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Reasons For Coughing Up Phlegm Without Feeling Ill

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.

White phlegm can also occur in asthma or other chronic lung diseases, one should consider that the color of phlegm alone is not a reliable diagnosis in itself. It's best to consult a healthcare professional if there any serious questions or concerns.

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:

Approximately 20% of people in the United States will experience GERD at some point.

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 can cause heartburn and other symptoms, including:

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.

Learn more about allergies.

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:

It is vital to report these symptoms to a doctor for immediate treatment.

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 typically produce symptoms until it spreads. However, some people may experience early symptoms.

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

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:

Allergies

The primary treatment for allergies is to identify and avoid triggers. Other treatments include:

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:

In most cases of asthma, people can effectively manage their symptoms with medication, such as quick-relief and corticosteroid inhalers.

Heart failure

Heart failure is a serious condition that requires immediate medical treatment.

Long-term treatment options include:

Here are some frequently asked questions.

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 may lead to phlegm production in severe cases.

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 may get some relief by gargling salt water.

Read on to learn more about gargling with salt water.

Why do I keep coughing up mucus but I'm not sick?

Although a person may cough up mucus as a result of an infection, it may also be due to another factor such as acid reflux. A person may experience heartburn with acid reflux or GERD, but they might otherwise not feel like they are sick.

When should I be worried about coughing up phlegm?

If a person coughs up phlegm and experiences other severe or long-lasting symptoms, it may be due to a serious underlying condition such as bronchitis and pneumonia. Phlegm that contains blood may indicate a serious condition such as lung disease. A person should contact a doctor as early as possible.

Why do I cough up thick jelly-like mucus?

Numerous infections and conditions can cause thick jelly-like mucus. The color of the mucus can help determine the cause. For example, green mucus may indicate pneumonia, while pink or red-tinted mucus can indicate lung disease or another condition that causes blood in mucus.

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.

COPD Causes And Symptoms

These men and women are fighting a common enemy: COPD – Chronic Obstructive Pulmonary Disease. Their lungs don't work normally…every breath taken can be a struggle. What do they believe to be the cause?

Bill Durham COPD Patient

Too many cigarettes. Smoked too long, about 40 years.

Loretta Freeman COPD Patient

I started smoking when I was 17.

Joseph Burlas COPD Patient

My wife says it's from 40 years of smoking.

Narrator

That's true for about 85-percent of COPD cases.

Gerald Staton, MD

We do see occasional patients that have various industrial exposures that can seem to contribute to that, but often they smoke cigarettes too and so it's probably a combination of factors.

Narrator

Consider what happened to 59-year-old Gregory Wright. As a firefighter he was exposed to burning plastics, asbestos and chemicals. Then he worked at an airport breathing in noxious fumes and gases.

Gregory Wright, COPD Patient

The doctor going over my medical history – did you ever smoke? Yes. I smoked for over 30 years.

Narrator

Another troublesome combination:

Gerald Staton, MD

Asthma seems to be a predisposition that if you are an asthmatic as a child and then smoke cigarettes then you have a fairly significantly higher risk of developing COPD later in life.

Narrator

Then there's a particularly lethal mix: a genetic, or hereditary predisposition due to alpha 1 antitrypsin deficiency.

Diane Kay, COPD Patient

I was diagnosed with alpha 1 in '99 but I had symptoms for years and being a flight attendant I had a difficult time keeping up with the rest of the crews.

Narrator

Although rare, people like Diane Kay have low levels of a so-called lung protector protein that's produced by the liver.

Diane Kay, COPD Patient

It took me forever to walk up the driveway from getting the mail. I had to take breaks, and you just think you getting older and at that the time I was a smoker. So you think you know you're older and you smoking and you know. What do you expect?

Narrator

She was susceptible to colds, bronchitis and laryngitis and it took her forever to get over these illnesses. The early COPD symptoms are often missed:

Gerald Staton, MD

Even people in their 30's and 40's will have the so-called smoker's cough. They think that's normal. They think everybody gets up in the morning and coughs up stuff, that's not normal. That's the beginning of symptoms.

Narrator

Shortness of breath tends to develop in their late 40's and 50's. Diane finally had to give up her job:

Diane Kay, COPD Patient

They kind of frown on flight attendants walking on an airplane with an oxygen mask (laughs).

Narrator

Eventually it became so difficult for Diane to breathe that she ended up needing a lung transplant. Her advice: don't smoke.

