Phlegm in the throat

When referring to a doctor with a complaint: “Doctor, I have phlegm in my throat,” patients may have several different conditions in mind. The most common is the so-called “postnasal drip syndrome”, which occurs against the background of a runny nose, adenoids or pharyngitis.

The mucus that forms on the surface of the nasal passages, pharynx or tonsils flows into the pharynx, irritates it and provokes coughing, a feeling of discomfort. But this is not sputum, namely mucus, just patients may mistakenly call it this term.

Some patients call sputum discharge from the nose, which flow down the back wall of the nasopharynx, as well as discharge in chronic pathologies of the oropharynx and larynx.

The second option is the formation of sputum in the lower respiratory tract, its difficult expectoration, which leads to the feeling that it “gets stuck”, accumulates in the throat.

Sputum is a secret in the form of mucus, which is formed in the cells of the epithelium (mucosa) of the bronchi. Fragments of bacteria, epithelial cells and other components can join this mucus.¹. When coughing and breathing, the mucus moves through the bronchi, enters the trachea and can be coughed up into the throat, where it mixes with the mucus of the upper respiratory tract and is swallowed.

Normally, sputum should be transparent and stand out in small quantities, without causing any discomfort. Smokers and people who work in dusty environments may produce large amounts of sputum¹.

Sputum, as a rule, is formed in the lower parts of the respiratory tract (trachea, bronchi, bronchioles) and, accumulating, irritates the receptors, which causes a cough reflex and exits through the mouth¹.

We will consider the separation of sputum (not nasopharyngeal mucus), which may be associated with various pathological processes. With such complaints, it is necessary to make a complete examination of the patient, find out the details of the anamnesis and conduct a series of tests.

Phlegm with cough

A cough with phlegm or a wet, productive cough can indicate various diseases of the respiratory system from SARS to allergies. There are a number of diseases and conditions that are characterized by a cough with sputum:

• Smoking. In the lungs of a smoker, more mucus is produced, which the body tries to get rid of, provoking a cough.
• Infections of the upper and lower respiratory tract. Quite often, a common cold can cause complications in the form of tracheitis, bronchitis and other serious illnesses, accompanied by a wet cough.
• Abscess (purulent focus) of the lung. In the presence of an abscess in the lung, separation of purulent contents is possible.
• Lungs’ cancer.
• Tuberculosis. This disease is characterized by the presence of blood in the sputum.
• Chronical bronchitis.

Phlegm without cough

If sputum accumulates in the airways, especially the lower ones, it reflexively provokes a cough. Without a cough reflex, the accumulation of sputum in the bronchi threatens to “waterlogged” the lungs and the development of pneumonia. Such situations are possible when taking cough suppressants at the same time as sputum thinners. Less often, such problems can occur in bedridden patients or people with serious neurological pathologies (when the cough center in the brain is disrupted).

If we are talking about mucus that accumulates in the nasopharynx, it can also form without coughing, a person usually swallows it with saliva.

Why does mucus accumulate

Sputum in the lower respiratory tract is almost always formed, but its volume is extremely scarce. Increased sputum production occurs when the bronchi, trachea or lungs are irritated, against the background of inflammation, foreign particles, pathogens, dust, allergens, etc.².

During inflammation, epithelial cells produce a larger volume of sputum, which is necessary for binding and removing the irritant. In sputum with viral and microbial infections, there is a large amount of epithelium, leukocytes, mucus and dead pathogens.

A large amount of sputum is produced with bacterial infections – bronchitis, pneumonia, as well as with complications of various pathologies – lung abscess, tumors, pulmonary edema, bronchial asthma².

What does the color of sputum mean?

The color of sputum can indirectly indicate the causes of inflammation, the severity of the condition and the location of the lesion. Normally, sputum is colorless or slightly whitish, it is very small, it is almost impossible to cough it up.

In addition to color, other characteristics of sputum are also evaluated – mucous, streaked, purulent, serous, etc.

Brown sputum. It is commonly released in smokers and people who frequently inhale smoke. It is a mixture of smoke, tar and small particles. In addition, brown sputum can be found in people who drink a lot of coffee and wine.

Sputum may acquire a brownish color due to small impurities of blood, when the hemoglobin of erythrocytes begins to actively decompose.

