Unpleasant phlegm. Symptoms of respiratory system diseases. The origin of the purulent smell when coughing

Sputum is a modified mucus that is produced by glandular cells of the mucous membranes of the bronchi and lungs. Mucus moisturizes the mucous membranes, and thanks to the movements of the villi of the epithelium airways is gradually eliminated from the lungs.

Normally, every day in an adult respiratory organs up to 150 ml of mucus is formed. When an infection enters the respiratory system, adults and children may develop inflammatory processes, which are manifested by changes in the characteristics of mucus.

Sputum is one of the very first signs of inflammation in adults and children. The characteristics of pathological discharge in combination with other clinical manifestations enable the doctor to establish a preliminary diagnosis.

Sputum analysis as a method for diagnosing pulmonary diseases

The characteristics of altered mucus do not differ between adults and children. Its change is influenced by the type of disease, the pathogen itself and where the sputum comes from (from the upper respiratory tract, trachea, bronchi or lungs).

For diagnostic purposes, when establishing a diagnosis of respiratory pathology, patients are prescribed. Material for research can be taken from a patient in two ways:

When expelling on its own, sputum is collected in a sterile container when coughing.
In the absence of sputum production, use suction devices (this collection method is used in adults during diagnostic bronchoscopy or in small children).

During laboratory examination of sputum, its characteristics are determined:

In addition to microscopy, which gives a general description and determines the types of sputum, the laboratory also carries out bacterioscopic analysis and, if necessary, bacteriological culture.

During bacterioscopy, the following is determined in the secretions:

When coughing up during the day, the material is collected in a separate container to determine its daily amount. This has important diagnostic and prognostic significance. The daily amount of pathological discharge can be:

small (individual spitting);
moderate (up to 150 ml per day);
large (150-300 ml per day);
very large (over 300 ml per day).

If necessary, pH (acidity) is determined in the secretions.

Measuring pH in the lungs has implications for prescribing antibacterial agents, unstable in acidic or alkaline environments.

Diagnosis of pathology by sputum analysis

Changes in the characteristics of the mucous secretions of the respiratory tract can be pathognomonic (correspond to only one pathology) or general (characteristic of many diseases). Interpretation of results laboratory research in most cases, it allows the doctor to establish or clarify the diagnosis and prescribe treatment.

Amount of sputum

The volume of pathological secretions that patients cough up per day depends on:

A small amount of discharge in adults is observed with laryngitis, bronchitis, tracheitis, pneumonia, and a large amount is discharged from cavities in the lung tissue (bronchiectasis, abscesses) or with pulmonary edema (due to sweating of plasma).

A decrease in the amount of pathological discharge after a previous increase may indicate:

subsidence of inflammation (accompanied by improvement of the patient’s condition);
violation of drainage of the purulent cavity (proceeds with an increase in clinical symptoms);
suppression of the cough reflex (in elderly or malnourished patients).

Sputum smell

The odor of normal bronchial mucus is neutral. As a result of a violation of bronchopulmonary metabolism (due to bronchial blockage, infection, tumor disintegration), various substances appear in the secretions that are not typical for normal mucus. These substances may have a different odor, which may suggest a diagnosis.

The smell of discharge changes to foul as a result of activity anaerobic bacteria, which cause putrefactive decomposition of proteins contained in sputum into substances with an unpleasant and fetid odor (indole, skatole, hydrogen sulfide).

Deterioration of bronchial drainage aggravates putrefactive processes in the lungs.

This sputum smell occurs when:

abscess;
bronchiectasis;
disintegrating cancer.

An opened lung cyst is usually accompanied by the release of altered mucus with a fruity odor.

Character of sputum

Mucous glassy sputum is transparent, colorless. When coughing, clear sputum appears on early stages and in recovery inflammatory diseases respiratory organs, as well as after an attack of bronchial asthma. White sputum may be produced when the patient is dehydrated.

Serous discharge is formed as a result of the sweating of blood plasma into the lumen of the bronchi. Discharge of this type is liquid, opalescent (irridescent), transparent yellow, foamy and sticky (due to the content large quantity squirrel).

As a result of active breathing movements chest sputum quickly foams, and sweating together with the plasma of blood cells gives the discharge a pinkish tint. Foamy, pinkish sputum is characteristic of pulmonary edema.

Mucopurulent sputum is viscous, thick, with a yellowish tint, yellowish-greenish. Released during acute inflammatory diseases or in the stage of exacerbation of chronic pathologies of the respiratory tract, pneumonia caused by staphylococcus, with abscesses (before breakthrough), actinomycosis of the lungs.

Purulent sputum is liquid in consistency and tends to separate into two or three layers.

Sputum is yellow or green sputum when coughing, it is typical for acute and prolonged bronchitis, tracheobronchitis, severe pneumonia, bronchiectasis, pleural empyema.

Sputum color

The color of sputum when coughing can range from white to black for various diseases, which is important for making a diagnosis. Based on its color, one can suspect a certain pathology:

With bacteriological culture, not only the pathogen is determined, but also its sensitivity to antibacterial drugs.

Treatment of pulmonary pathologies

Treatment of diseases of the bronchopulmonary system should be comprehensive and prescribed only by a doctor who knows how to get rid of sputum and other manifestations of pulmonary pathology. Self-medication can be dangerous to the health and life of the patient.

The treatment program will depend on the diagnosis and may include:

Conservative treatment:
- medicinal;
- non-medicinal;
Surgery.

As a rule, the vast majority of lung diseases are of an infectious nature, so the basis of drug therapy is antibacterial therapy (depending on the type of pathogen): Amoxiclav, Sumamed, Cefazolin, Ciprofloxacin, Levofloxacin. For viral etiology of the pathogen, antiviral drugs(Acyclovir, Ganciclovir, Arbidol), and for fungal infections - antifungals (Amphotericin B, Fluconazole, Itraconazole).

To thin and facilitate the passage of secretions, reduce swelling of the bronchial mucosa and increase their lumen, patients are prescribed:

bronchodilators and mucolytics: Bromhexine, Bronchipret, Acetylcysteine, Potassium iodide;
antihistamines: Zyrtec, Zodak, Fenistil, Suprastin;
bronchodilators: Atrovent, Ventolin, Eufillin;
anti-inflammatory drugs (they are also painkillers): Ibuprofen, Nimesulide, Diclofenac.

In most cases pulmonary pathologies good discharge of secretions formed in the bronchi and lungs significantly facilitates the course of the disease.
Symptomatic drugs that are used in the complex treatment of respiratory diseases include:

antipyretic drugs: Paracetamol, Aspirin;
antitussives (for debilitating nonproductive cough): Libexin, Tusuprex, Cough tablets.

It is advisable to prescribe immunomodulatory drugs (Dekaris, Timalin, Anabol) to increase resistance immune system patients.

If the acid-base balance in the blood is disturbed, it is prescribed infusion therapy, and in case of severe intoxication syndrome, detoxification therapy.

If necessary, after suppression of acute inflammatory process Surgical treatment is performed, the extent of which depends on the disease. The patient can undergo:

drainage of the pleural cavity;
opening of a lung abscess;
tumor removal;
removal of a lung or part of it.

It is dangerous to ignore the appearance of pathological discharge from the respiratory system. Any self-medication for pathology of the bronchopulmonary system is unacceptable. Early detection of the disease and prescription proper treatment promotes a speedy recovery of the patient and an improved prognosis.

The appearance of a cough always causes a lot of inconvenience both for the sick person and for those around him. But sometimes a cough with bad breath occurs. And such a phenomenon not only brings serious psychological discomfort to the patient, but also often indicates serious problems with health.

Causes of a coughing patient unpleasant odor from the mouth, there are many. At the same time, the cough itself and the smell can be interconnected and be a consequence of one disease, or signal different pathological processes in organism.

All causes of such symptoms can be divided into the following groups:

Diseases of the respiratory system;
Dental problems associated with oral diseases;
ENT pathology;
Disease of the endocrine system, diabetes;
Problems with the gastrointestinal tract (GIT).

