Sputum: What It Is, Diagnosis, and Treatment

Sputum is a mucus layer that serves a protective lining. The mucus layer found in the respiratory tract prevents the area from drying out and becoming irritated. It acts as a protective structure against foreign substances such as dust and pollen that enter the body. The mucus layer changes in color and structure for various reasons, forming sputum. Generally benign, sputum can sometimes indicate a different health issue. In cases of respiratory and lung diseases, sputum production may increase due to irritation and infection. Therefore, sputum can provide preliminary information about health status. Additionally, home conditions, work environments, and habits can directly or indirectly influence sputum formation. Although producing sputum is seen as the body's way of cleansing itself, it is beneficial to monitor it closely. If there are changes in color, structure, or habit, the underlying cause should be investigated.

What is Sputum?

There are certain mechanisms that help protect the respiratory tract from foreign substances and maintain airway patency. One of these mechanisms is the mucus produced by the lungs and airways. Mucus plays a role in keeping the respiratory tract moist and in the removal of foreign substances. Generally, the mixture of mucus and saliva expelled through coughing in the presence of irritation or infection is referred to as sputum. The color and structure of sputum can vary in the presence of infections, respiratory diseases, and lung conditions. Therefore, sputum analysis is performed to investigate substances expelled from the upper respiratory tract. Sputum provides information not only about the upper respiratory tract but also about the lower respiratory tract.

The consistency of sputum can change for many different reasons. It may be thick, sticky, or frothy. If an infection progresses, sputum may become even thicker. Sputum caused by allergies is generally not dark. Additionally, sputum may become somewhat thicker in the morning and during dehydration. Since frothy and colored sputum indicates a serious issue, it is advisable to consult your doctor without delay.

What Causes Sputum?

Sputum is a mucus located in the throat and lungs. It has a thicker structure compared to the mucus produced in the nose and sinuses. It helps keep the respiratory tract moist and warm. However, producing sputum is usually not a cause for concern. Sputum is expelled to clear foreign and irritating substances from the lungs and throat. However, if colored sputum occurs or if sputum is coughed up when there is no illness, there may be another underlying reason. In this case, sputum can indicate that something is going wrong in your body. There are several primary causes of sputum associated with coughing:

• Infections and allergies
• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Gastroesophageal reflux disease (GERD)
• Dry, arid environments
• Fluid loss from the body

In addition to these, your lifestyle habits can contribute to sputum and coughing. Smoking and drug use, along with your working conditions, can affect sputum production.

A series of tests are conducted to understand the cause of sputum.

A sputum sample is taken early in the morning before consuming anything. After rinsing the mouth with clean water, a sputum sample is provided along with a cough.
For patients who have difficulty expelling sputum, sputum induction may be performed. This is especially used in the diagnosis of airway diseases such as tuberculosis. The patient is encouraged to cough by inhaling a hypertonic solution vapor, and a sputum sample is collected.
Another sampling procedure is bronchoscopy. Using a bronchoscope, which is equipped with a light and camera, a sputum sample is taken from the throat, and the respiratory tract is examined.

What Does the Color of Sputum Indicate?

The color of sputum is an indicator of bacterial infection present in respiratory and lung diseases. It helps detect the presence of inflammatory cells in the respiratory tract and is an easily interpretable marker. It provides a rapid estimate of the likelihood of a bacterial infection.

