[43F] With chronic phlegm and nasal scabs

Patient Description

A 43-year-old female has been experiencing chronic hard, chunky phlegm and scabs from the throat and sinuses for the past 2 to 3 years. The phlegm is described as dark yellow, white, and brownish-green in color. The patient reports that coughing and blowing it out provide some relief. These symptoms occur daily and persist throughout the day. The onset of the phlegm was gradual, with no identifiable environmental or lifestyle factors that worsen or improve the condition. The patient has a history of smoking for 15 years, currently smoking 10-15 cigarettes per day, and a history of drug use. There is no history of lung conditions such as asthma, chronic bronchitis, or COPD. The patient notes the problem is primarily in the nasopharynx area and has not identified any specific environmental irritants or allergens affecting this area.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Chronic Sinusitis: This condition involves inflammation of the sinuses that can lead to persistent phlegm production and nasal scabs. It can be caused by infections, nasal polyps, or a deviated septum. Treatment often includes nasal corticosteroids, saline nasal irrigation, and sometimes antibiotics if a bacterial infection is present.

  • Postnasal Drip: This occurs when excess mucus from the nose drips down the back of the throat, which can cause phlegm and throat irritation. It can be due to allergies, infections, or irritants. Treatment may involve antihistamines, decongestants, or nasal sprays.

  • Chronic Bronchitis: Given your smoking history, chronic bronchitis is a possibility. It involves long-term inflammation of the airways, leading to mucus production. Quitting smoking is crucial, and treatments may include bronchodilators and steroids.

  • Environmental Irritants: Smoking and exposure to irritants can cause chronic phlegm production. Reducing exposure and quitting smoking can significantly improve symptoms.

What you can do

  1. Consult a Healthcare Provider: It's important to see a healthcare provider for a formal diagnosis and treatment plan. They may recommend imaging studies or refer you to an ENT specialist.

  2. Quit Smoking: Smoking cessation is crucial for improving respiratory health. Consider seeking support through smoking cessation programs or medications.

  3. Stay Hydrated: Drinking plenty of fluids can help thin mucus, making it easier to expel.

  4. Use a Humidifier: Adding moisture to the air can help soothe irritated airways and reduce phlegm production.

  5. Track Symptoms: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

What you should look out for

Seek medical attention if you experience:

  • Difficulty breathing or shortness of breath
  • Chest pain
  • Blood in your phlegm
  • Unexplained weight loss

These could be signs of a more serious condition that requires prompt evaluation. Remember, while I can provide information, it's important to consult a healthcare professional for personalized medical advice.

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1 mo ago

People Also Ask


What are the common causes of chronic phlegm production?

Chronic phlegm production can be caused by conditions such as chronic sinusitis, postnasal drip, chronic bronchitis, and exposure to environmental irritants. Allergies and infections can also contribute to excess mucus production.


How can smoking affect phlegm production and respiratory health?

Smoking can irritate the airways and lungs, leading to increased mucus production and chronic phlegm. It can also cause or exacerbate conditions like chronic bronchitis, which further contributes to respiratory issues.


What are the treatment options for chronic sinusitis?

Treatment for chronic sinusitis may include nasal corticosteroids to reduce inflammation, saline nasal irrigation to clear mucus, and antibiotics if a bacterial infection is present. In some cases, surgery may be necessary to address structural issues like nasal polyps or a deviated septum.


When should I seek medical attention for phlegm-related symptoms?

You should seek medical attention if you experience difficulty breathing, chest pain, blood in your phlegm, or unexplained weight loss, as these could be signs of a more serious condition that requires prompt evaluation.


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