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All of Your Questions About Mucus, Answered

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Posted by Andrew J. Gangemi, MD

Mucus isn't something most people spend too much time thinking about. But as a pulmonologist, I know that the sticky substance plays an important role in keeping us healthy and that mucus changes can mean something in the body is not quite right.

Understanding what mucus does and how it can change can help you better manage your health, whether you're dealing with a run-of-the-mill cold or you have a chronic lung or heart condition. You may be able to breathe easier, too, since managing heavy or annoying mucus is something that can often be done right at home.

Here are some things you may have wondered about mucus and what I tell my patients about it.

What is mucus, and why do we have it?

Mucus is a thin, clear liquid consisting of water, salts, and protective immune cells. It lines many parts of the body, including the mouth, sinuses, eyes, stomach, and even the intestines. It's also produced in the lungs and the lower respiratory tract. We often refer to this type of mucus as phlegm or sputum.

Mucus is important for many reasons. We need mucus to keep our tissues lubricated. It's also crucial for protecting the body against invaders and irritants — everything from viruses and bacteria to dust, smoke, and chemicals.

When a germ or irritant enters the airways, the material gets trapped by sticky mucus. Then the body tries to get rid of the material by coughing and sneezing it out. That's why mucus production goes up when we're sick: The body makes more of it as it works harder to fight off the invader.

What does normal mucus look like?

We produce mucus all the time. But when someone’s respiratory tract is healthy, their mucus is either clear, thin, and watery or completely unnoticeable. Still, mucus is always there, working in the background to protect you.

What could it mean if my mucus doesn’t look normal?

Mucus is much more obvious when the body is fighting off an infection or irritant or dealing with certain chronic health problems. Not only is there more mucus, it also takes on a different color and texture.

In fact, I may look to a patient's mucus for clues about what could be making them sick. Oftentimes a change in mucus color or consistency can be a sign of an infection (including many viral or bacterial infections) or a flare of an underlying lung condition, such as chronic obstructive pulmonary disease (COPD). In patients with underlying lung conditions, a change in sputum quality along with shortness of breath or chest pain should warrant fast medical attention. As the infection or the exacerbation clears, so too will the person's mucus.

Phlegm that's red, pink, or brown could indicate blood. This can certainly look alarming, and in some cases it may mean that a person has a serious medical problem that requires immediate attention. But other times, bloody mucus is just the result of a respiratory infection that's causing a lot of coughing. The force of the coughing can sometimes break small blood vessels in the lungs or airways and cause mild bleeding. In patients with severe heart failure, pink tinged, frothy sputum could be the early sign of fluid buildup in the lungs during a heart failure exacerbation.

Black mucus could be a sign of a fungal infection. These types of infections typically require fast medical treatment, especially if someone has a weakened immune system — which can be caused by things like cancer treatments or a chronic disease, such as HIV, type 1 diabetes, or rheumatoid arthritis.

I frequently have a lot of mucus. What may be causing that?

It's normal for someone to experience thick, heavy mucus when they have an infection. But those with certain medical conditions may be prone to excess mucus on a regular basis. This can make it harder to breathe comfortably and may actually increase the risk for getting sick.

You may be more likely to have heavy mucus if you have asthma or allergies, or if you have a chronic lung disease such as cystic fibrosis, COPD (especially chronic bronchitis), bronchiectasis, or lung cancer. Smoking can also cause a buildup of mucus.

How can I treat my chest mucus?

There are ways to make excess mucus more manageable, whether it's from a short-lived infection or a chronic health condition. I encourage my patients to try these simple strategies:

  • Drink plenty of water. Dehydration can make mucus thicker and harder to cough up.
  • Run a humidifier. Making the air moister can loosen phlegm and allow it to be coughed up more easily.
  • Take a walk. Movement can encourage the body to cough up excess phlegm.
  • Smoking cessation. Cigarettes have many health consequences beyond irritating your lungs, including increasing your risk for heart attacks, strokes, and many cancers. The chemicals in cigarettes lead to over-production of mucus with a thicker consistency. Learn more about smoking cessation resources at Temple.
  • Sleep with your head elevated. Lying flat can create the sensation of mucus pooling in the back of the throat. Propping your head up with a pillow can promote easier drainage.
  • Try an over-the-counter expectorant. Expectorant medications like guaifenesin (Mucinex is a common brand) work to thin mucus, so it can be coughed up more easily. Avoid cough suppressants and decongestants, though. Both can actually make it harder for mucus to be expelled or coughed up.
  • Avoid exposure to irritants. If chemicals, fragrances, smoke, or pollution tend to worsen your mucus, try to steer clear of them as much as possible.
  • Stay up-to-date on flu, pneumococcal pneumonia, and COVID-19 vaccines. These can help reduce the risk of serious respiratory infections, which increase mucus production.

When should I see a doctor about mucus?

Sometimes thick or discolored mucus clears up on its own, especially if it’s caused by a mild infection or allergies. But phlegm that persists, worsens, or is accompanied by other symptoms may need medical attention.

  • Call your doctor within a few days if you have white, yellow, or green mucus that occurs with symptoms such as fever, chills, coughing, or sinus pain. These could be signs of a bacterial infection that requires antibiotics.
  • Seek immediate medical attention if you develop new or worsening red, brown, black, or frothy phlegm. These could indicate a serious lung or heart problem or one that is worsening.

If you have allergies, asthma, or another chronic lung condition, let your doctor know if you are coughing up mucus or experiencing a noticeable increase in mucus production, or changes in its color or texture. Together, you can decide on a plan for better managing your symptoms. Smoking cessation stops the “smoker’s cough” and chronic phlegm production. Medications including pills and nebulizer treatments can make mucus thinner and easier to clear. Finally, chest physiotherapy with mechanical devices (vibrating vests and flutter devices) clear mucus from the airways and improve breathing.

Concerned about your mucus? Schedule an appointment with a lung specialist at the Temple Lung Center. Our highly experienced pulmonologists and other lung disease experts treat common and complex lung problems.

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Andrew J. Gangemi, MD

Andrew J. Gangemi, MD is an Assistant Professor of Thoracic Medicine and Surgery at the Lewis Katz School of Medicine at Temple University and pulmonologist at the Temple Lung Center. His areas of focus include COPD, smoking cessation and sarcoidosis.

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