Diane Kay, COPD Patient

It basically caused me to have a transplant. If I hadn't been a smoker or worked in an environment where there is second hand smoke I probably wouldn't have had a transplant I never would have gotten as sick as I got, as quickly as I did.

Narrator

For WebMD, I'm Rhonda Rowland.

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Narrator

These men and women are fighting a common enemy: COPD – Chronic Obstructive Pulmonary Disease. Their lungs don't work normally…every breath taken can be a struggle. What do they believe to be the cause?

Bill Durham COPD Patient

Too many cigarettes. Smoked too long, about 40 years.

Loretta Freeman COPD Patient

I started smoking when I was 17.

Joseph Burlas COPD Patient

My wife says it's from 40 years of smoking.

Narrator

That's true for about 85-percent of COPD cases.

Gerald Staton, MD

We do see occasional patients that have various industrial exposures that can seem to contribute to that, but often they smoke cigarettes too and so it's probably a combination of factors.

Narrator

Consider what happened to 59-year-old Gregory Wright. As a firefighter he was exposed to burning plastics, asbestos and chemicals. Then he worked at an airport breathing in noxious fumes and gases.

Gregory Wright, COPD Patient

The doctor going over my medical history – did you ever smoke? Yes. I smoked for over 30 years.

Narrator

Another troublesome combination:

Gerald Staton, MD

Asthma seems to be a predisposition that if you are an asthmatic as a child and then smoke cigarettes then you have a fairly significantly higher risk of developing COPD later in life.

Narrator

Then there's a particularly lethal mix: a genetic, or hereditary predisposition due to alpha 1 antitrypsin deficiency.

Diane Kay, COPD Patient

I was diagnosed with alpha 1 in '99 but I had symptoms for years and being a flight attendant I had a difficult time keeping up with the rest of the crews.

Narrator

Although rare, people like Diane Kay have low levels of a so-called lung protector protein that's produced by the liver.

Diane Kay, COPD Patient

It took me forever to walk up the driveway from getting the mail. I had to take breaks, and you just think you getting older and at that the time I was a smoker. So you think you know you're older and you smoking and you know. What do you expect?

Narrator

She was susceptible to colds, bronchitis and laryngitis and it took her forever to get over these illnesses. The early COPD symptoms are often missed:

Gerald Staton, MD

Even people in their 30's and 40's will have the so-called smoker's cough. They think that's normal. They think everybody gets up in the morning and coughs up stuff, that's not normal. That's the beginning of symptoms.

Narrator

Shortness of breath tends to develop in their late 40's and 50's. Diane finally had to give up her job:

Diane Kay, COPD Patient

They kind of frown on flight attendants walking on an airplane with an oxygen mask (laughs).

Narrator

Eventually it became so difficult for Diane to breathe that she ended up needing a lung transplant. Her advice: don't smoke.

Diane Kay, COPD Patient

It basically caused me to have a transplant. If I hadn't been a smoker or worked in an environment where there is second hand smoke I probably wouldn't have had a transplant I never would have gotten as sick as I got, as quickly as I did.

Narrator

For WebMD, I'm Rhonda Rowland.

Pulmonary Contusion (Bruised Lung): Causes And Treatments

Severe complications may warrant care in the ICU

Medically reviewed by Reza Samad, MD

Pulmonary contusion (bruised lung) occurs as the result of serious blunt force trauma and can be a sign that you sustained a severe injury. Despite your lungs being protected by your rib cage, they can become bruised when met with significant force and typically result from high-impact injuries. Such injuries can be sustained in a car accident or a fall from a significant height.

This article explores pulmonary contusion causes, symptoms, and recovery timeline.

SDI Productions / Getty Images

Pulmonary Contusion Causes and Risk Factors

Like most of your organs, your lungs are surrounded by layers of connective tissue. Exactly how lung contusions develop is questionable, but these interior bruises are thought to result from damage to the air sacs (alveoli) in your lungs, which can disrupt your breathing.

