Coughing up green chunks of mucus can be breath-taking occurrence especially if you are experiencing it for the first time. Find out what it means, causes and treatment options
What does it mean when you cough up green mucus chunks?
In the layers of your respiratory tract, there are mucus-producing cells and they line the mouth, the throat, lungs and the nose.
They are also liners of the gastrointestinal tract (GIT). When in the GIT, they are mostly charged with ensuring that the acid produced from the parietal cells of the stomach does not corrode the luminal walls.
In the respiratory tract, the mucosa serves to prevent further entry of pathogens in air you inhale and instead trigger a reflexive expulsion. This is good for the prevention of lower respiratory tract infections such as pneumonia which may be direly fatal if contracted.
Some other benefit of the mucus is to wet the surface of the luminal walls so that they are not dry. Note that drying occurs when the weather is cold or when you sleep on cold surfaces and when the respiratory tract dries up, you become more prone to getting lower respiratory tract infections.
Chunks, according to an MD from the University of South Carolina School of Medicine, are linked to dryness of the respiratory tract. Expectorants are medications that are used in the stimulation of the mucosa to have mucus produced and also expelled to retain the balance.
You have so far been able to understand how the mucus can be of benefit to you. There is yet another benefit that could be attributed to the appearance of the mucus.
While it is normal and physiological to have mucus and therefore sputum produced in your respiratory tract, some of the features in appearance accrued to some sputum could be a lead to a pathology.
Therefore, the color, thickness, content and frequency associated with the mucus you produce are observable traits that should never be taken for granted when making a diagnosis.
One such appearance anomaly that this material seeks to dig into is coughing of green mucus, chunks alongside other color blends. So what does it mean when you cough green mucus chunks? It could mean that you have an infection.
One of the telltale signs that you are having a worsening respiratory status especially in the presence of chronic bronchitis or bronchiectasis is the greenish turning of the normal color of expectorated phlegm.
In this case, there is usually an increased volume of sputum production accompanied by an increase in the level of neutrophil sequestration.
These pathological changes normally occur in the airways that are inflamed. When you have an infection, neutrophils are generated and enter such infection sites and as they try to correct the situation, lead to the production of reactive oxygen intermediates and other degradative enzymes.
In the neutrophilic azurophilic granules is a constituent known as myeloperoxidase (MPO) which is a peroxidase enzyme that strives to sequester the reactive oxygen species so as to prevent oxidation of the adjacent cells. They oxidants, such as hypochlorous acid (HOCl) could be largely damaging as they are toxic.
The MPO, apart from serving this function, also augments the function of neutrophils against the bacterial infection according to Klebanoff SJ (May 2005).
The neutrophils verdoperoxidase (myeloperoxidase) is responsible for the formation of a green coloration on the mucus as it contains a heme pigment. It is not only found in mucus, but also in pus from infected lesions (Keith C. Meyer, 2004). Infections such as Streptococci spp. and Staphylococcus aureus highly generate hydrogen peroxide and trigger the production of the MPO enzyme.
There are also links between the presence of systemic Candida albicans, a fungal infection and the increased release of MPO enzyme.
The common cold is one such result of infections in the respiratory tract and so is sinusitis which could be triggered by underlying conditions such as Cystic Fibrosis (CF), Chronic Obstructive Pulmonary Disease (COPD), nasal polyps, cancer and structural abnormalities among others.
Structural abnormalities will include issues with deformities that may be incumbent in the nasal passage and the nose septum. Infections are also more prevalent in new borns and children as they may suffer nasal injuries.
Causes
Now that you know infections are the biggest causes of green mucus chunks, then it is high time you went deeper into what type of infectious conditions could lead to such an appearance.
With such information, you will be able to pick out the presenting illness and therefore be able to treat it accordingly. If you see a green phlegm, it could be that you have:
Bronchitis
This is a condition that occurs when the bronchial tubes are inflamed. These are the tubes that carry the air into the lungs. During this illness, you will get a persistent cough and produce lots of mucus.
You can either get acute or chronic bronchitis. In acute bronchitis, which is the commonest, the productive cough lasts for a few weeks while in the chronic bronchitis, a more serious condition, continues to have a resurgence or totally does not go away.
This is what is referred to as chronic obstructive pulmonary disease (COPD). Bronchitis kicks off as a dry cough which eventually culminates into a clear or white sputum.
As times goes, this turns into a green or yellow mucus. Why does this occur? When you are suffering from a viral bronchitis, the sputum will be clear but as it goes bacterial, a green or yellow tinge appears.
Pneumonia
When the airspaces in the lungs are inflamed, due to an infection, you get pneumonia. The inflammation of the air spaces is specifically referred to as pneumonitis.
The most common bacteria that leads to this is the Streptococcus pneumonia and presents with central cyanosis, fever (typically >38°C), cough, shortness of breath, tachycardia and chills.
The cough is characterized by production of sputum of varying colors. The colors of the mucus come in handy in determining the causative agent.
While Streptococcus pneumonia causes a rusty colored mucus and Klebsiella species pneumonia a red-currant jelly sputum, green mucus is characteristic of Pseudomonas, Haemophilus, and other pneumococcal species.
