Expectoration when coughing – what the color reveals

Expectoration when coughing - what the color reveals

Coughing is a natural protective reflex of the body and occurs with various diseases. In addition to the dry cough, there can also be a mucous cough with sputum. Whether green, yellow, brown or white, the colour of the sputum can be very different and indirectly indicates the possible cause of the cough. The following section will explain how mucus forms in the throat, what it means to cough up, what colours the sputum can take on, and what diseases these colours can indicate. You will also learn what expectoration without coughing can mean and what helps with mucus in the throat.

What is the phlegm when coughing?

Mucus, sputum or phlegm – many terms describe the same thing: the substance we cough up when we cough, called “productive”, i.e. mucous. Essentially, sputum is made up of the mucous secretions that our airways produce. This mucus is then coughed up and hereafter referred to as sputum. Unlike saliva, which is produced in the mouth, mucus is produced exclusively in the lungs.

To understand how mucus is formed, you must look at the airways under a microscope. Our lungs have a vast surface area that needs to be protected from external pathogens. The body has different cells for this, such as goblet cells, which sit in the wall of the airways and constantly produce mucus. Like in a sticky flytrap, bacteria and pollutants get trapped in this slime.

The airways are lined with a so-called ciliated epithelium to prevent these potentially dangerous substances from getting further into the lungs. This transports the mucus upwards with the help of tiny extensions, the cilia, until the mucus reaches the oesophagus from the airways.


What do you mean by coughing up?

There are two possible routes for the mucus from the oesophagus. It either gets into the stomach and is rendered harmless there by the gastric acid, or the bronchial mucus is coughed up or, to put it technically, coughed up. Then, it is called sputum.

In various diseases where mucus production is significantly increased, the body does not manage to break down all the mucus with gastric acid. For this reason, it builds up in the airways, and we have to cough up the mucus produced.

The whole process is called mucociliary clearance. Without this cleansing, serious diseases can develop, such as cystic fibrosis ( mucoviscidosis ), in which the body produces a very viscous mucus that is difficult to cough.

What colours can the sputum take on, and what do they mean?

The slime can vary in consistency and colour. The appearance of the sputum often provides the first clues as to which disease is causing the cough. The doctor often makes a suspected diagnosis based on the colour. However, the colour can differ from person to person, so colour alone is not a reliable criterion for a diagnosis.

The following brief overview explains the most common changes in sputum and their possible meaning:

  • Yellow-green sputum: There is usually a bacterial infection in the lungs. The inflammation caused by the bacteria leads to increased mucus production. In the meantime, however, it has been found that viruses can also trigger such a colour change.
  • Green sputum, when coughing, can be an indication of a Pseudomonas infection.
  • White-glassy sputum is often an indication of a viral infection.
  • White-foamy sputum:  This suggests pulmonary congestion.
  • Greyish sputum may indicate a bacterial infection in the healing process. If the sputum is grey, this can also be a sign of a so-called dust lung.
  • Brown sputum: The reason for brown spots in sputum is usually old blood. Smokers are also more likely to have brown sputum. The colour can be caused by the tobacco or other ingredients in the cigarette.
  • Bloody-red sputum often occurs with severe pneumonia, but it can also be a sign of lung cancer.
  • Crumbly, purulent sputum: This is often a sign of tuberculosis.


What does yellow-green sputum mean when coughing?

Pneumonia is an infection of the lungs with harmful bacteria. The body responds to these invaders by activating the immune system and sending masses of white blood cells to the lungs. It is precisely these cells that make up a large part of the mucus.

The mucus’s colour depends on the disease stage or individual differences in those affected. The mucus can appear yellowish, greenish, or a mixture of both.

On the other hand, the colour also depends on the pathogens. One type of bacteria that can cause pneumonia (inflammation of the lungs) is called Pseudomonas aeruginosa. When this type of bacteria is predominant, it is referred to as a Pseudomonas infection, typically accompanied by green mucus. Those affected often describe increased green sputum in the morning, caused by increased nocturnal mucus production, which is coughed up the following day.

Especially in patients with chronic lung disease, such as in the context of COPD, it is often not the colour itself that is meaningful but a colour change. If the colour of the sputum changes, there may be an infection in the lungs.

Due to the high mucus production as part of an infection, a lot of sputum is coughed up. This can irritate the mucous membranes in the throat and lead to a sore throat. It is also possible that the sputum tastes salty. If the cough with sputum does not go away, antibiotic therapy must be carried out. Depending on the age and risk factors of the person affected, pneumonia is a severe disease that should be treated immediately.

What does white sputum mean?

Viruses usually cause white mucus. In the context of a cold, which in most cases is caused by viruses, the pathogens settle in the airways, the so-called bronchi. Inflammation occurs there, which triggers irritation of the bronchial mucosa. This leads to the typical, dry, dry cough. The clinical picture is then called bronchitis. Usually, at the end of the cold, the dry, irritating cough turns into a productive cough, with the phlegm being more of a white colour.

But smokers can also cough up white phlegm. Due to the constant irritation of the mucous membranes by the various pollutants contained in cigarette smoke, irritation of the bronchial mucosa occurs, similar to bronchitis. Even after quitting smoking, productive expectoration can still happen before the mucous membrane regenerates.

If the sputum takes on a white-foamy consistency, this can be an indication of pulmonary congestion. Some people with heart failure experience a backlog of blood in the lungs due to the weakness of the heart. This back pressure increases the pressure in the lungs, resulting in leakage of fluids entering the lungs. Especially at night, when lying down, those affected feel increased shortness of breath since more fluid gets from the cells into the lungs.

What does bloody sputum mean?

Blood in the sputum is an alarm signal for many people. In addition to cancer, irritated mucous membranes can lead to blood expectoration. For example, frequent vomiting causes the mucous membrane to be severely attacked by stomach acid, which can sometimes lead to minor bleeding. Even with severe pneumonia, the constant coughing can irritate the mucous membrane so severely that minor bleeding occurs.

Lung cancer is also a common cause of bloody sputum. However, aspergillosis (a group of diseases caused by mould) or tuberculosis can also cause blood in the sputum. In particular, purulent sputum may speckle with small blood spots in tuberculosis.

Blood can take on different colours in sputum. If the bleeding is recent, the sputum will be red. If the bleeding is a little older, the sputum looks brown, or brown spots can appear in the sputum. Black sputum is less common.

The technical term for blood in the sputum is hemoptysis. To find out the exact cause, more specific tests must be carried out since many diseases accompany this symptom. Therefore, if you have blood in your sputum, you should seek medical advice.


Dry cough without sputum

Having a sore throat or a sore throat are the colloquial terms used to describe a dry cough. The causes can differ, from a mild cold to pulmonary fibrosis. The latter is a change in the lung tissue. Connective tissue gradually replaces functional lung tissue, meaning those affected can absorb less and less oxygen.

Expectation without coughing – where does the phlegm come from?

In addition to the lungs, the nose also has a ciliated epithelium. If we have a cold or a sinus infection, a process similar to that in the lungs happens. The mucus production has ramped up, and our drainage system is still blocked. As a result, mucus accumulates in our throat, which is particularly noticeable in the morning.

What should you do if there is congestion in the throat?

The most crucial measure against mucus in the throat is drinking enough water. The liquid thins the mucus and makes transporting it to the stomach easier, where it is rendered harmless. So-called expectorants such as ACC® can be used medicinally. These act directly on the mucus and make it less dense.



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