Most often the reason pathological condition is due to problems with oral health or functional disorders work of the gastrointestinal tract. With kidney pathologies, a cough may also occur, and the symptom is accompanied by the appearance of an ammonia odor from the mouth.

Respiratory diseases

Almost all respiratory diseases provoke coughing. And if the main cause is a pathology of the bronchi or lungs, then the patient’s coughing may be accompanied by a smell and particles of pus in the coughed up sputum. Most often, the condition is possible with the following pathologies:

Bronchitis;
Pulmonary obstruction;
Bronchiectasis;
Gangrene or lung abscess.

In rare cases, a cough with odor and discharge of pus particles occurs with bronchial asthma.

The appearance of such symptoms is possible in cases where the inflammatory process is accompanied by the production of a large amount of sputum. The mucus does not have time to be eliminated naturally and accumulates. The body removes it by coughing. And mucus rotting occurs due to the activity of pathogenic microorganisms, as well as when dead particles of the mucous membrane settle in the sputum.

Oral diseases

The appearance of an unpleasant rotten or rotten odor, both with and without a cough, may indicate oral diseases or insufficient hygiene. Irregular brushing of teeth leads to the appearance of plaque on them, as well as rotting food particles that remain in the small crevices of the oral cavity even several hours after eating. The unpleasant odor from the mouth becomes especially pronounced after sleep.

Other causes of odor include the following oral diseases:

Stomatitis;
Caries;
Gingivitis;
Tartar formed from plaque due to insufficient oral hygiene;
Gum abscess;
Periodontal disease.

Pathologies of the oral cavity often become causes of disruption of the gastrointestinal tract. This is possible because, passing through diseased teeth, food carries some pathogenic microorganisms into the stomach.

ENT pathology

Almost all ENT diseases arise as a result of exposure to pathogenic microorganisms on the mucous membrane. These can be either viral or bacterial, most often coccal, infections. When they infect the human mucosa, they actively multiply in it. The result of the life activity of pathogenic microflora is the appearance purulent inflammation.

The main ENT diseases that provoke the appearance of cough with an unpleasant odor and pus are:

Sinusitis. Pus accumulates in the maxillary sinuses and remains there constantly;
Tonsillitis. It is characterized by inflammation of the tonsils and the appearance on their surface of accumulations of pus, consisting of dead bacteria, dead epithelial cells and leukocytes.

The appearance of small, foul-smelling lumps when coughing most often indicates tonsillitis. With sinusitis, pus is most often excreted in sputum.

Diabetes

The appearance of a cough with a specific odor from the oral cavity is also possible with diabetes. In this case, the cough itself occurs due to constant dry mouth that accompanies the pathology, and the foul odor is a reaction to dehydration.

In diabetes mellitus, cough may be accompanied by the aroma and taste of acetone. This phenomenon occurs when the mucous membranes are dry due to fasting or lack of fluids, especially with excessive sweating.

Diseases of the gastrointestinal tract

Foul smell, as well as a cough, can occur in a person with slow digestion, low acidity gastric juice, and also due to rotavirus infection. The smell of rotten eggs occurs when coughing and belching due to fermentation and rotting of undigested food. Coughing in such cases is often accompanied by the flying out of small lumps of rotting food. The pathology may also be accompanied by vomiting.

Sour belching and cough with sour smell, may indicate gastritis or peptic ulcer of the stomach or duodenum.

Diagnostics

With this type of problem, the patient should consult a therapist. After conducting a visual examination and recording complaints, the doctor can refer the patient for consultation to the following specialists:

Gastroenterologist. If the patient has problems with the gastrointestinal tract;
Pulmonologist. If you suspect problems with your lungs;
Dentist. In case of obvious problems with the condition of the teeth;
Endocrinologist.

However, before visiting highly specialized specialists, the patient is usually prescribed the following mandatory tests and examinations:

General analysis blood;
General urine analysis;
Examination of sputum and mucus from the throat.

A general blood test is one of the methods for diagnosing cough with odor

If problems with the lungs are suspected, the patient also needs to undergo fluorography. And according to the test results, if a patient experiences a cough with bad breath, additional diagnostic tests may be prescribed:

Bronchoscopy;
Analysis of blood sugar levels is carried out over time;
Fibrogastroscopy;
Ultrasound of organs abdominal cavity.

Often, to make an accurate diagnosis, the patient needs to donate blood for a biochemical analysis.

Treatment depending on the cause of the odor

Since bad breath, like a cough, is only a symptom of an existing pathology, it is necessary to treat the underlying cause:

In case of pathologies of the respiratory system, the patient is provided with accelerated removal of sputum using special postural drainage or massage. Also used in treatment are antispasmodics and adrenomimetics, which prevent a decrease in the bronchial lumen and the occurrence of pulmonary spasm. For abscesses, surgical treatment of the disease is prescribed.
If the symptoms are caused by diseases of the oral cavity, treatment is carried out through its sanitation. Also, diseased teeth are filled, and, if necessary, removed and replaced with dentures. At the same time, treatment of the mucous membrane is carried out by spraying and rinsing the mouth medicinal compounds herbal and alcohol based.
Diseases of the ENT organs are treated with antibacterial drugs. Medicines are used mainly locally. Foci of infection can be thoroughly sanitized. In some cases, therapy is carried out surgically. In the case of sinusitis, this is clearing the sinuses, and in case of tonsillitis, it is removing the tonsils.
Treatment for foul-smelling cough in diabetes involves organizing proper nutrition and the patient’s drinking regimen, as well as regular monitoring of blood sugar levels.
Problems with the gastrointestinal tract are eliminated by normalizing the acidity of gastric juice, using sorbents and liver enzymes. During treatment, the patient also needs to take probiotics and follow a diet. If the patient has weakness of the gastric sphincter, he is not recommended to take a horizontal position for 1.5-2 hours after eating.

Only the attending physician is responsible for selecting medications and establishing a treatment regimen for the pathology. Treatment is prescribed based on the results of examinations and with mandatory consideration of the general health condition and characteristics of the patient’s body.

Prevention measures

Preventive measures to avoid the appearance of bad breath when coughing and the discharge of pus are general:

Adhere to healthy eating rules;
Observe the rules of personal hygiene;
Stop smoking;
Take daily walks in the fresh air;
Increase immune resistance with physical activity and hardening;
Carry out regular preventive examinations with a dentist and general practitioners;
If you become ill, be sure to consult a doctor. Don't engage self-diagnosis and self-medication.

During treatment of various pathological processes, it is important to complete the entire course of therapy. Otherwise, there is a risk of not treating the disease, which can lead to the development of a number of complications.

Sputum is an abnormal fluid secreted by the respiratory tract through coughing. Sputum is valuable diagnostic material. It is collected in a clean wide-necked glass container with a screw-on lid in the morning when coughing, after thoroughly rinsing the mouth and throat, before eating. Collecting sputum a day or more in advance is not advisable, since prolonged standing causes proliferation of flora and autolysis of cellular elements. Sometimes it becomes necessary to store sputum in the refrigerator. The source of the most valuable information is the contents of the tracheobronchial tree obtained during bronchoscopy (bronchial lavage water).

Sputum examination: macroscopic, microscopic, bacterioscopic. During macroscopic examination, attention is paid to: the nature of sputum, quantity, color, smell, consistency, layering, the presence of various inclusions. The nature of sputum is determined by its composition. The simplest type is mucous membrane, consisting only of mucus. It is released for acute bronchitis and resolution of an attack of bronchial asthma. With a mixture of mucus and pus, mucopurulent sputum is formed, in which the purulent component in the form of lumps or streaks often predominates. Observed in chronic bronchitis, bronchopneumonia. Purulent-mucous – contains mucus and pus (the predominance of pus, the mucus has the appearance of strands). Characteristic of bronchiectasis, abscess pneumonia.