At times, the mucus is bloody in addition to being yellow or green.
Sinusitis
An infection of the air cavities that are located within the nasal passages. It is either caused by an infection or an allergic reaction to certain irritant chemicals or particles.
When it is caused by an infection, the signs and symptoms aside sinus headache, facial tenderness, fever, nasal stuffiness and postnasal drainage, results in a cough that is characterized by varying colors that could range from yellow to green.
Acute sinusitis is rarely associated with bacteria but is with viruses and the mucus or snot produced therefore will not be green or yellow.
However as chronic sinusitis is linked to a prolonged blockage of the ostia which is implicated in entrapment of bacteria, you could have secondary bacterial infection.
Cystic fibrosis
This is a chronic lung disease that manifests as a build-up of mucus in the lungs. It is caused by a defective gene and hence much common in children and younger ages in adulthood.
Since the disease leads to build-up of thick mucus in the lungs, it is characterized by a persistent cough and frequent lung infections.
The lung infections could range from bronchitis to pneumonia and hence present with the colored coughed sputum described in the pneumonia and bronchitis.
The disease also presents with wheezes, poor growth, and frequent bulky stool that is greasy with some hypomotility of the lower gastrointestinal tract.
Nasal polyps
Are non-cancerous growths that line the nasal passage or the sinuses. When they hang down the nasal passage into the lumen like grapes, they tend to cause some blockage.
Recurring infections, asthma and drug sensitivities are some of the reasons you will have nasal polyps.
They are painless but since they cause mechanical blockages, could result in a number of infections.
The mucus may drip backwards into the throat which is then coughed out. It could be yellow or green to brown.
What does it indicate; –
If the green mucus is thick and sticky
The thickness and stickiness of the mucus may depend on the severity of the infection. There are infections that are associated with much more production of mucus than others. The causes of green mucus mentioned in the previous section all have a potential of producing thick and sticky mucus though some may have this potential more than the other.
Therefore, some of the indicators of green, thick and sticky mucus could be:
- Bronchitis
- Chronic Obstructive Pulmonary Disease (COPD)
- Cystic Fibrosis
- Pneumonia
Producing thick mucus also means that you are dehydrated and is a common feature in those with the above mentioned infections when they cough in the morning.
If it is yellow green mucus
So long as your immune system is sending neutrophils to fight a breach, they will always be fighting an infection. It could be that you have a viral or bacterial infection such as:
- Sinusitis
- Pneumonia
- Bronchitis
- Cystic Fibrosis
Remember the reason as to why you have such coloration is due to the production of myeloperoxidase which is responsible for the green hue.
Coughing up green mucus no fever
When you cough up mucus that is green, you may have a fever or not. It is typical to have a fever when you have an infection such as pneumonia, bronchitis, sinusitis and rhinitis. This may warrant further investigation into the probability of:
Other neutrophilic triggers
There are two types of neutrophilia: shift and true neutrophilia. In shift neutrophilia, the increase in the cells is transient and factors such as doing rigorous exercises or taking an injection of epinephrine may induce this.
There are other conditions that may be co-morbid with a cough that may increase the population of neutrophils such as paroxysmal tachycardia. Therefore, these could trigger a slight tinge in the sputum.
Additionally, occupational hazards could expose you to allergens that could trigger a greenish colored mucus such as those who do marble polishing or working in construction sites.
Masked pyrexia
If you are taking analgesics for another condition, there is a huge possibility that you may mask your infection.
Since infections are followed by a high fever, such may not be felt when you are for instance, an osteoarthritic patient on high dose paracetamol or diclofenac.
Green mucus cough sore throat
Sore throats are common presentation of infections by Streptococcus pyogenes. This bacteria has already been mentioned as a trigger of the production of hydrogen peroxide and therefore an increase in the level of myeloperoxidase. Sore throats caused by Staph can also trigger the same.
The throat is made of larynx, tonsils and the pharynx and most of these parts will be afflicted with respective inflammations. Infections that may be linked to this include, the mononucleosis, varicella-zoster, measles and mumps viruses.
Coughing up green mucus from chest (lungs)
Chesty cough is a manifestation of a lower respiratory infection. Such infections include those due to cystic fibrosis, COPD, bronchitis and pneumonia.
Most of these infections are associated with such a colored sputum and chest congestion and hence a normal characteristic.
Coughing up green mucus in the morning
If you already have the infections implicated as causes of green sputum, then you will notice that the cough and sputum will be worse in the morning.
This is so due to a suppressed cough reflex when you sleep hence an accumulation of the mucus. The intensity is also increased by an increased post-nasal drip during sleep from the nose or infected sinuses.
Hard ball-like green mucus
Chunks of mucus that you will cough out as balls may be due to a condition such as Catarrh. This condition is associated with an excessive discharge of mucus due to an excessive inflammation of the mucous membranes.
You must have been infected to have the green mucus. You will notice hard ball-like and squishy green mucus mostly in the morning and milder or non during the day.
Light or dark green mucus
Your mucus will get lighter when you are still in the earlier stages of the infection in question. It will therefore get darker as the infection increases in severity.