Yellow mucus. Often occurs with infectious lesions of the bronchi and lungs. Often this happens with viral infections, but it is quite possible in the presence of a bacterial infection. To determine the cause of this color, microscopy and sputum culture on the flora is necessary.

Green sputum. Often the cause of green sputum is a bacterial infection of the lower respiratory tract. But in some patients, this color of sputum is not associated with infections and occurs as a reaction to external stimuli.

Pink or red sputum. This coloration is associated with the presence of blood in the sputum. Sometimes this type of sputum is also called rusty if the streaks of blood begin to decompose, changing the color of the hemoglobin. Pink color is possible with the development of pulmonary edema or with minor bleeding in the area of ​​uXNUMXbuXNUMXbthe lung tissue. Pink foamy sputum can be with serious cardiac pathologies.

Blood streaks or hemoptysis often occur with tuberculosis, severe tumor lesions of the lungs, against the background of pulmonary embolism.

White sputum. White sputum, especially if it looks like lumps of glass, is typical for bronchial asthma. It is difficult to separate, very thick. It can often occur with other allergic respiratory lesions.

Gray sputum. Usually occurs against the background of inflammation of the lower respiratory tract with viral infections. Sometimes sputum becomes gray in color due to pollution of the surrounding air and the removal of dust particles with mucus.

How to get rid of phlegm

In order to get rid of sputum, it is necessary to understand the causes of its occurrence. Therapeutic measures in this case directly depend on the disease that caused the formation of sputum.

• In an acute inflammatory process, anti-inflammatory drugs and antibiotics, antipyretics are prescribed. To thin and facilitate the separation of sputum, mucolytic and expectorant drugs are prescribed.
• For allergies – antihistamines and hormonal drugs – corticosteroids.
• When smoking, it is necessary to give up bad habits. At the same time, it takes time to restore the mucous membrane.

Any therapeutic measures should be discussed with the doctor. Only a specialist can determine the cause of excess sputum and treatment tactics.

Rinsing. Rinsing will not help get rid of phlegm. They are effective only in the presence of postnasal drip syndrome and the appearance of mucus in the throat. The most effective rinsing with saline, soda solutions, antiseptics.

Inhalations. The use of inhalation in the presence of sputum in the bronchi is a controversial issue. If it is thick and difficult to separate, inhalation with sterile solutions using a nebulizer or ultrasound machine will help in thinning and sputum discharge. But if it is a cough with copious liquid sputum, inhalation is dangerous, as it can lead to pneumonia.

Do not inhale with herbal decoctions, mineral water or essential oils. These solutions are non-sterile, their components are difficult to remove from the bronchi and threaten to worsen the condition.

Compresses. Various compresses for the appearance of sputum in the lower respiratory tract have not been proven effective.

mucolytic drugs. Can also be used to loosen phlegm in the throat³.

Mucolytic drugs

Prevention of phlegm in the throat

With effective prevention, most diseases can be avoided. And even if they develop, they proceed in an easier form. Measures to prevent the accumulation of sputum in the throat include strengthening the immune system, prolonged exposure to fresh air, an active lifestyle, a healthy diet, adherence to the daily routine, a stable psycho-emotional state, giving up bad habits such as smoking, alcohol.

Popular questions and answers

We asked our expert general practitioner Mikhail Lystsov answer the most frequently asked questions regarding phlegm in the throat.

Sources of:

1. “The use of mucolytic therapy in the treatment of infectious and inflammatory diseases of the respiratory tract” Krivopalov A.A. Shamkina P.A. https://cyberleninka.ru/article/n/primenenie-mukoliticheskoy-terapii-v-lechenii-infektsionno-vospalitelnyh-zabolevaniy-respiratornogo-trakta/viewer
2. “Bacterial infections of the upper respiratory tract – how to treat?” Polyakova A.S. Bakradze M.D. https://cyberleninka.ru/article/n/bakterialnye-infektsii-verhnih-dyhatelnyh-putey-kak-lechit/viewer
3. Propaedeutics of internal diseases: Textbook. A.L. Grebenev, M., 2001 https://fliphtml5.com/lluzx/qfzv/basic/101-150