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What can sputum phlegm tell us Medically reviewed by Meredith Goodwin, MD, FAAFP — By Amanda Barrell — Updated on September 28, 2022The body produces mucus, also known as phlegm or sputum, to protect sensitive tissues in the airways. Changes in the color, thickness, or quantity of phlegm may indicate a health problem.
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Mucus consists of mucins and other proteins. The body produces mucus to keep the thin, delicate tissues of sensitive areas — such as the respiratory tract — moist.
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Mucus lines and protects sensitive surfaces inside the body, and it helps trap and remove small particles of foreign matter that may pose a threat. Sometimes, the lungs produce too much mucus.
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The body attempts to expel this excess by coughing it up as sputum or phlegm. Here, learn about what changes in phlegm can mean and what to do if they happen.
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Colors
Share on PinterestThe different colors of sputum can indicate whether a person has a health problem and what kind of problem they may have. Here are some of the colors that may be present.ColorReasonclear, white, or grayusually indicates healthy lungs, but a lot of sputum may indicate a lung disease, allergy, or viral infectiondark yellow or greencan indicate a bacterial or viral infection, such as pneumonia, or cystic fibrosis, an inherited condition that involves excess mucus buildupbrownoften occurs in people who smoke and those with black lung disease, a condition resulting from exposure to coal dustpinkcan indicate pulmonary edema (fluid on the lungs), from a condition such as congestive heart failureredcan be a sign of an internal injury, lung cancer, or a pulmonary embolism (PE), which is a blood clot on the lung that needs immediate medical attention
Causes of changes in sputum
There are many reasons why the body produces excess sputum or sputum with an unusual color or texture.
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They include:
Smoking
Smoking increases the risk of various diseases, including lung cancer, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). One reason for excess mucus production may be to protect the lungs from damage due to particles.
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However, one older study from 2011 suggested that smoking may suppress a protein known as Bik in the lungs of smokers with chronic bronchitis. Usually, this protein kills unwanted mucus cells. However, it seems that smoking may prevent this by reducing the action of Bik, resulting in excess mucus production.
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What to know about smoker’s cough. Asthma
People with asthma have airways that are sensitive to allergens, such as pollen and air pollution.
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They also have a higher risk of respiratory infection. These factors can lead to airway inflammation and cause the airways to produce additional mucus as they try to protect themselves.
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Treatment options include identifying and avoiding triggers and using inhalers to manage or prevent attacks. Cystic fibrosis
A person with cystic fibrosis (CF) has inherited genetic features that cause the body to produce thick mucus.
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This unusually thick mucus can block the airways and cause breathing difficulties. The thick mucus in CF becomes an ideal environment for bacteria to grow, increasing the risk of infection. Doctors often diagnose CF at birth, as it is part of the screening process for newborns.
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A person with CF will likely receive ongoing follow-up care. Treatment options include:drugs that help change the protein that causes mucus to thickenmechanical removal of sputumbreathing support The person will also need to take measures to avoid respiratory infections, as they can be life threatening in people with CF. Respiratory tract infections
Sputum that is a different color from saliva may be a sign of a lower respiratory tract infection (RTI), which affects the lungs.
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Examples include bacterial or viral pneumonia and bronchitis. With bacterial RTIs, sputum may also have a thick consistency and an unpleasant odor.
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In the early stages of an RTI, sputum may be dark green or yellow. As the infection retreats, the color becomes lighter. It is the presence of an enzyme called myeloperoxidase that gives the sputum its green color during an infection.
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Here are some examples of RTIs that may affect sputum. COVID-19
Some people with COVID-19 have a dry cough, but around 30% have a cough that produces sputum. This can aggravate breathing problems.
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One study suggests that those with breathing problems early in the disease may develop more severe symptoms and have a worse outcome than those who first notice a fever, pain, and diarrhea. Other symptoms of COVID-19 include:a loss of the sense of taste or smellcongestion or a runny nosefatigueheadachesore throatnausea, vomiting, or both
Treatment options include: isolatingresting at homeusing over-the-counter (OTC) pain relief medications
A doctor may prescribe antiviral medications if a person has a high risk of severe infection due to another health condition. A person needs emergency medical help if they have: difficulty breathingongoing pressure or pain in the chestconfusiondifficulty waking up or staying awakepale or blue nail beds or lips, which indicate low oxygen levels
Flu
Flu, or influenza, is a viral infection.
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A person with the flu may have green or yellow phlegm. Other symptoms include:a fevercoughsore throattirednessheadachegeneral aches and painsdiarrhea and vomiting, especially in children
People may treat the flu by:resting at homeavoiding other peopleusing OTC pain relieverstaking antiviral drugs, if a doctor prescribes them
Vaccines can help prevent the flu.
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Bronchitis
Bronchitis is an infection of the lung’s main airways: the bronchi. They become inflamed and produce extra mucus.
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A person may cough up clear, gray, or greenish phlegm. Acute bronchitis lasts about 3 weeks and usually goes away without treatment.
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Treatment includes resting, drinking plenty of fluids, and taking nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief. Chronic bronchitis lasts at least 3 months and is recurring.
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It is a symptom of other lung conditions, including emphysema and COPD. Avoiding smoking can help manage it. If symptoms worsen or do not improve, people should speak with a doctor.