Darker green means that the neutrophils are more concentrated and hence means that the amount of the reactive oxygen species are higher which means that the amount of myeloperoxidase is large.
Green brown mucus
Since you are already familiar with the causes of green mucus, this should be easy to connect. When you have some traces of blood in the sputum, the greenish color diminishes and takes a brown coloration. Therefore causes of bleeding should be investigated.
Another consideration is that since the color of blood is not imminent, it could be that the internal bleeding must have occurred deeper along the respiratory tract. Some common causes of bloody sputum include cancer, congestive heart failure, lung abscess, pneumonia, pulmonary embolism and tuberculosis.
When these conditions occur simultaneously with those that cause green mucus, then a brown color is possible.
There are conditions that only lead to a brown coloration such as pneumonia, pneumoconiosis, cystic fibrosis, lung abscess and bronchitis.
Green mucus and blood (red)
This could be a result of conditions that lead to a red or pink tinge in the color of sputum such as cancer, lung abscess, pneumonia, tuberculosis and cancers. It could also be a tear of the respiratory tract during the reflexive cough mechanism.
When much of the sputum is forced out, it could lead to a tear of the lumen and hence some minimal bleeding.
Constant cough and green mucus for 3 weeks
A constant cough for 3 weeks is no longer considered acute but a chronic condition. Therefore, in addition to being an infection, this could be:
- Chronic bronchitis
- Pneumonia
- COPD
Best medicine for treatment
Treating infection in a timely manner is imperative especially those affecting the respiratory tract. Infections may build up to become some really severe or serious conditions that could be fatal.
Not treating upper respiratory tract infections could complicate into a lower respiratory infection. Depending on the cause of the infection, it will require that you either manage or treat then prevent futuristic infections of similar nature.
This is what you can use:
Antibiotics and analgesia: antibacterial and antifungal agents would be prescribed for the treatment of the infections. For instance, the treatment of pneumonia would involve the administration of a penicillin or a cephalosporin so as to treat the Strep. Pneumonia.
This could be co-administered with a macrolide antibiotic such as erythromycin. Amoxicillin/clavulanic acid could be indicated for the treatment of bronchitis.
For the pleuritic pain associated with some infections such as pneumonia, pain will have to be managed with the administration of an analgesic drug so as to recover from shallow breathing and the cough. The analgesics also reduce the inflammation in such conditions.
Expectorant, mucolytics and antitussive cough syrups: the cough is another condition that needs to be treated. In as much as cough syrups are said to have limited benefit in treatment, they in deed have been shown to improve the comfort of the patient.
Antitussives could help in suppressing the cough while expectorants, in the elimination of the excessive sputum. One good example is the carbocysteine or guaifenesin in some products. Cough syrups that contain mucolytics such as bromhexine and ambroxol are effective in breaking down the mucus into lighter fluids.
Antihistamines: since some infections are either accompanied by allergic rhinitis, or simply put, green sputum may be associated with some allergies, it is important to have this drug at bay. To a patient, you can administer a cetirizine tablet or syrup for a child to ease the signs and symptoms of allergy by inhibiting the histaminergic activity.
Natural antibiotics: a very common natural antibiotic is ginger and garlic. Both of these can be added to the same concoction so as to make an antibacterial cocktail. Garlic is known for its allicin formed from the principal compound, alliin when its cloves are crushed and boiled to make the antibacterial mixture.
Home Remedies
Dealing with the sputum is the most difficult part of this treatment. There are ways that you can use in order to reduce the phlegm and get rid of the green mucus chunks.
Alongside having the antibiotics taken for the infection which will hopefully treat the infection and rid your sputum of the green hue, here are some tips on how to reduce the mucus:
Steam
Inhaling steam has been shown to be the simplest of all the effective ways you can reduce the mucus. This is due to the ability of the steam to break down the mucus into expectorable fluids easily coughed out but not as chunks.
In order to nail this, take a steam shower twice a day and make it a full heat shower. Afterwards, remain the bathroom for about 5 minutes while breathing in deeply so as to inhale the steam.
You can also pour some steaming water into a basin or bucket and with your head above the rim of the bucket, cover yourself with some blanket or towel then inhale for about 5 minutes. Do this each day.
Salt water:
Salt is effective in reducing the thickness of the mucus. So as to do this, add a tablespoon of salt to a cup of boiled but warm water. Use this solution as a gargle twice a day for optima results.
Take some ginger tea
This will help you relieve the throat of the thick sputum. The tea needs to be hot. You can also add some lemon to it. The ascorbic acid in the lemon has some mild antibacterial properties.
Have this with some minimal amount of sugar especially if you have a sore throat.
Make some lemon juice
As mentioned before, lemon has some mild astringent and antimicrobial properties. The astringent properties may help in preventing optimal production of mucus in the throat and will help kill the bacteria.
You will need to cut some lemon into slices then add them into a glass of hot water. Into the hot water, add some honey to taste and to sooth the throat. Then have this as a drink thrice a day.
You can also mix this mixture with some garlic or ginger.
