Green mucus from throat/nose
Dear Doctor,
I have daily green/greenish spots of mucus in my throat. This occurs mainly in the morning, when I cough up the thick mucus with green spots in the shower. After that, it's quiet for a while. Throughout the day, more green mucus loosens up due to drinking (I drink about 3-4 liters of water daily), but usually less than in the morning, probably because I can't cough up the mucus at night. I always have to provoke the cough, as I don't usually suffer from coughing. However, it is worst after eating. The mucus loosens up and I often have to clear my throat for half an hour, which affects my voice (I assume this is due to frequent irritation of the vocal cords). Unfortunately, this significantly limits my quality of life.
This problem has been ongoing for years. Two pulmonary specialists found nothing (spirometry with excellent results according to the pulmonologist, X-rays, etc.; even taking a low dose of a corticosteroid spray Flixotide 250 micrograms for two months - one puff per day - did not help). The same goes for two ENT specialists (CT scan of the sinuses showed no abnormalities, nasal endoscopy also did not reveal any findings). Antibiotic therapy with various medications was attempted, but did not improve the condition. A hiatus hernia with reflux was successfully eliminated in July of last year using a Nissen fundoplication (no more reflux since then, verified by impedance measurement and two gastroscopies; unfortunately, I now often have bloating, but that is another issue). My blood values are consistently very good to excellent (no increase in inflammatory markers). I have no speech problems (see below), nor any functional voice disorder (such as vocal cord strain). Smoking is hardly an issue for me; I rarely smoke. However, when I do smoke, it worsens the mucus production. I found in a forum that it could be due to dry mucous membranes. I certainly have dry mucous membranes, which I try to alleviate through regular saline rinses (nasal irrigation), but this does not improve my mucus issues.
For completeness, I mention that about a year ago, I was diagnosed with a very mild form of IgA nephritis (twice with microscopic hematuria, in connection with severe ENT symptoms; since then, there is rarely detectable microhematuria with urine test strips). I am under regular nephrological surveillance (2x a year with the nephrologist), who has assured me based on my parameters that I do not need to worry further. The monitoring will of course continue. Additionally, I suffer from familial migraines, which have significantly improved in recent years.
Despite the mucus production, my performance is not affected at all: I can speak for hours as a lecturer at the university and - apart from the slightly hoarse voice due