If there is no mucus, then the sputum is purulent. Most often it can be observed after a pulmonary empyema breaks through into the bronchus. Muco-bloody - consists of mucus streaked with blood or blood pigment. It is noted for catarrh of the upper respiratory tract, bronchogenic cancer, pneumonia. Mucopurulent-bloody - contains mucus, pus and blood. Appears in bronchiectasis, tuberculosis, pulmonary actinomycosis, bronchogenic cancer. Bloody discharge (hemoptysis) - occurs with tumors of the bronchi and lung, lung injury, actinomycosis. Serous discharge - characteristic of, is blood plasma that has sweated into the bronchial cavity.

The amount of sputum (the size of individual portions and daily amounts) depends on the nature of the disease and on the patient’s ability to expectorate. A scanty amount of sputum is characteristic of inflammation of the respiratory tract (tracheitis, acute bronchitis in the initial stage, bronchopneumonia). An abundant amount of sputum (from half a liter to two) is usually observed when there are cavities in the lungs, as well as dilated bronchi in bronchiectasis, or when there is increased blood filling in the lungs and sweating of a large amount of blood plasma into them (pulmonary edema). The color and clarity of sputum depend on its nature and the composition of inhaled particles.

Sputum usually has a glassy consistency, yellow tint in mucopurulent. The yellow-greenish color is characteristic of sputum, in which the purulent component predominates over the mucous one. Simply purulent sputum usually has a yellow-green color. With mucous-bloody sputum, in addition to the characteristic glassy consistency, there is a bloody or rusty tint. In the presence of pus, lumps and red streaks are observed in such sputum.

By the nature of the discharge one can judge the localization of the pathological process. Pulmonary bleeding is accompanied by liquid, foamy discharge, which is red in color. Sputum that looks like “raspberry jelly” is characteristic of the disintegration of a lung tumor. Pulmonary edema produces liquid, transparent, sticky yellow sputum with opalescence. Small particles that enter the lungs with dust can give sputum a specific color. Thus, white sputum is often found in flour millers; miners are at risk of developing lung diseases accompanied by black sputum.

The smell emanating from sputum should be interpreted with caution. So, it often appears only when it stands for a long time, because freshly secreted sputum is odorless. Although it must be remembered that sputum can be retained both in the bronchi and in the cavities formed in the lungs. The smell in this case appears due to the addition of abundant bacterial flora, causing the breakdown of proteins and, as a consequence, the appearance of a putrid odor. This situation can occur with bronchiectasis. Lung abscess, tuberculosis and malignant neoplasms also often lead to the appearance of unpleasant-smelling sputum. The foul odor of respiratory tract secretions is characteristic of lung gangrene.

In sputum one can identify: Kurshman spirals – corkscrew-shaped tubular bodies that have diagnostic value for bronchial asthma; fibrinous convolutions - tree-like branched formations of elastic consistency, which are important for fibrinous bronchitis, less often - for lobar pneumonia; rice-shaped bodies (Koch lenses) - dense formations of a cheesy consistency, which consist of detritus and also contain tuberculosis bacilli and elastic fibers; found in cavernous pulmonary tuberculosis; purulent plugs Dietrich - consist of detritus, bacteria, crystals fatty acids, occur with gangrene of the lung; films; necrotic pieces of lung; lung tumor particles; drusen of actinomycetes; Echinococcus elements; foreign bodies accidentally falling from the cavity (sunflower seeds, etc.).

Microscopic examination of sputum is carried out in fresh unstained and fixed stained preparations. The elements of sputum that are found in the native preparation can be divided into three main groups.

1. Cellular elements – squamous epithelium(single cells are always found, multiple cells occur during inflammatory phenomena in the oral cavity); columnar epithelium (found in acute catarrh of the upper respiratory tract, acute bronchitis, bronchial asthma); macrophages “fat balls” (found in lung cancer, tuberculosis, actinomycosis), siderophages - “cells of heart defects”, macrophages with hemosiderin (found during stagnation in the pulmonary circulation, during pulmonary infarction), coniophages - dust macrophages (characteristic of pneumoconiosis and dust bronchitis); tumor cells; leukocytes (in mucous sputum - single, in purulent - cover all fields of vision); red blood cells (single ones can be in any sputum stained with blood).

2. Fibrous formations - elastic fibers that indicate the breakdown of lung tissue during tuberculosis, abscess, tumor, coral fibers (deposition of fatty acids and soaps on the elastic fiber) and calcified fibers (impregnated with lime salts); fibrinous fibers (with fibrinous bronchitis, lobar pneumonia, sometimes with actinomycosis); Kurshman spirals.

3. Crystal formations - Charcot-Leyden crystals (a product of crystallization of proteins of decayed eosinophils, found in bronchial asthma, helminthic lesions of the lungs), hematoidin crystals (found in hemorrhages in the lung tissue, in necrotic tissue), cholesterol crystals (found when sputum is retained in cavities - tuberculosis, abscess, echinococcosis); fatty acid crystals - also form when sputum stagnates in the lung cavities.

Staining of preparations is carried out in order to study blood cells in sputum and for bacteriological research. To study blood cells in sputum, the Romanovsky-Giemsa staining method is used. With this staining method it is possible to differentiate cells of the leukocyte series, erythrocytes, however highest value has the release of eosinophils (sputum eosinophilia is characteristic of bronchial asthma, helminthic lung lesions, eosinophilic pneumonia). Bacterioscopic examination of sputum with Gram staining is of indicative value for identifying gram-positive and gram-negative microflora. Ziehl-Neelsen staining is performed to detect Mycobacterium tuberculosis.

If bacterioscopy fails to detect them due to the small number of mycobacterium tuberculosis, a number of additional studies are resorted to (luminescent microscopy, methods of bacterial accumulation - flotation and electrophoresis). Sometimes in a colored preparation it is possible to detect different kinds fungi - aspergillus, candida, actinomycetes. The bacteriological method makes it possible to isolate the causative agent of the disease in its pure form by inoculating sputum on nutrient media, to determine virulence and drug resistance(sensitivity) of the isolated microorganism, which is necessary for the rational selection of antibacterial agents. In some cases, experimental animals are infected with sputum obtained from a sick person.

When bad breath appears when coughing, the first thing the patient thinks about is possible complications. Convenience to others fades into the background.

The most common causes of unpleasant odor

There are three main groups of diseases that are accompanied by a not very pleasant aroma:

Oral diseases. This list is quite extensive; almost all violations are included in it. Starting with banal caries and ending with gum abscesses.
Respiratory tract diseases. Pathologies are usually associated with inflammation, thickening of the bronchial wall and increased mucus secretion. Expectorated sputum is not the most aromatic substance.
Systemic diseases. These include diabetes mellitus, acute renal failure, and liver problems.

Fortunately, dental problems occupy the leading place in terms of prevalence. They do not threaten the patient’s life, and it is enough to spend a couple of days of your time and not a small amount of money on treatment.

What can cause bad breath?

What to do if your cough begins to be accompanied by an unpleasant odor:

Still, examine your oral cavity. Bronchitis could coincide with gum suppuration, then there is no need to panic in advance. Although you will have to be treated for two different diseases.
A cough accompanied by sputum may be a sign of bronchitis or even a lung abscess. After the appearance of mucus, you should not continue to sit at home; only an experienced doctor will be able to make the correct diagnosis.
With bronchitis, the problem is a violation of the secretion of mucus by specific cells. Compaction of the wall of the bronchi and narrowing of their lumen leads to the development of congestion and the accumulation of foul-smelling fluid in the bronchial tree.
An abscess is a cavity in which pus accumulates. And so it is clear that in this case there is no talk of any pleasant smell from the mouth.
Chronic tonsillitis or tonsillitis can also bring a couple of not the best aromas into your life. The pathology is localized in the upper respiratory tract.
Availability foreign body in the nasal cavity will be accompanied by sneezing rather than coughing. But the smell may still be present.

Bad breath due to lung damage

Specific treatment that would eliminate only horrible smell, does not exist. For these conditions, complex therapy is necessary that can eliminate the cause of the aroma that disturbs others.

Should be wary of the development of putrefactive processes, especially when it comes to the respiratory tract.

