Update: October 2018
Under the sputum, health workers understand the secret that stands out
cells of the bronchi, where the contents of the nose and sinuses are mixed in, and
also saliva. AT норме она прозрачная и слизистая, ее немного, и она
it is allocated only in the mornings for people who smoke, work for
dusty production or live in dry air conditions.
AT этих случаях ее называют трахеобронхиальным секретом, а не
sputum. With the development of pathologies in the sputum may fall: pus,
when there is bacterial inflammation in the airways, blood,
when damage occurred on the way from the nose to the end of the bronchi
vessel, mucus in cases of inflammation of a non-bacterial nature. it
the contents may become more or less viscous.
Pathological processes as causes of phlegm in the throat
without coughing usually take up localization from the nasopharynx, where it flows
the contents of the nose and its paranasal sinuses, up to the trachea. If the disease
affected deeper structures: trachea, bronchi or tissue
lung, sputum production will be accompanied by coughing (in children
younger vomiting can become an analogue of coughing
amount of mucus or other content). Bronchitis and pneumonia
can, of course, proceed without coughing, but then the sputum
here will not disturb.
When sputum production is considered normal
The mucous membrane of the bronchi consists of cells on the surface
which there are cilia – microtubules, able to make
movement (normally in the upward direction to the trachea). Between
ciliary cells are small glands – goblet
cells They are 4 times smaller than ciliated, but they are not located
so that after every four ciliated 1 goblet is: there is
areas consisting of only one, or only of cells of the second
type Glandular cells are completely absent in the small bronchi and
bronchioles The goblet and ciliary cells are united by a common
the name is “mucociliary apparatus”, and the process of mucus movement in
bronchi and trachea – mucociliary clearance.
The mucus produced by the goblet cells
– это основа sputum It is necessary to withdraw those from the bronchi.
dust particles and microbes that, in view of their microscopic
values were not seen by the cilia cells that are in
nose and throat.
The vessels are tightly attached to the mucous membrane of the bronchi. Of them
go out immune cells controlling the absence
foreign particles in the air going to the lungs. Notкоторые клетки
Immunity also exists in the mucosa itself. Their function is that
Therefore, sputum, more precisely, the tracheobronchial secret, there is in
the norm; without it, the bronchi would become covered with soot and impurities from within,
would be constantly inflamed. Its quantity is from 10 to 100 ml per
day. It may contain a small number of leukocytes, but in it
no bacteria, no atypical cells, no fibers,
contained in lung tissue. The secret is formed slowly,
gradually, and when he reaches the oropharynx, a healthy person, not
noticing, swallows this minimal amount of mucous
Why do you have phlegm in your throat without coughing?
it происходит вследствие или повышенной выработки секрета, или
deterioration of its removal. The causes of these conditions are many. ATот основные
- Work in enterprises with high levels of air pollution
particles of silicates, coal or others.
- Irritation of the throat with alcohol, cold, spicy or
hot food can cause a sputum without coughing. AT этом
If there is no malaise, no worsening of breathing, no other
- Faringo-laryngeal reflux. This is the name of the cast
the contents of the throat, where the ingredients of the stomach, not having
severe acidic environment, closer to the respiratory neck. Other
симптомы этого состояния это першение в горле, cough.
- Acute sinusitis. The main symptoms will be worsening.
conditions, fever, headache, discharge
copious amounts of snot. These симптомы выходят на первый
- Chronic sinusitis. Most likely, this pathology will be
describe as “phlegm in the throat without cough.” It manifests itself
obstruction of nasal breathing, deterioration of smell, fatigue.
From the sinuses down to the pharynx is thick sputum, and it happens
- Chronic tonsillitis. Здесь human беспокоит «мокрота»,
bad breath, whitish on the tonsils
masses that can themselves and with certain movements of the muscles of the mouth
stand out, their smell is unpleasant. The throat does not hurt, the temperature can
be increased, but – within 37 – 37.3 ° C.
- Chronic catarrhal rhinitis. Here is no aggravation of the nose
lays only in the cold and then – one half; sometimes from the nose
a small amount of mucous discharge. With
exacerbations appear thick abundant snot, they create a feeling
sputum in the throat.
- Chronic hypertrophic rhinitis. Here the main symptom is
difficulty breathing through the nose, its one half, which is why human
may have a headache in this half. Also getting worse
Smell, taste, there is a slight nasal. Detachable
accumulates in the throat or excreted.
- Vasomotor rhinitis. AT этом случае human периодически могут
�”Overtake” bouts of sneezing, which occurs after itching in the nose,
oral cavity or pharynx. Nasal breathing is occasionally difficult, and
liquid mucus is released from the nose to the outside or into the pharyngeal cavity. These
seizures associated with sleep, may appear after a change in temperature
air, overwork, eating spicy foods, emotional stress
or increase blood pressure.
