It is not unusual to cough up phlegm with a common cold. However, it can also indicate a different, sometimes serious, underlying condition such as stomach acid reflux, lung disease, or heart disease.
This article looks at the possible causes of coughing up phlegm, treatment, what different colors of phlegm might indicate, and when a person might consider contacting a doctor.
Cough and excess mucus production are common symptoms of upper respiratory tract infections. These illnesses will typically also cause:
Lower respiratory tract infections, which include bronchitis and pneumonia, are more serious. They may produce longer-lasting symptoms.
Other possible causes of coughing up phlegm include:
Acid reflux
Acid reflux is when stomach acid moves up into the esophagus (food pipe). If someone experiences this regularly, a doctor will likely diagnose it as gastroesophageal reflux disease (GERD). GERD can occur due to dysfunction in the lower esophageal sphincter, a hiatal hernia, or dysfunction in the esophagus.
The main symptom of GERD is heartburn, though acid reflux can also cause a cough.
Other symptoms include:
- excess saliva
- sore throat
- difficulty swallowing
- oral hygiene issues
Approximately
Laryngopharyngeal reflux (LPR) is similar to GERD. However, in people with LPR, stomach acid can move up into the esophagus, the voice box, and even the nasal cavity.
LPR can occur due to dysfunction in the lower esophageal sphincter, esophagus, and upper esophageal sphincter. This
- postnasal drip
- frequent throat clearing
- a cough
- feeling a lump in the throat
- excess mucus
Learn about the differences between acid reflux, heartburn, and GERD.
Allergies
Allergic rhinitis causes similar symptoms to a cold, such as:
Some people with allergies may also develop a postnasal drip, which occurs when excess mucus leaks down the throat. This can cause a person to cough up phlegm.
Environmental factors
Exposure to certain irritants, such as smoke and other fumes, can irritate the airway. This irritation can cause a cough with excess phlegm.
Read on to learn more about air pollution and its effects on health.
Lung disease
Some lung diseases, such as asthma and chronic obstructive pulmonary disease (COPD), cause a persistent cough and excess phlegm.
Other symptoms of lung disease include:
Learn about obstructive lung disease.
Heart failure
Heart failure is a condition in which the heart cannot correctly pump or relax to circulate blood around the body. It causes symptoms such as:
- difficulty breathing
- fatigue
- chronic cough
- wheezing
- production of white or pink phlegm
- swelling of the ankles, legs, feet, and abdomen
- nausea and reduced appetite
- disorientation and confusion
- heart palpitations
It is
Learn the difference between heart failure and a heart attack.
The color of phlegm may help indicate the cause of a cough and excess respiratory mucus production. Phlegm may be clear, cream, white, yellow, green, rust-orange, or red.
Lung diseases unrelated to infection, such as asthma or emphysema, tend to cause clear phlegm.
However, some forms of lung disease, as well as heavy smoking can produce brown or black phlegm. Black phlegm may be a sign of pneumoconiosis, which some people refer to as “coal workers’ lung.”
Green phlegm is typically associated with infection. According to the American Lung Association, pneumonia can cause a cough that produces green, yellow, or bloody phlegm.
Pink or rust-colored phlegm that contains blood can indicate the presence of a serious medical issue such as tuberculosis or an abscess.
Read on to learn more about phlegm colors.
Lung cancer does not
Lung cancer is a less common cause of coughing up phlegm without feeling ill, and many of its symptoms are similar to those of other conditions, such as a lung infection. However, bloody phlegm can be one of the symptoms. Additional common lung cancer symptoms include:
- chronic cough
- chest pain when laughing, breathing deeply, or coughing
- hoarse voice
- reduced appetite
- trouble breathing
- fatigue and weakness
- chronic and recurring respiratory tract infections
- wheezing
Learn about the symptoms of stage 1 lung cancer.
To diagnose why a person is coughing up phlegm, a doctor may ask them about the duration of their symptoms and whether there are any known triggers. They will likely ask about the color or texture of the phlegm.
The doctor will check for allergies or respiratory conditions, such as asthma. If they suspect that GERD is the cause, they may perform an upper GI endoscopy.
Blood tests or chest scans are sometimes necessary to rule out other conditions. A person may also need a sputum test to diagnose the type of lung disease.
Anyone with a persistent cough should contact a doctor for a diagnosis. In many cases, the cause will not be serious, though it might still require treatment.
If a person has a cough that produces blood, it is even more urgent that they contact a doctor to check there is no serious underlying cause.
The treatment for coughing up phlegm depends on its cause.
Acid reflux
Management strategies for GERD and LPR include:
- lifestyle changes, such as stopping smoking if appropriate and avoiding foods that trigger heartburn
- medications, which might include antacids to help relieve heartburn
- surgery, in severe cases
Allergies
The primary treatment for allergies is to identify and avoid triggers. Other treatments include:
- antihistamines
- decongestants
- nasal corticosteroids
Infections
Most upper respiratory infections will go away on their own.
Over-the-counter decongestants and other products can help with some symptoms in the meantime.
Infections that affect the lower respiratory tract may require treatment from a doctor, who will most likely prescribe an antibiotic.
It is important that a person finishes the entire course of antibiotics, even if their cough and phlegm go away sooner.
Lung disease
A doctor might recommend the following treatments for COPD:
- medications
- pulmonary rehabilitation
- supplemental oxygen
- surgery
In
Heart failure
Heart failure is a serious condition that requires immediate medical treatment.
Long-term treatment options include:
- lifestyle changes, such as exercising regularly and eating a balanced, nutritious diet
- medication therapy, such as an angiotensin converting enzyme inhibitor, loop diuretic, or beta-blocker
- implantable devices, such as a defibrillator
- surgery, such as a left ventricular assist device, coronary artery bypass grafting, or angioplasty
Some FAQs about coughing up phlegm may include:
What is the difference between phlegm, mucus, and sputum?
Although people often use all three terms interchangeably, there is a slight difference between them. Mucus is a general term referring to the substance produced by mucous membranes anywhere in the body. Phlegm and sputum both refer to mucus produced in the lungs and lower respiratory tract.
Does COVID-19 cause coughing up phlegm?
Research shows that when a person first contracts COVID-19, it typically causes a dry cough. As the disease progresses, it
Does coughing up mucus mean infection?
No, coughing up mucus does not always indicate an infection. While an infection is one possible cause for coughing up mucus, other causes can include acid reflux, allergies, environmental factors, lung disease, or heart failure.
What are some natural remedies for coughing up phlegm?
Treating coughing up phlegm depends on the underlying cause and may require medical advice. However, a person
Read on to learn more about gargling with salt water.
Most causes of coughing up phlegm are not serious. However, more severe conditions, such as COPD or heart failure, require lifelong treatment.
Coughing up phlegm is typically not a cause for concern. For example, GERD and the common cold are responsible for many cases of coughing up phlegm. However, in some cases, this symptom might indicate an undiagnosed condition.
Most causes are treatable. However, while at-home remedies will be sufficient for some, others will require long-term treatment.