The lungs are an amazing organ. Even after losing 60-70% of lung tissue, a person is able not only to live normally, but also to calmly run a hundred meters at a level with healthy people. But the accumulation of pus can lead to the melting of adjacent tissues and the rupture of an abscess in the bronchi.

You can roughly imagine what a drowning person feels when choking on water. After a breakthrough, the patient may find himself in a similar position, only instead of water there will be pus.

There is always a great temptation to take an antitussive remedy at the height of the disease and get rid of a debilitating cough. But if the cough is accompanied by mucus, you should under no circumstances do this. Due to the cough reflex, the bronchial tree is cleared of the fluid accumulated in it. Stopping this process will not lead to anything good; it is better to be patient a little and cough up all the mucus.

Cough and bad breath: causes

Bad breath is a common problem that affects adults and children. A similar sign is detected by the patient independently or by others. The smell becomes noticeable not only during close contact, but also during coughing. And everyone would like to know its cause, especially parents who notice such a symptom in their child.

Causes and mechanisms

Normally, there should be no unpleasant odors coming from your mouth. If you had to notice something similar, then you should understand the reason for what is happening, because it may be hidden in serious pathological processes. But first, it doesn’t hurt to exclude rather banal situations, for example, insufficient oral hygiene or the influence of dietary preferences (monotonous protein foods).

Pathological odor from the mouth when coughing most often indicates problems with the ENT organs and respiratory system. The exhaled air is saturated with volatile molecules that are formed during purulent processes and infectious tissue breakdown. Therefore among probable diseases The following should be noted:

Sinusitis.
Tonsillitis.
Bronchiectasis.
Abscess and gangrene of the lungs.

With sinusitis, for example, cough occurs due to the so-called postnasal drip syndrome, when mucus flows through the back wall throats. And tonsillitis is often accompanied by pharyngitis, when the mucous membrane of the throat is irritated. In bronchopulmonary pathology, this reflex is associated with the accumulation of sputum in the respiratory tract, which creates the need to clear the latter.

But in addition to these conditions, we must not forget about possible violations on the part of other organs. Pathology of the gastrointestinal tract (gastroduodenitis, cholecystitis, pancreatitis, peptic ulcer) is mediated by motor disorders when food stagnates or backflow of contents is observed (gastroesophageal and duodenogastric reflux). Metabolic disorders in diabetes mellitus, renal failure or some hereditary fermentopathies also lead to the appearance of an unpleasant odor from the mouth. And cough in such cases may be due to concomitant ARVI or other respiratory pathology.

Bad breath in a child that occurs when coughing can be caused by various reasons that require differential diagnosis.

Symptoms

It will be possible to determine the source of the violations only after a thorough examination. And its basis lies in clinical diagnostics. The doctor first analyzes complaints and other anamnestic information received from the patient himself or the child’s parents. This allows us to identify subjective symptoms and get an idea of the onset and development of the pathology. And the results of a physical examination (examination, listening, etc.) allow us to objectify the picture.

Sinusitis

If in paranasal sinuses If pus accumulates in the nose, then an unpleasant sweetish odor may be felt from the baby’s mouth. Additional signs present in the clinical picture will help establish the diagnosis:

Deterioration of nasal breathing.
Mucopurulent discharge from the nose.
Weakened sense of smell.
Distension and pain in upper jaw.

The inflammatory process is accompanied by fever and intoxication. When tapping on the upper jaw in the area of the affected sinuses, the pain intensifies, as does when tilting the head. If there is redness and swelling of the skin on the outside, then one can think about complications (subperiosteal abscess).

Tonsillitis

A long-term inflammatory process in the tonsils is accompanied by the deposition of pus in the lacunae. Foul-smelling pathological exudate is a mixture of dead bacteria, leukocytes and epithelium. Children with tonsillitis are also concerned about:

Discomfort in the throat when swallowing.
Dry cough.
Low-grade fever.
Increased sweating.
Weakness and fatigue.

Upon examination, purulent masses are visible in the lacunae of the loosened tonsils, the palatine arches are thickened and swollen. With an exacerbation, the fever becomes higher, pain appears when swallowing, and signs of intoxication are noted. Decompensated tonsillitis is accompanied by damage to the joints, kidneys and heart (toxic form).

Chronic tonsillitis is a rather serious disease, especially in children. It manifests itself as local disorders and systemic toxic-allergic disorders.

Bronchiectasis

If dilations form in the bronchi, then physiological secretions can accumulate in them, in which bacteria will sooner or later begin to develop. Again, this will be a prerequisite for bad breath and cough. The latter will become the main symptom of the disease. The cough is constant and is accompanied by the discharge of a large volume of purulent sputum (especially in the morning). Signs of pathology also include:

Children are falling behind physical development, the chest is deformed. On the hands, the fingers take the form of " drumsticks", acrocyanosis appears. During periods of exacerbation, body temperature rises, cough intensifies, and the amount of sputum increases.

Abscess and gangrene of the lungs

Another situation where coughing patients have bad breath is an abscess or gangrene of the lung. These diseases relate to infectious destruction, that is, pathology with the destruction of alveolar tissue. With an abscess, a decay cavity is formed in the lung, surrounded by granulation and fibrous tissue. While the abscess is maturing, the patient is concerned about:

All these symptoms most often develop against the background of pneumonia, so the onset can be quite delayed. But the moment the abscess breaks into the bronchus is difficult not to notice, because when you cough, a large amount of sputum suddenly begins to come out. This is accompanied by an improvement in well-being. During auscultation over such a cavity, bronchial or amphoric breathing with local moist rales is heard, and tympanitis is determined by percussion.

The inflammatory process in lung gangrene does not have clear boundaries and is accompanied by greater severity of toxic phenomena. Against the background of necrosis, multiple decay cavities form in the tissue. Local and general signs become much stronger than with an isolated abscess. Exhausted sputum, as well as the smell from the mouth, are putrid in nature.

With abscess and gangrene, areas of decay form in the lungs, which leads to the appearance of a purulent or putrid odor from the respiratory tract.

Additional diagnostics

The source of the disorder can only be determined through a thorough examination of the patient. Additional methods help the doctor with this. Among the laboratory and instrumental procedures prescribed to the patient, it is worth noting:

General blood analysis.
Analysis of nasal discharge and sputum, throat smear (microscopy, culture).
X-ray of the paranasal sinuses and lungs.
CT scan.
Bronchoscopy and bronchography.

To rule out diseases digestive tract and metabolism, fibrogastroscopy, ultrasound of the abdominal organs, examination may be required biochemical parameters blood. Consulting related specialists will also not hurt. All this makes it possible to make a final diagnosis and accurately indicate the source of the unpleasant odor when coughing. Next, the doctor will prescribe appropriate therapy.

Cough with phlegm

Cough. carries phlegm (a mixture of mucus and saliva) from the lungs to the mouth, which is the body's way of getting rid of secretions that accumulate in the lungs. Smoking is the main cause of cough with phlegm. Do not try to persuade the patient to hold back his cough. This can impair lung function and increase the risk of respiratory tract infection.

Many people who cough with phlegm do not pay attention to it or consider it normal. They do not see a doctor until they experience serious health problems such as shortness of breath. coughing up blood. chest pain, weight loss, or frequent respiratory problems.

Color and smell of sputum

Color, consistency and smell of sputum - important indicators human condition. The same applies to the sound of coughing. What do the color and consistency of sputum mean:

Transparent, thin, watery sputum is usually formed with a cold or other upper respiratory tract diseases, asthma, allergies; under the influence of irritants (for example, cigarette smoke).
Thick greenish or yellow sputum indicates sinusitis, bronchitis, or pneumonia.
Brown or reddish sputum usually contains blood. This can be the result of injury caused by coughing, as well as pneumonia, tuberculosis, severe irritation, or even lung cancer.

If a person who usually does not cough develops a persistent cough with phlegm, this is an ominous sign - there may be a life-threatening condition. You should urgently consult a doctor, especially if the sputum is bloody, with pus, yellow, greenish or rust-colored.

