match for crusting-type nasopharyngeal bursitis. I think one of the strongest indicators is that it always seems to come from the same spot which is exactly midline - this makes sense for embryological reasons, as this pocket called the nasopharyngeal bursa (which in some of us seems to openly drain into our throats) is a remnant of the notochord. The notochord is a long thin tube that develops when embryos are only 3 weeks old, and forms straight down the middle of an embryo to help mark the place where our spines and spinal cords should eventually form. I've found some literature suggesting this condition is hard to diagnose since a) the area is a little too small to be seen well on CT scan, sometimes can be seen on MRI, and 2) if a crust isn't actively present the day you have your nasal endoscopy, it's probably quite hard for ENT to visually detect the opening. Anyway, it seems like the experience of folks on this forum has generally been that many ENT specialists are either unaware of this condition (which is unfortunate, as crusting-type pharyngeal bursae were first described way back in 1939), or offering procedures which may be at best unnecessary, or at worst, unhelpful. Multiple scholarly articles suggest that relatively minor procedures like electrocautery could be successful in dealing with this. Has anyone been offered or undergone this approach? This article suggests that these may sometimes heal on their own, but it sounds like thats the exception rather than the rule (good photo of a 'crust' as seen by nasal endoscopy, search for DOI: 10.1177/0145561320980189). Best to all.

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Did you ever find a resolution? I have the EXACT same story as you.

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Hi all, I am a doctor (Internal Medicine, not an ENT), not affiliated in any way with Mayo. Sharing my experience because I too have been dealing with similar symptoms for almost 10 years now. I've had these same sort of dark yellow - light brown crusts, concave shape often with a "tail" of moister mucous (see photos), that seem to form on a regular basis, perhaps more often in drier environments, that feel like they are coming from midline pharynx (back of nose, upper throat). When they do fall off, I notice an unpleasant almost "yeasty" odor. Saline sprays and nasal irrigation help when it's close to falling off but is stubbornly stuck. From what I've recently read, this seems like a pretty close match for crusting-type nasopharyngeal bursitis. I think one of the strongest indicators is that it always seems to come from the same spot which is exactly midline - this makes sense for embryological reasons, as this pocket called the nasopharyngeal bursa (which in some of us seems to openly drain into our throats) is a remnant of the notochord. The notochord is a long thin tube that develops when embryos are only 3 weeks old, and forms straight down the middle of an embryo to help mark the place where our spines and spinal cords should eventually form. I've found some literature suggesting this condition is hard to diagnose since a) the area is a little too small to be seen well on CT scan, sometimes can be seen on MRI, and 2) if a crust isn't actively present the day you have your nasal endoscopy, it's probably quite hard for ENT to visually detect the opening. Anyway, it seems like the experience of folks on this forum has generally been that many ENT specialists are either unaware of this condition (which is unfortunate, as crusting-type pharyngeal bursae were first described way back in 1939), or offering procedures which may be at best unnecessary, or at worst, unhelpful. Multiple scholarly articles suggest that relatively minor procedures like electrocautery could be successful in dealing with this. Has anyone been offered or undergone this approach? This article suggests that these may sometimes heal on their own, but it sounds like thats the exception rather than the rule (good photo of a 'crust' as seen by nasal endoscopy, search for DOI: 10.1177/0145561320980189). Best to all.

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Hello. This is my first time commenting on here. I'm a nurse with over 10 year of experience, and 2 of that working directly for ENT specialists. In addition, I am currently suffering from the same symptoms that many have mentioned. Symptoms: Daily mucus plug that is about the size of a full fingernail. It begins with swallowing excessive post-nasal drainage, the drainage builds up, then an irritated and stinging sensation, and finally it reaches a point when I know hacking once more will dislodge it. Once dislodged, it has a firm yet tacky texture with fresh mucus borders. Sometimes it has a scant amount of blood. I have a history of sinonasal surgeries to correct a deviated nasal septum and to open for proper drainage of the sinus cavities. Most recently, I went to my local ENT at Ohio State which is ranked #3 in the country for ENT. They performed a nasal endoscopy and found that I have a nasal perforation at the back base of the septum. He stated he believes that the back of the opening is acting as a dam, preventing the drainage from draining quick enough. This is backing up and allowing it time to dry and become tacky. They have recommended that the perforation be corrected to allow better drainage. Let me say this, it occurs worse in fall and winter (dry months). Note, these symptoms are different than those experiencing scabs in the nose, and different from those with COPD who cough up mucus plugs (this is a lung disorder). Those experiencing what I have would do well to use saline rinses that promote flushing out excess mucus. It is a drainage issue. Best of luck to everyone and may we all gain some relief soon.

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Hi all, I am a doctor (Internal Medicine, not an ENT), not affiliated in any way with Mayo. Sharing my experience because I too have been dealing with similar symptoms for almost 10 years now. I've had these same sort of dark yellow - light brown crusts, concave shape often with a "tail" of moister mucous (see photos), that seem to form on a regular basis, perhaps more often in drier environments, that feel like they are coming from midline pharynx (back of nose, upper throat). When they do fall off, I notice an unpleasant almost "yeasty" odor. Saline sprays and nasal irrigation help when it's close to falling off but is stubbornly stuck. From what I've recently read, this seems like a pretty close match for crusting-type nasopharyngeal bursitis. I think one of the strongest indicators is that it always seems to come from the same spot which is exactly midline - this makes sense for embryological reasons, as this pocket called the nasopharyngeal bursa (which in some of us seems to openly drain into our throats) is a remnant of the notochord. The notochord is a long thin tube that develops when embryos are only 3 weeks old, and forms straight down the middle of an embryo to help mark the place where our spines and spinal cords should eventually form. I've found some literature suggesting this condition is hard to diagnose since a) the area is a little too small to be seen well on CT scan, sometimes can be seen on MRI, and 2) if a crust isn't actively present the day you have your nasal endoscopy, it's probably quite hard for ENT to visually detect the opening. Anyway, it seems like the experience of folks on this forum has generally been that many ENT specialists are either unaware of this condition (which is unfortunate, as crusting-type pharyngeal bursae were first described way back in 1939), or offering procedures which may be at best unnecessary, or at worst, unhelpful. Multiple scholarly articles suggest that relatively minor procedures like electrocautery could be successful in dealing with this. Has anyone been offered or undergone this approach? This article suggests that these may sometimes heal on their own, but it sounds like thats the exception rather than the rule (good photo of a 'crust' as seen by nasal endoscopy, search for DOI: 10.1177/0145561320980189). Best to all.

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