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The following groups have a greater risk of developing pneumonia: older adultsthose who smokepeople with compromised immune systems or other health conditions
Pneumonia
A person with pneumonia may have a dry cough or a cough that produces thick sputum that is yellow, green, brown, or blood-stained. This is a viral or bacterial infection that leads to the swelling of lung tissue.
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Other common symptoms include:breathing difficultychest painrapid heartbeatfever and chillsfeeling generally unwelllow appetite
If someone thinks they have pneumonia, they should seek medical advice. Anyone who is unable to breathe or is coughing up blood should seek emergency help.
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Treatment options include resting, drinking plenty of fluids, and taking antibiotics if the infection is bacterial. Some people may need to spend time in the hospital.
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Tuberculosis
Tuberculosis (TB) is a bacterial infection. It usually affects the lungs but can occur in other parts of the body, such as the stomach.
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A person with TB in the lungs may cough up blood or blood-streaked phlegm. Other symptoms include:a severe cough lasting 3 weeks or longerchest painweakness and fatiguelow appetite and weight lossfever and chillsnight sweats
People with TB will need a course of antibiotics lasting several months, but some types of TB are becoming resistant to antibiotics. When to speak with a doctor
A person should consult a doctor if they believe they may have:asthmaTBbronchitispneumonia
It is best to seek medical advice if a person has:a cough that is severe or does not go awaytraces of blood in their sputumconcerns about any symptoms
Anyone with the following symptoms should seek emergency medical help:breathing difficultychest paina rapid heart ratecoughing up bloodconfusiona high fever
If a person has signs of COVID-19, they should stay home and avoid contact with other people.
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However, anyone with an underlying health condition or compromised immune system should seek medical advice. Those with breathing difficulties need emergency medical care.
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How do you stop a runny nose? What is a sputum culture test
A doctor might recommend a sputum culture test for someone with a change in their sputum.
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This can help: identify the reason for changes in sputummonitor how treatment for an existing condition is workingshow whether a condition is worsening
To perform a sputum culture test, a person will need to rinse their mouth with water, breathe deeply, and then cough into a container. To facilitate the production of sputum, the doctor may: tap on the person’s chest to loosen any sputumask the person to inhale a salty vaporpass a bronchoscope — a thin, lighted tube with a small brush at the end — through the mouth and into the airways to collect a sample
The person may need to avoid eating or drinking for 2 hours before the test.
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The doctor may also recommend further tests to identify bacteria that may be causing the problem. Frequently asked questions
Here are some answers to questions people often ask about phlegm and sputum. Is phlegm the same as sputum
Sputum is another word for phlegm.
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Both terms refer to mucus that people cough up from the lungs. Scientists may also call it “airway surface liquid.” Mucus is present in other parts of the body as well.
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What causes phlegm
The body produces mucus to protect the lungs and help remove debris. Sometimes, the body may produce extra mucus, such as in the case of an infection. People with cystic fibrosis have a genetic feature that causes their bodies to produce extra mucus.
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Blood in mucus may result from damage to airway tissue. What do the different colors mean
Mucus is usually clear, gray, or white.
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Green or yellow mucus may be a sign of an infection. Brown mucus can affect people who smoke and those with black lung disease, which results from exposure to coal dust. Mucus that contains blood may be pink or red.
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Summary
Mucus is an essential fluid that helps protect sensitive tissues inside the body. It consists of proteins and other substances.
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Mucus in the airways, known as phlegm or sputum, helps remove dust and debris and keep the lungs clear. Sometimes, problems arise that can change the thickness, amount, or color of mucus. Anyone with concerns about changes in their phlegm or sputum should seek medical advice.
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If a person is coughing up blood or has difficulty breathing, they need emergency medical attention. Last medically reviewed on September 28, 2022RespiratoryEar, Nose, and Throat 15 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations.
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We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles.
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You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Bronchitis. (2019).https://www.nhs.uk/conditions/bronchitis/Chest infection.
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(2020).https://www.nhs.uk/conditions/chest-infection/COVID-19 treatments and medicines. (2022).https://www.cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.htmlEvans, C. M., et al.
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(2010). Mucus hypersecretion in asthma: Causes and effects.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2709596/Flu: What to do if you get sick.
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(2022).https://www.cdc.gov/flu/treatment/takingcare.htmHill, D. B., et al.
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(2018). Pathological mucus and impaired mucus clearance in cystic fibrosis patients result from increased concentration, not altered pH.https://erj.ersjournals.com/content/52/6/1801297Influenza (flu).
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(2022).https://www.cdc.gov/flu/index.htmMebratu, Y. A., et al.
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(2011). Cigarette smoke causes Bik to cause epithelial cell hyperplasia and mucous cell metaplasia.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137142/Overview pneumonia. (2019).https://www.nhs.uk/conditions/pneumonia/Sputum culture.
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(n.d.).https://medlineplus.gov/lab-tests/sputum-culture/Symptoms of COVID-19. (2022).https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.htmlTuberculosis (TB).
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(2022).https://www.cdc.gov/tb/default.htmUnderstanding mucus in your lungs. (2021).https://www.lung.org/blog/lungs-mucusYu, E., et al. (2021).
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Cystic fibrosis.https://www.ncbi.nlm.nih.gov/books/NBK493206/Zhou, A., et al. (2021).
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Symptoms at disease onset predict prognosis in COVID-19 disease.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725726/FEEDBACK:Medically reviewed by Meredith Goodwin, MD, FAAFP — By Amanda Barrell — Updated on September 28, 2022
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New clues arise
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