Urgent medical attention is also necessary for restlessness or clouding of consciousness; if the patient has uneven, rapid or slow breathing. These symptoms indicate acute disorder breathing.

To avoid spreading the infection, the patient should:

When coughing, cover your mouth and nose with a tissue;
always spit sputum into a jar with a lid;
wash your hands often.

Causes of cough with phlegm

The number one reason is smoking. Why? When you smoke, your airways produce more mucus, which in turn creates more phlegm to get rid of. Smoking also paralyzes the fine hairs in the respiratory tract, which normally help remove mucus.

The following ailments also contribute to coughing with phlegm:

Asthma. Often the disease begins with a dry cough and mild hoarseness, and gradually develops to severe wheezing and coughing with phlegm. Thick mucous discharge may form.

Chronical bronchitis. In this disease, chronically blocked airways produce a dry cough that gradually turns into a cough with sputum that may contain pus.

Common cold. With this disease, a person may cough up sputum consisting of mucus or a mixture of mucus and pus.

Reaction to stimuli. Inhaling particles of paint, dust and other substances can increase the formation of mucus in the respiratory tract, which irritates them, causing coughing. This often happens in people suffering chronic sinusitis and allergies.

Lung cancer. An early symptom of this disease is a chronic cough with a small amount of blood-streaked sputum. The sputum may contain pus or a mixture of pus and mucus.

Pneumonia. With this disease, a dry cough may occur, turning into a cough with sputum. The color of sputum changes depending on what bacteria are present in it.

Tuberculosis. The patient may cough up small or large amounts of sputum that contains mucus, blood, or pus.

What does the smell and sound of a cough mean?

Unpleasant, putrid smell may be a symptom of bronchitis, lung abscess, tuberculosis. A dry cough indicates that the vocal cords, and a metallic tint indicates damage to the main respiratory tract.

Pneumonia can cause:

chills with trembling;
high temperature;
muscle pain;
headache;
rapid pulse;
rapid breathing;
sweating.

Exercises to remove phlegm

If you have a cough with phlegm, special exercises will help expand and clear your lungs and help prevent pneumonia and other lung diseases. To master these exercises, follow these directions:

Lie comfortably on your back. Place one hand on your chest and the other on your upper abdomen at the base of your sternum.
Bend your knees slightly and support them with a small pillow. Try to relax. (If you have recently had chest or abdominal surgery, keep them still with a pillow.)
Exhale, then close your mouth and inhale deeply through your nose. Focus on feeling your belly rise without expanding your chest. If the hand lying on your stomach rises when you inhale, then you are breathing correctly. Use not only the chest muscles to breathe, but also the diaphragm and abdomen. Hold your breath and slowly count to five.
Close your lips as if to whisper and exhale completely through your mouth without puffing out your cheeks. Use your abdominal muscles to push out all the air, keeping your ribs down and inward. Exhalation should take twice as long as inhalation.
Rest for a few seconds. Then continue the exercise until you have done it correctly five times. Gradually increase the number of repetitions to ten. Once you have mastered this exercise, you can do it sitting, standing, or lying in bed. During the day, try to breathe deeply every hour or two.

These exercises, like the ones described above, will help clear secretions from your lungs and prevent lung infections. Read the following guidelines to learn the correct technique:

Sit on the edge of the bed, leaning forward slightly. If your feet do not reach the floor, place a stool. If you feel weak, rest your hands on the nightstand with a pillow on it.
To stimulate the cough reflex, breathe deeply and exhale through pursed lips. Exhale completely through your mouth without puffing out your cheeks. “Squeeze out” the air using your abdominal muscles.
Inhale again, hold your breath, and cough twice vigorously (or, if you can't, three times gently), focusing on getting all the air out of your chest.
Rest briefly, then perform the exercise at least twice. Repeat this at least once every two hours.

Other self-help measures:

Drink more fluids to thin out lung secretions and make them easier to drain. However, if fluid has accumulated in the lungs (pulmonary edema), consult your doctor first.
Use a room humidifier. This will soothe inflamed airways and soften dried secretions.
Get plenty of rest.
Avoid pulmonary irritants - especially tobacco smoke.
When coughing, stand or sit up straight to help your lungs expand.
You can use medicines and mixtures.

Humidify the air. To soothe airway inflammation and prevent lung secretions from drying out, talk to your doctor about using a room humidifier.

What will they say at the hospital? The patient may be prescribed medications that dissolve phlegm (mucolytics); helping to clear mucus from the lungs (expectorants); dilating airways (bronchodilators). Antibiotics are prescribed to treat the bacterial infection that is causing the cough.

If your child has a cough with phlegm

Because children's airways are narrow, a child who coughs up phlegm may have a blocked airway and have difficulty breathing if the phlegm builds up. Therefore, it is necessary to consult a doctor.

Reasons that cause a child to cough with sputum:

asthma is a chronic lung disease that causes repeated bouts of difficulty breathing;
acute bronchiolitis - a viral disease of the lower respiratory tract (occurs mainly in children from two months to one year);
cystic fibrosis is a chronic disease that affects many organs; Whooping cough is a highly contagious respiratory disease that causes sudden bouts of high-pitched coughing.

To clear mucus from your child's airways, your doctor may prescribe an expectorant. Use the medicine strictly as prescribed by your doctor. Do not give your child other medicines—such as cough suppressants—unless your doctor tells you to. Suppressing a cough may worsen the patient's condition.

The appearance of an unpleasant odor during coughing and its elimination

One of the common complaints when visiting a doctor is bad breath, which occurs mainly during coughing. It can be observed at the beginning of the pathology or after completion of the course of treatment. In some cases, there is no other clinical symptom other than this symptom. Let us immediately note that the presence of odor is always considered as a pathology that requires elimination. Therefore, if such a symptom occurs, you should visit a doctor and determine the cause of its appearance.

What causes the smell

There are a huge number of factors that provoke the appearance of cough. In some cases, there are several reasons at once. In such a situation, the doctor begins treatment, eliminating one of the factors, and observes the changes.

Most often, a cough with an unpleasant odor occurs due to poor hygiene and inflammatory processes.

Insufficient oral care

When you don't brush your teeth regularly, plaque accumulates on their surface. It consists of exfoliated cells, bacteria and food debris. The plaque has a purulent odor and can cause discomfort when coughing or talking. Also characteristic is the smell, reminiscent of rotten eggs. It is caused by the release of hydrogen sulfide during the life of bacteria.

The taste is especially pronounced after sleep. This is explained by the fact that during rest, blood flow slows down significantly and the volume of saliva decreases. Accordingly, it can no longer wash the surface of the teeth and remove plaque from them. Therefore, after sleep, people are more likely to experience unpleasant sensations. To get rid of the smell, just brush your teeth regularly.

Pathologies of the oral cavity

Helitosis, which is the name given to the appearance of an unpleasant sensation, is especially common in cases of pathologies of the teeth and gums. provoke bad smell Can caries, periodontal disease, gingivitis, plaque, stomatitis and so on. The most pronounced symptom is in the presence of purulent inflammation, for example, a fistula. This is due to the activity of staphylococcus and streptococcus.

If there are pathologies of teeth and gums, you can get rid of the smell only with complete sanitation of the oral cavity.

ENT pathology

Almost all diseases of the nasopharynx develop as a result of infection with coccal flora. During the life of bacteria, a purulent process is formed, which causes unpleasant feeling. In addition, it is ENT pathologies that are accompanied by coughing. During periods of exacerbation, helitosis becomes more pronounced. The deviation can be eliminated only together with the doctor through the selection of drugs that are effective against the root cause of the complaints.

Bronchial diseases

Almost all pathologies of the lungs and bronchial tree cause coughing. Moreover, it is often accompanied by a pronounced smell of pus. This is explained by the fact that during the inflammatory process, an increased volume of sputum is produced. It contains desquamated cells of the bronchial mucosa, bacteria and toxins, which causes the smell.

In some diseases, the inflammatory process initially occurs with the release of sputum and pus. This is especially true for advanced bronchitis, abscesses, and bronchiectasis. Elimination of symptoms begins with treatment of the underlying disease. Without this effect it will not be possible to achieve.