- Pharyngitis. Here, phlegm in the throat occurs on the background
pain in it. More often, the sum of these sensations causes a cough,
which is either dry or there is a small amount of liquid
- Sjogren syndrome. At the same time, there is a decrease in saliva production,
and because of the dryness of the mouth it seems as if it has accumulated in the throat
Cough Free Sputum Color
By this criterion, one can suspect:
- white mucus mucus is in favor of the fungal
(often – candidal) tonsillitis;
- clear sputum with white veins may accompany
chronic catarrhal pharyngitis;
- sputum green, thick, may indicate
chronic hypertrophic pharyngitis;
- and if the sputum is yellow, and there is no coughing, it’s
speaks in favor of the purulent process of the upper respiratory tract
(rhinitis, pharyngitis, laryngitis).
If sputum is felt exclusively in the morning
Sputum in the morning can talk about:
- reflux esophagitis – casting of stomach contents into the esophagus and
throat. In this case, there is a weakness of the circular muscle, which is not
must pass that which fell into the stomach, back. Accompanied by
this pathology is usually heartburn, which occurs when taking
horizontal position after eating, as well as periodically
belching with air or sour contents. Arising in
being pregnant and accompanied by constant heartburn is her
a symptom associated with compression of the abdominal organs
- chronic sinusitis. Symptoms: difficulty in nasal breathing,
deterioration of smell up to its complete absence, mucus in
- chronic bronchitis. In this case, the sputum has
mucopurulent (yellow or yellow-green) character,
accompanied by weakness, low body temperature.
- be the first sign of acute bronchitis. Celebrated here
fever, weakness, loss of appetite;
- developing in the spring and autumn period, talk about
bronchiectasis. Other symptoms are malaise,
temperature rise. In the summer and winter, the person feels again
- appearing against a background of heart disease, testify of their
decompensation, that is, the appearance of stagnation in the lungs;
- developing in young children, talk about adenoiditis. AT
In this case, nasal breathing is disturbed, children breathe through their mouth, but
There are no temperatures or signs of a cold.
Cough with phlegm
If a person notes the appearance of cough, after which stands out
sputum; this suggests a disease of the trachea, bronchi or lungs. It
may be acute and chronic, inflammatory, allergic,
tumor or wear a stagnant nature. One by one only
sputum cannot be diagnosed: examination is necessary,
listening to pulmonary noise, x-ray (and sometimes
computed tomography of the lungs, sputum analyzes – general and
AT некотором роде сориентироваться по диагнозу поможет цвет
sputum, its texture and smell.
Cough Color Sputum
If yellow coughs are excreted when coughing, it may
- purulent process: acute bronchitis, pneumonia. Distinguish these
condition is possible only according to instrumental studies
(x-ray or CT scan of the lungs), since the symptoms are
they are the same;
- the presence of a large number of eosinophils in the pulmonary or
bronchial tissue, which also indicates eosinophilic
pneumonia (then the color is yellow, like a canary);
- sinusitis. Celebrated here плохое дыхание носом, отделение не
only sputum, but also a snot of yellow mucopurulent character,
- a yellow liquid sputum with a small amount of mucus appearing on
background icteric staining of the skin (with hepatitis, tumors, cirrhosis
liver or biliary tract occlusion)
that lung damage has occurred;
- yellow ocher speaks of siderosis – a disease
found in people working with dust that contains
iron oxides. With this pathology of special symptoms, except cough,
The phlegm of yellow-green color speaks of:
- purulent bronchitis;
- bacterial pneumonia;
- to be a normal sign after tuberculosis that was
cured by specific drugs.
If a rusty colored discharge is coughing, this indicates
that in the airways there was a vessel injury, but
blood, until it reached the mouth, was oxidized, and hemoglobin became
hematin. This may be when:
- a strong cough (then there will be rust-colored streaks that
will disappear through 1-2 days);
- pneumonia when inflammation (purulent or viral) by melting
lung tissue, leading to vascular damage. Here will be:
fever, shortness of breath, weakness, vomiting, absence
appetite, sometimes diarrhea;
- Pulmonary thromboembolism of the pulmonary artery.
If brown mucus is coughing, it also speaks of
the presence in the airways of the “old”, oxidized blood:
- if the lungs had a congenital pathology almost always
bullae (cavities filled with air). If such a bull lay
not far from the bronchus, and then exploded, will be separated
коричневая sputum. If at the same time the air also got into the cavity
pleura, shortness of breath, a feeling of lack of air, which
may increase. �The “sick” half of the chest does not breathe, but during
the time of bursting of the bulla was marked by pain;
- gangrene of the lung. Here significant comes to the fore
deterioration of general condition: weakness, clouding of consciousness, vomiting,
heat. Phlegm is not only brown but also
has a putrid odor;
- pneumoconiosis – a disease arising from industrial
(coal-coal, silicon) dust. Characterized by chest pain,
first dry cough. Gradually, bronchitis becomes chronic,
often leads to pneumonia;
- lung cancer. The disease does not make itself felt for a long time, gradually
there are coughing fits. The person loses weight rapidly, starts at night
to sweat, it becomes harder for him to breathe;
- tuberculosis. Celebrated here слабость, потливость (особенно
night), lack of appetite, loss of body weight, long dry
Phlegm color from light green to dark green speaks of
that there is a bacterial or fungal process in the lungs.