• Clear Sputum: It is normal for the body to regularly produce mucus and sputum. Clear sputum helps keep the respiratory tract moist and contains water, proteins, and antibodies. If the body produces an excessive amount of clear sputum, it usually indicates that the body is trying to expel allergens such as pollen. However, in some cases, it may indicate viral bronchitis, allergic rhinitis, and viral pneumonia.
• Green or Yellow Sputum: Indicates that neutrophils (white blood cells) are fighting an infection. Sputum may initially appear yellow and later turn green. Green or yellow sputum can be seen in bronchitis, sinusitis, cystic fibrosis, and pneumonia.
• White Sputum: Usually results from viral bronchitis, COPD, gastroesophageal reflux, and congestive heart failure.
• Brown Sputum: Rusty or brown-stained sputum typically indicates old blood. It may appear after red or pink sputum in some cases. It is often associated with bacterial pneumonia and bronchitis, lung abscesses, cystic fibrosis, and inhalation of toxins such as coal and asbestos.
• Black Sputum: Also known as "melanoptysis." It is caused by inhalation of high concentrations of black substances like coal dust and fungal infections. Smoking and the use of inhalable drugs can also lead to black sputum.
• Bloody, Red, or Pink Sputum: The red and pink color comes from blood. It indicates a serious problem. Conditions such as tuberculosis, pulmonary embolism (blood clot in the lungs), congestive heart failure, lung inflammation, and lung cancer should be considered.

How is Sputum Treated?

Sputum often becomes bothersome and exacerbates coughing. There are some lifestyle changes that can help prevent sputum formation. Additionally, there are various methods to clear sputum:

• Stay Hydrated: Drinking plenty of fluids is more important than you might think. Water is essential for the body to fight off infection and eliminate toxins.
• Keep Indoor Air Moist: Keeping the air in your home humid helps moisturize the throat and loosens sputum.
• Nasal Spray or Drops: These can help alleviate mucus buildup in the nose. They thin the mucus produced by the sinuses, making it easier to expel.
• Inhaling Steam: This can be beneficial for clearing sputum as it warms and moistens the respiratory tract. Essential oils like eucalyptus can also be used to help loosen sputum.
• Limit Caffeinated Beverages: Consuming too much caffeine-containing drinks like tea and coffee can lead to dehydration, which means lower humidity.
• Mucolytics: Medications to thin mucus and help expel sputum can be used under a doctor's advice.
• Avoid Smoking: Smoking can increase sputum production. Consult your doctor for assistance with this issue.

How to Clear Sputum in Infants and Children?

Sputum can make it difficult for infants and children to breathe and can hinder their ability to fall asleep. Excess sputum may even cause nausea and vomiting. While mucus typically protects against infection, an excessive buildup of mucus can, paradoxically, lead to infection. Therefore, it is necessary to regularly clear it:

• Use a Sterilized Nasal Aspirator: This can be used to suction excess mucus. It should be sterilized after each use.
• Nasal Spray: This can be applied to help loosen and expel mucus.
• Humidifiers in Children's Rooms: These can be beneficial, but the machines must be regularly cleaned.
• Warm Baths: A warm bath can help soften sputum and facilitate steam inhalation.
• Remove Potential Allergens: Be cautious to remove potential allergens from the environment, such as dust, pollen, and pets.
• Avoid Dropping Liquids into Infants' Noses: Do not administer medication without consulting a doctor. Honey should not be given to infants under one year old. If the infant's sputum and nasal congestion are severe, consult a doctor.

Natural Methods to Clear Sputum

There are several natural methods to control sputum:

• Gargling with Warm Salt Water: This can help break down sputum. It loosens the sputum and facilitates the expulsion of foreign allergens from the throat.
• Honey: It is often used in the treatment of cough and sputum. It helps moisturize the throat by loosening thick mucus. It can be consumed plain or mixed in warm teas.
• Ginger: A natural anti-inflammatory, ginger can help prevent excessive mucus buildup. Ginger used in teas is considered effective for cough, sore throat, and sputum.
• Turmeric: The main ingredient, curcumin, is effective in reducing infections that trigger sputum production. It is anti-inflammatory and can facilitate mucus expulsion.
• Broths: Soups made from meat are a good source of vitamins, minerals, and proteins, helping against infection. Drinking warm or hot soup can aid in breaking down sputum.
• Certain Foods: Foods like onion, garlic, broccoli, and pineapple are considered good options against inflammation in the airways.

Untreated sputum can make breathing difficult, irritate the throat, and cause coughing. It negatively affects sleep patterns and can even make eating difficult. Temporary and mild sputum is usually not a serious symptom and often resolves on its own. However, persistent and severe sputum may indicate another problem. In this case, be sure to consult your doctor.