Gastrointestinal diseases

Pathologies of the stomach and esophagus also quite often cause the smell of pus that accompanies a cough. It “rises” up the esophagus from the stomach due to incomplete closure of the valve. The nature of the smell can determine the disease:

Sour indicates gastritis or ulcers; in some cases, inflammation of the pancreas is detected.
The smell of rotten protein indicates liver pathology.
Putrefactive is more often observed in diseases of the sphincter.

Important: pathologies of the digestive system often cause plaque accumulation on the tongue, which is also the cause of the odor that accompanies coughing.

Baby smell

While communicating with the baby, the mother may notice that coughing or even talking is accompanied by the release of an unpleasant odor. The reason for this in children may be such abnormalities as a runny nose, sore throat, stomatitis, and digestive pathologies. But besides this, more serious deviations, in particular diabetes, should not be ruled out.

Smell of acetone

As already mentioned, the type of pathology can be determined by the nature of the symptom. This is especially true when the cough is accompanied by the smell of acetone. Most often this indicates a disruption in the absorption of carbohydrates. This situation occurs in diabetics with a lack of insulin.

Diabetes mellitus can be suspected based on the following complaints:

frequent urge to empty the bladder;
severe dry mouth;
weakness.

All this indicates an excess of sugar, which can lead to very sad consequences. It is important to emphasize that when the smell of acetone comes from the oral cavity, this is observed from skin and even from urine.

At the same time, it should be noted that if you have an unpleasant smell reminiscent of acetone when coughing, you do not need to immediately panic, suspecting diabetes. Perhaps the cause of this condition was diet or simple starvation.

Important: if a child smells of acetone, you should first rule out malnutrition.

Ammonia smell

The taste of ammonia and the same odor are most often noted in cases of impaired renal function. In addition, similar symptoms can occur with dehydration. In this case, the patient may suffer from cough due to dryness of the mucous membranes of the throat.

Eating disorder

Another cause of helitosis may be malnutrition. First of all, it is an excess of proteins. When eating food, fibers become trapped between the teeth, which subsequently causes odor. This is one of the explanations that vegetarians, in the absence of pathologies internal organs, there is never bad breath. In addition, coffee, alcohol, and soda can disrupt the acidity in the mouth.

Malnutrition is the simplest cause of helitosis. To get rid of it, it is enough to brush your teeth after eating and follow the rules of a balanced diet, including avoiding overeating.

How to get rid of odor

To eliminate the taste in the mouth during coughing, treatment should be carried out after a complete examination. It will be aimed at eliminating the symptoms and causes of the disease. Thus, so that the patient is not bothered by the presence of an unpleasant taste in the mouth, a diagnosis should be determined and treatment prescribed:

For diseases of the ENT organs, antibacterial therapy and complete elimination of the source of inflammation are used.
In case of pathologies of the teeth and gums, a consultation with a dentist and sanitation with filling of the teeth and treatment of the mucous membrane are prescribed.
Diseases of the digestive system require a special course of treatment.
The presence of acetone odor requires determination of glucose levels and selection of effective therapy. As a rule, in this case the patient is admitted to a hospital.
The smell of ammonia requires a full diagnosis of the kidney condition, after which treatment will be prescribed.

In each case, the set of drugs will be different. It is important to consult a doctor as soon as possible if you suspect diabetes, if you have purulent sputum, or if there is a significant deterioration in your general condition.

How to reduce odor

The patient may have chronic pathologies that are not always treatable. To avoid suffering from unpleasant odor, you should use tips to eliminate it. The simplest ones are chewing gum, sprays and other flavorings.

The following recipes do a good job of eliminating cough odor:

Silver water - you can prepare it yourself or purchase it at the pharmacy.
Herbal infusion. Sage and pine needles help a lot, and if there is purulent sputum, it is recommended to use chamomile or marigold.

Propolis, both in the form of chewing gum and by preparing an infusion.
Manganese - used to prepare the solution.
Activated carbon – used under the tongue. Helps eliminate unpleasant odor.

At the same time, such advice will only help if helitosis is a residual phenomenon or caused by a malnutrition. In other cases, the effect will be short-term. Only complete treatment will help eliminate the smell completely.

What can cause bad breath - see this video:

Sputum in respiratory diseases

Normally, up to 150 ml of mucus is formed in the respiratory organs of an adult every day. When an infection enters the respiratory system, adults and children may develop inflammatory processes, which are manifested by changes in the characteristics of mucus.

Sputum is one of the very first signs of inflammatory diseases of the respiratory system in adults and children. The characteristics of pathological discharge in combination with other clinical manifestations enable the doctor to establish a preliminary diagnosis.

Sputum analysis as a method for diagnosing pulmonary diseases

For diagnostic purposes, when establishing a diagnosis of respiratory pathology, patients are prescribed a sputum test. Material for research can be taken from a patient in two ways:

When expelling on its own, sputum is collected in a sterile container when coughing.
In the absence of sputum production, use suction devices (this collection method is used in adults during diagnostic bronchoscopy or in small children).

During laboratory examination of sputum, its characteristics are determined:

colorless (slightly whitish, glassy);
yellow (yellowish);
green;
yellow-green;
red (pink, bloody);
“rusty” (brown);
in the form of “raspberry” or “currant jelly”;
chocolate (brown);
white-gray;
dirty gray;
creamy (white);
black.

without smell;
unpleasant;
fetid (putrid);
cadaverous (sickening);
specific.

Division into layers:

squamous epithelium;
columnar epithelium;
alveolar macrophages;
siderophages (cells with hemosiderin - a breakdown product of hemoglobin);
dust cells;
tumor (cancerous) cells.

neutrophils (quantity);
eosinophils (number);
lymphocytes (quantity);
basophils (presence);
monocytes (presence).

Red blood cells (quantity).

Kurshman spirals (quantity);
elastic fibers (unchanged) (presence);
elastic fibers (coraloid) (presence);
elastic fibers (calcified) (presence);
fibrin fibers (threads, clots) (presence);
diphtheritic films (presence);
necrotic pieces of tissue (presence).

Charcot-Leiden (number);
Koch lenses (availability);
Dietrich plugs (availability);
cholesterol (presence);
fatty acids (presence);
hematoidin (presence).

Foreign bodies.

In addition to microscopy, which gives a general description and determines the types of sputum, the laboratory also carries out bacterioscopic analysis and, if necessary, bacteriological culture.

During bacterioscopy, the following is determined in the secretions:

bacteria (tuberculosis bacillus, pneumococci, Klebsiella, Pseudomonas aeruginosa and Escherichia coli and others);
fungi (candida, actinomycetes, aspergillus);
protozoa (Trichomonas);
helminths (roundworms, elements of echinococcus).

small (individual spitting);
moderate (up to 150 ml per day);
large (ml per day);
very large (over 300 ml per day).

If necessary, pH (acidity) is determined in the secretions.

Measuring the pH of the environment in the lungs is important for prescribing antibacterial agents that are unstable in acidic or alkaline environments.

Diagnosis of pathology by sputum analysis

Changes in the characteristics of the mucous secretions of the respiratory tract can be pathognomonic (correspond to only one pathology) or general (characteristic of many diseases). Interpretation of laboratory test results in most cases allows the doctor to establish or clarify the diagnosis and prescribe treatment.

Amount of sputum

The volume of pathological secretions that patients cough up per day depends on:

A decrease in the amount of pathological discharge after a previous increase may indicate:

subsidence of inflammation (accompanied by improvement of the patient’s condition);
violation of drainage of the purulent cavity (proceeds with an increase in clinical symptoms);
suppression of the cough reflex (in elderly or malnourished patients).

Sputum smell

The smell of discharge changes to fetid as a result of the activity of anaerobic bacteria, which cause putrefactive decomposition of proteins contained in sputum into substances with an unpleasant and fetid odor (indole, skatole, hydrogen sulfide).

Deterioration of bronchial drainage aggravates putrefactive processes in the lungs.