- abscess or gangrene of the lung. Symptoms of pathologies are very similar.
(if we are talking about an acute and not a chronic abscess,
whose symptoms are more scarce). This is a pronounced weakness
malaise, shortness of breath, chest pain, very high, almost not
antipyretic, body temperature;
- bronchiectasis. This is a chronic pathology,
associated with the expansion of the bronchi. It is characterized by flow from
exacerbations and remissions. When exacerbated in the morning and after finding
purulent sputum (green, yellow-green) on the stomach. Person
feels unwell, his temperature is high;
- actinomycous process. AT этом случае отмечается длительно
fever, malaise, coughing, mucopurulent
- cystic fibrosis is a disease when almost all the secrets
produced by the glands of the body, become very viscous, bad
evacuated and suppurate. It is characterized by frequent pneumonia and
pancreatic inflammation, lag in growth and body weight. Without
special diets and taking enzymes such people can die from
complications of pneumonia;
- sinusitis (its symptoms are described above).
White phlegm is characteristic of:
- ORZ: then the sputum is transparent white, thick or foamy,
- lung cancer: it is not only white, but it has streaks of blood.
There are also weight loss, fatigue;
- bronchial asthma: it is thick, glassy, it is released after
- heart disease. The color of this sputum is whitish, the consistency is
Transparent, vitreous, difficult to discharge sputum characteristic
for bronchial asthma. The disease is characterized by exacerbations when
there is difficulty breathing (difficult to exhale) and audible to
distance wheezing, and remission when a person feels
Diagnosis of sputum by consistency and odor
In order to evaluate this criterion, it is necessary to produce
expectoration of sputum in a transparent glass container, evaluate it
immediately, and then remove, covered with a lid, and let it brew (in
In some cases, sputum may become flaky, which will assist in
- Слизистая мокрота: она выделяется, в основном, при ОРATИ;
- Liquid colorless characteristic of chronic processes
developing in the trachea and pharynx;
- Foaming sputum of white or pinkish color is excreted when
edema of the lung that may accompany both cardiac
diseases, and poisoning by inhalation gases, and pneumonia, and
inflammation of the pancreas;
- Sputum mucopurulent character can be allocated when
tracheitis, sore throat, bacterial bronchitis, complicated cystic fibrosis
- Vitreous: characteristic of bronchial asthma and COPD.
An unpleasant smell is characteristic of the complicated bronchiectasis.
disease, lung abscess. Offensive, putrid odor characteristic
для gangrene of the lung.
If the sputum is divided into 2 layers when settling, this is
probably lung abscess. If three layers (top – foamy, then
liquid, then – flaky), it can be gangrene of the lung.
What does sputum look like in case of major diseases?
Sputum for tuberculosis has the following characteristics:
- mucous consistency;
- not large (100-500 ml / day);
- then there are streaks of greenish or yellowish pus.
colors, white blotches;
- if there are cavities in the lungs that have violated the integrity
tissue in sputum blood streaks appear: rusty or scarlet,
larger or smaller, up to pulmonary
With bronchitis, sputum has a purulent character,
practically odorless. If the vessel is damaged, in the sputum
bright scarlet streaks of blood fall.
With pneumonia, if there is no purulent fusion of blood vessels,
sputum is purulent and yellow green or yellow
Colour. If pneumonia is caused by a flu virus, or
the bacterial process has captured a large area, the discharge can
have rusty color or streaks of rusty or scarlet blood.
Phlegm in asthma mucous, viscous, whitish or clear.
ATыделяясь после приступа кашля, похожа на расплавленное стекло, ее
referred to as vitreous.
What to do when sputum appears
- Consult a doctor. The first should be a therapist, then –
otolaryngologist (ENT) or pulmonologist. The direction to them will give
therapist. You also need to talk about the advisability of putting
- Купить 2 стерильные баночки для сдачи sputum ATесь этот день
take copious amounts of warm fluid. In the morning, on an empty stomach
take 3 deep breaths and cough up (do not spit) sputum. AT одну
the jar needs more detachable (this should go to the clinical
laboratory), the other – less (in the bacteriological
- If the symptoms resemble tuberculosis, the delivery of sputum in
clinical laboratory where under the microscope will be detected
Mycobacterium tuberculosis, you need to produce three times.
- Independently do not need to do anything. Maximum –
make inhalation with “Berodual” in the age dosage (if
sputum is separated after coughing) or dissolve antiseptic type
�”Strepsils”, “Septolete”, “Faringosept” (if there was no cough). Not
knowing some nuances, for example, that when hemoptysis take
mucolytics (ACC, carbocysteine) is impossible, you can greatly harm
Автор: Кривега Мария Салаватовна врач-реаниматолог