Blunt force injuries are the cause most chest traumas. It's possible to develop a pulmonary contusion without a traumatic injury, but the most common causes of pulmonary contusions are:

Read Next: Causes of Lung Pain and Treatment Options

Pulmonary Contusion Symptoms

The symptoms that can appear early on with bruised lungs can mimic those of other chest injuries. If you develop a pulmonary contusion, you may experience symptoms like:

It's possible to have no symptoms with a pulmonary contusion. It can take between 24 and 48 hours after the initial injury for symptoms to develop. Later signs of a severe pulmonary contusion or complications caused by the injury include:

Cyanosis (bluish skin, lips, or nail beds, which can indicate a lack of oxygen)

Decreased breath sounds

Decreased oxygen levels

Distention (swelling) of the jugular vein in the neck

Flailing motions in the chest (chest movements that indicate multiple broken ribs)

Increased heart rate

Increased respiratory rate

Nasal flaring

Retractions in the chest wall when you breathe

Pulmonary contusions can't be seen with the naked eye and are often only diagnosed once severe complications occur.

Related: The Different Types of Chest Trauma and Injuries

Pulmonary Contusion on X-Ray

If you or a loved one sustains a traumatic chest injury, the healthcare team will first evaluate symptoms and vital measurements like heart rate, blood pressure, and oxygen saturation. Once your condition is stabilized, they will do imaging studies to investigate the full extent of your injuries.

A chest X-ray and ultrasound can provide enough information for a diagnosis. However, a computed tomography (CT) scan is more comprehensive, and most providers prefer this option when available.

On an X-ray, a bruised lung can appear as an area of patchy shadowing or consolidation, but an X-ray may not detect early damage.

A CT scan can provide more detailed images of the lung and surrounding areas. This is important since blunt chest injuries can impact more than just the lungs. CT imaging allows healthcare providers to examine surrounding spaces and vessels in the chest cavity for related damage.

Short- and Long-Term Pulmonary Contusion Complications

There are short-term and long-term problems that can arise from a pulmonary contusion.

Immediately after the injury, a pulmonary contusion can lead to complications such as:

Pulmonary contusions are serious injuries that usually require prolonged hospitalization and treatment. The long-term consequences of a pulmonary contusion will depend heavily on the extent of the initial damage, what complications developed, and how quickly or effectively these problems were treated.

When complications like ARDS and pneumonia develop from a pulmonary contusion, long-term respiratory failure is a genuine threat. Long-term respiratory failure carries a mortality rate of between 10% and 25%.

More severe pulmonary contusions are also associated with more extensive treatments like prolonged stays in a critical care unit and extended use of mechanical ventilation.

Treatment and Management

Traumatic injuries are often complex, which could contribute to a missed or late diagnosis of pulmonary contusion. Pulmonary contusions can heal without complications in a week or less when recognized and treated appropriately.

Healthcare providers monitor pulmonary contusions closely to identify complications and prevent respiratory failure. Additional management strategies include:

Intravenous fluids to treat hypovolemia (fluid loss)

Pain management to control labored breathing

Sitting in a reclining position

Treating fluid overload with diuretic medications

Using supplemental oxygenation through noninvasive or invasive methods

With complications, invasive oxygen therapy like intubation and mechanical ventilation are possible options. If complications progress to ARDS, prone (lying on your stomach) positioning and other intensive treatments may follow.

Overall, treatment for pulmonary contusion isn't always predictable. Early detection, diagnosis, and treatment are vital in preventing respiratory failure, but complications are common.

Pulmonary Contusion Recovery and Rehabilitation

Supportive care like oxygen therapy and good respiratory hygiene can help reduce the likelihood of severe complications.

The goals of recovery and rehabilitation for a pulmonary contusion are to ensure the following:

You are consistently getting enough oxygen.

You get rid of injury-associated pain.

Your airways remain clear.

Healthcare providers advise those recovering from a pulmonary contusion to cough and take regular deep breaths to keep their lungs clear and support recovery.

Prevention

Prevention measures for pulmonary contusions are standard safety measures aimed at avoiding traumatic injuries. These include things like:

Avoiding high-risk activities

Following workplace safety rules

Preventing falls

Wearing protective gear during contact sports

Wearing seat belts when driving or riding in a vehicle

These steps can help prevent traumatic injuries, but not entirely. It's important to seek immediate medical care in the event of chest trauma to quickly detect and treat bruised or damaged lungs.

Summary

A pulmonary contusion is a common traumatic chest injury and one that can cause significant short- and long-term complications. Standard safety measures to prevent traumatic injury, like wearing a seat belt, can help you avoid these injuries. Treatment when these injuries do happen often requires hospitalization and sometimes prolonged intensive care.

If you've had an injury to the chest, see a healthcare provider for a full assessment to prevent a missed diagnosis and severe consequences.

Read the original article on Verywell Health.

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