This sputum smell occurs when:

An opened lung cyst is usually accompanied by the release of altered mucus with a fruity odor.

Character of sputum

Mucous glassy sputum is transparent, colorless. Transparent sputum when coughing appears in the early stages and during the recovery stage of inflammatory diseases of the respiratory system, as well as after an attack of bronchial asthma. White sputum may be produced when the patient is dehydrated.

As a result of active respiratory movements of the chest, the sputum quickly foams, and sweating together with the plasma of blood cells gives the discharge a pinkish tint. Foamy, pinkish sputum is characteristic of pulmonary edema.

Mucopurulent sputum is viscous, thick, with a yellowish tint, yellowish-greenish. It is released in acute inflammatory diseases or in the acute stage of chronic pathologies of the respiratory tract, pneumonia caused by staphylococcus, abscesses (before breakthrough), actinomycosis of the lungs.

Purulent sputum is liquid in consistency and tends to separate into two or three layers.

Yellow or green sputum when coughing is characteristic of acute and prolonged bronchitis, tracheobronchitis, severe pneumonia, bronchiectasis, and pleural empyema.

Sputum color

The color of sputum when coughing can range from white to black for various diseases, which is important for making a diagnosis. Based on its color, one can suspect a certain pathology:

white sputum indicates a fungal infection of the lungs;
yellow sputum when coughing is characteristic of acute bacterial diseases;
green sputum is released in acute tracheitis, bronchitis, pneumonia caused by gram-negative bacteria, bronchiectasis, pleural empyema, cystic fibrosis;
the lemon color of discharge from the bronchi and lungs indicates an allergic etiology of the disease;
red indicates pulmonary hemorrhage;
sputum Brown, coughing in the morning, occurs with bronchitis of smokers;
brown sputum in non-smokers ( rusty sputum) may indicate the presence of diapedetic hemorrhage, which is typical for pneumococcal lobar pneumonia, tuberculosis, and pulmonary infarction;
gray sputum when coughing in smokers indicates sinusitis of viral etiology;
black sputum is a sign of an occupational lung disease - pneumoconiosis (in miners), chronic bronchitis or pneumonia, tuberculosis or decaying lung cancer.

With bacteriological culture, not only the pathogen is determined, but also its sensitivity to antibacterial drugs.

Treatment of pulmonary pathologies

The treatment program will depend on the diagnosis and may include:

As a rule, the vast majority of lung diseases are of an infectious nature, so the basis of drug therapy is antibacterial therapy (depending on the type of pathogen): Amoxiclav, Sumamed, Cefazolin, Ciprofloxacin, Levofloxacin. For viral etiology of the pathogen, antiviral drugs are prescribed (Acyclovir, Ganciclovir, Arbidol), and for fungal etiology, antifungal drugs are prescribed (Amphotericin B, Fluconazole, Itraconazole).

To thin and facilitate the passage of secretions, reduce swelling of the bronchial mucosa and increase their lumen, patients are prescribed:

bronchodilators and mucolytics: Bromhexine, Bronchipret, Acetylcysteine, Potassium iodide;
antihistamines: Zyrtec, Zodak, Fenistil, Suprastin;
bronchodilators: Atrovent, Ventolin, Eufillin;
anti-inflammatory drugs (they are also painkillers): Ibuprofen, Nimesulide, Diclofenac.

In most cases of pulmonary pathologies, good discharge of secretions formed in the bronchi and lungs significantly facilitates the course of the disease.

Symptomatic drugs that are used in the complex treatment of respiratory diseases include:

antipyretic drugs: Paracetamol, Aspirin;
antitussives (for debilitating nonproductive cough): Libexin, Tusuprex, Cough tablets.

It is advisable to prescribe immunomodulatory drugs (Dekaris, Timalin, Anabol) to increase the resistance of the patient's immune system.

If the acid-base balance in the blood is disturbed, infusion therapy is prescribed, and in case of severe intoxication syndrome, detoxification therapy is prescribed.

If necessary, after suppressing the acute inflammatory process, surgical treatment is performed, the scope of which depends on the disease. The patient can undergo:

drainage of the pleural cavity;
opening of a lung abscess;
tumor removal;
removal of a lung or part of it.

It is dangerous to ignore the appearance of pathological discharge from the respiratory system. Any self-medication for pathology of the bronchopulmonary system is unacceptable. Early detection of the disease and prescribing the correct treatment contributes to the patient’s speedy recovery and improved prognosis.

Update: October 2018

By sputum, health workers understand the secretion that is secreted by the cells of the bronchi, which contains the contents of the nose and its sinuses, as well as saliva. Normally, it is transparent and mucous, there is little of it, and it is released only in the morning from people who smoke, work in dusty industries, or live in dry air conditions.

In these cases, it is called tracheobronchial secretion rather than sputum. With the development of pathologies, the following can enter the sputum: pus, when there is bacterial inflammation in the respiratory tract, blood, when damage to the vessel has occurred on the way from the nose to the end of the bronchi, mucus in cases of non-bacterial inflammation. This content may become more or less viscous.

Pathological processes as the cause of the accumulation of sputum in the throat without coughing usually occupy a localization from the nasopharynx, where the contents of the nose and its paranasal sinuses flow, to the trachea. If the disease affected more deep structures: trachea, bronchi or lung tissue, sputum production will be accompanied by cough (in children younger age An analogue of coughing can be vomiting with a large amount of mucus or other contents). and they can, of course, proceed without a cough, but then the sputum separation will not be a concern.

When is sputum production considered normal?

The mucous membrane of the bronchi consists of cells on the surface of which there are cilia - microtubules that can move (normally - in the upward direction, towards the trachea). Between the ciliated cells are small glands called goblet cells. There are 4 times fewer of them than ciliated cells, but they are not located in such a way that after every four ciliated cells there is 1 goblet cell: there are areas consisting of only one, or only of the second type of cells. Glandular cells are completely absent in the small bronchi and bronchioles. Goblet cells and ciliated cells are united by a common name - “mucociliary apparatus”, and the process of movement of mucus in the bronchi and trachea is called mucociliary clearance.

Mucus produced by goblet cells is the basis of sputum. It is needed to remove from the bronchi those particles of dust and microbes that, due to their microscopic size, were not noticed by the cells with cilia that are in the nose and throat.

The vessels are tightly adjacent to the mucous membrane of the bronchi. They come out immune cells, exercising control over the absence of foreign particles in the air entering the lungs. Some immune cells are also present in the mucous membrane itself. Their function is the same.

Therefore, sputum, or more precisely, tracheobronchial secretion, is normal; without it, the bronchi would be covered from the inside with soot and impurities, and would be constantly inflamed. Its amount is from 10 to 100 ml per day. It may contain a small number of white blood cells, but neither bacteria, nor atypical cells, nor fibers contained in lung tissue are detected. The secretion forms slowly, gradually, and when it reaches the oropharynx, healthy man without noticing, swallows this minimal amount of mucous contents.

Why can you feel phlegm in your throat without coughing?

