Ask a doctor on the topic of Internal medicine

Brown phlegm in the morning, fungus on the tongue, pain in the chest bone

November 29, 2011 | 20,00 EUR | answered by Christian Welsch

Hello!

I am 29 years old and (unfortunately) a smoker.

For a long time, I have been dealing with various minor ailments. Recently, I have been to the doctor frequently and have undergone various tests. Thankfully, all the results came back without any serious findings.

- X-ray of the lungs
- CT scan of the lungs
- Blood tests including tumor markers
- Lung function test
- EKG

As I mentioned, everything is okay, no findings.

My primary care physician diagnosed a mild chronic bronchitis about 5 years ago, which was treated with a corticosteroid spray and has not been detected in recent tests.

Additionally, I have been suffering from reflux disease for a few years and take acid blockers daily. However, I still experience slight acid reflux.

Now, onto my current problem:

For a while now, I have had a brown coating on my tongue, which my doctor identified as a fungal infection and tried to treat with lozenges and gels. Unfortunately, without success. I frequently clean my tongue with a scraper, which removes the brown coating, but leaves behind small white "pimples" and the coating quickly returns.

Furthermore, in the mornings after waking up, I have thick brown mucus in my throat, which I then spit out by clearing my throat (without coughing). After 2-3 rounds, throughout the day, only white, glassy mucus comes out when clearing my throat or coughing.

Additionally, I have experienced pain behind the sternum when sneezing and coughing for some time. The pain also occurs when stretching the chest. I have been to physical therapy multiple times, where a misaligned thoracic vertebra was identified. Unfortunately, this issue keeps recurring. Could there be a connection?

Overall, I often feel tired and fatigued. In the mornings, I often feel like I am coming down with a cold.

Can anyone suggest a connection between these symptoms or have any ideas about what could be causing my complaints?

Thank you very much! I am truly at a loss and starting to worry about my health.

Christian Welsch

Dear inquirer,

you are describing mostly typical side effects of smoking...
The brown coating on the tongue has no medical value and does not have to be a fungus. Many smokers have this, as long as the tongue does not burn or hurt, nothing needs to be done. Coughing and phlegm are typical side effects of smoking, as smoking destroys the cilia in the nose and lungs, and the body gets rid of the mucus that the mucous membranes (they are called that because they produce it) no longer clear along with the dirt acquired during inhalation.

Many smokers also suffer from reflux, which can exacerbate this symptomatology. The pain behind the breastbone could also be due to reflux, but the symptoms suggest a spine-related condition.

In the case of the symptoms you described, in my opinion, an endoscopy and possibly a sleep study (ambulatory polysomnography) would also be beneficial as additional tests (due to the symptoms of phlegm and fatigue).

Sincerely, C. Welsch