This occurs due to either increased secretion production or deterioration of its excretion. There are many reasons for these conditions. Here are the main ones:

Work in enterprises with increased level air pollution with particles of silicates, coal or others.
Smoking.
Throat irritation from alcoholic drinks or cold, spicy or hot foods can cause a feeling of mucus without coughing. In this case, there is no malaise, no deterioration in breathing, or any other symptoms.
Pharyngo-laryngeal reflux. This is the name for the reflux of the contents of the throat, where the ingredients of the stomach have arrived, which do not have a pronounced acidic environment, closer to windpipe. Other symptoms of this condition are sore throat and cough.
Spicy . The main symptoms will be deterioration of the condition, fever, headache, and the release of copious amounts of snot. These symptoms come to the fore.
Chronic sinusitis. Most likely, this particular pathology will be described as “phlegm in the throat without cough.” It is manifested by difficulty in nasal breathing, deterioration of smell, and fatigue. Thick mucus secretes from the sinuses into the throat, and this happens constantly.
. Here the person is bothered by “phlegm”, bad breath, whitish masses may be visible on the tonsils, which can be released by themselves and with certain movements of the muscles of the mouth, their smell is unpleasant. The throat does not hurt, the temperature may be elevated, but within 37 – 37.3°C.
Chronic catarrhal rhinitis. Here, outside of an exacerbation, the nose only gets stuffy in the cold, and then only on one half; Sometimes a small amount of mucous discharge is released from the nose. During an exacerbation, thick, abundant snot appears, which creates a feeling of phlegm in the throat.
Chronic hypertrophic rhinitis. Here the main symptom is difficulty breathing through the nose, one half of it, which is why a person may have a headache in this half. The sense of smell and taste also deteriorates, and a slight nasal sound appears. Discharge accumulates in the throat or is discharged outward.
Vasomotor rhinitis. In this case, a person may periodically be “overtaken” by attacks of sneezing, which occurs after itching in the nose, mouth or throat. Nasal breathing is periodically difficult, and liquid mucus is released from the nose outward or into the pharyngeal cavity. These attacks are associated with sleep and can appear after a change in air temperature, overwork, eating spicy food, emotional stress or increased blood pressure.
Pharyngitis. Here, phlegm in the throat occurs against the background of soreness or pain in it. More often, the sum of these sensations causes a cough, which is either dry or produces a small amount of liquid sputum.
. At the same time, there is a decrease in saliva production, and due to dryness in the mouth, it seems as if phlegm has accumulated in the throat.

Color of sputum without cough

Based on this criterion, one can suspect:

mucous white sputum indicates fungal (usually candidiasis) tonsillitis;
clear sputum with white streaks may accompany chronic catarrhal pharyngitis;
green, thick sputum may indicate chronic hypertrophic pharyngitis;
and if yellow sputum comes out and there is no cough, this speaks in favor of a purulent process in the upper respiratory tract (rhinitis, pharyngitis,).

If phlegm is felt only in the morning

Sputum production in the morning may indicate:

reflux esophagitis - reflux of stomach contents into the esophagus and throat. In this case, there is weakness of the orbicularis muscle, which should not let what gets into the stomach back out. This pathology is usually accompanied by heartburn, which occurs when taking a horizontal position after eating, as well as periodic belching of air or sour contents. Occurring during pregnancy and accompanied by constant heartburn, it is a symptom associated with compression of the abdominal organs by the pregnant uterus;
chronic sinusitis. Symptoms: difficulty in nasal breathing, deterioration of the sense of smell up to its complete absence, mucus in the throat;
chronic bronchitis. In this case, the sputum has a mucopurulent (yellow or yellow-green) character, accompanied by weakness and low body temperature.
be the first sign of acute bronchitis. There is an increase in temperature, weakness, loss of appetite;
developing into spring-autumn period, talk about bronchiectasis. Other symptoms include malaise and fever. In summer and winter, a person again feels relatively good;
appearing against the background of heart diseases, indicate their decompensation, that is, the appearance of congestion in the lungs;
developing in young children, talk about. In this case nasal breathing impaired, children breathe through their mouths, but there is no temperature or signs of acute respiratory infections.

Sputum when coughing

If a person notices the appearance of a cough, after which sputum is released, this indicates a disease of the trachea, bronchi or lungs. It can be acute and chronic, inflammatory, allergic, tumor, or stagnant. It is impossible to make a diagnosis based on the presence of sputum alone: an examination, listening to lung sounds, an X-ray (and sometimes CT scan) lungs, sputum tests - general and bacteriological.

To some extent, the color of the sputum, its consistency and smell will help you navigate the diagnosis.

Color of sputum when coughing

If you produce yellow sputum when you cough, this may indicate:

purulent process: acute bronchitis, pneumonia. It is possible to distinguish these conditions only according to instrumental studies (X-ray or computed tomogram of the lungs), since their symptoms are the same;
the presence of a large number of eosinophils in the lung or bronchial tissue, which also indicates eosinophilic pneumonia (then the color is yellow, like a canary);
sinusitis. Here there is poor breathing through the nose, separation of not only sputum, but also yellow mucopurulent snot, headache, malaise;
yellow liquid sputum with a small amount of mucus, which appears against the background of icteric discoloration of the skin (due to a tumor, or blockage of the bile ducts with a stone) indicates that damage to the lungs has occurred;
yellow ocher color speaks of siderosis, a disease that occurs in people who work with dust that contains iron oxides. With this pathology there are no special symptoms other than cough.

Sputum is yellow-green in color talking about:

purulent bronchitis;
bacterial pneumonia;
be a normal symptom after tuberculosis that has been cured with specific drugs.

If you cough up rust-colored discharge, this indicates that vascular injury occurred in the respiratory tract, but the blood, by the time it reached the oral cavity, was oxidized, and hemoglobin became hematin. This may happen when:

severe cough (then there will be streaks of rusty color that will disappear after 1-2 days);
pneumonia, when inflammation (purulent or viral), melting the lung tissue, leads to damage to blood vessels. There will be: fever, shortness of breath, weakness, vomiting, lack of appetite, and sometimes diarrhea;
PE pulmonary embolism.

If you cough up brown mucus, this also indicates the presence of “old”, oxidized blood in the respiratory tract:

if the lungs had one, almost always congenital pathology, like bullae (cavities filled with air). If such a bulla lay close to the bronchus and then ruptured, brown sputum will be released. If at the same time air also enters the pleural cavity, shortness of breath and a feeling of lack of air will be noted, which may increase. The “sick” half of the chest does not breathe, and pain was noted during the rupture of the bulla;
. Here, a significant deterioration in the general condition comes to the fore: weakness, clouding of consciousness, vomiting, high temperature. The sputum is not only brown in color, but also has a putrid odor;
pneumoconiosis - a disease that occurs due to industrial (coal, silicon) dust. Characterized by chest pain, first a dry cough. Gradually, bronchitis becomes chronic, often leading to pneumonia;
. The disease does not make itself felt for a long time, and coughing attacks gradually appear. A person suddenly loses weight, begins to sweat at night, and it becomes increasingly difficult for him to breathe;
tuberculosis. There is weakness, sweating (especially at night), lack of appetite, weight loss, and a prolonged dry cough.

Sputum color ranging from light green to dark green indicates that there is a bacterial or fungal process in the lungs. This:

abscess or gangrene of the lung. The symptoms of the pathologies are very similar (if we are talking about acute rather than chronic abscess, the symptoms of which are more sparse). This is severe weakness, malaise, shortness of breath, chest pain, very high body temperature that practically does not respond to antipyretics;
bronchiectasis. This is a chronic pathology associated with dilation of the bronchi. It is characterized by a course of exacerbations and remissions. During an exacerbation, purulent sputum (green, yellow-green) comes out in the morning and after lying on the stomach. The person feels unwell and has a fever;
actinomycosis process. In this case, it is noted for a long time elevated temperature, malaise, coughing up mucopurulent greenish sputum;
Cystic fibrosis is a disease when almost all the secretions produced by the body’s glands become very viscous, are poorly evacuated and suppurate. It is characterized by frequent pneumonia and pancreatic inflammation, stunted growth and body weight. Without a special diet and enzyme supplementation, such people may die from complications of pneumonia;
sinusitis (its symptoms are described above).

White sputum typical for:

ARI: then the sputum is transparent white, thick or foamy, mucous;
lung cancer: it is not only white, but there are streaks of blood in it. Weight loss and fatigue are also noted;
bronchial asthma: it is thick, glassy, released after a coughing attack;
heart diseases. The color of such sputum is whitish, the consistency is liquid.

Transparent, glassy, difficult to separate sputum characteristic of bronchial asthma. The disease is characterized by exacerbations, when there is difficulty breathing (difficulty exhaling) and wheezing audible at a distance, and remissions, when the person feels satisfactory.

Diagnosis of sputum by consistency and smell

In order to evaluate this criterion, it is necessary to expectorate sputum into a transparent glass container, evaluate it immediately, and then remove it, cover it with a lid, and let it sit (in some cases, the sputum may separate, which will help in diagnosis).

Mucous sputum: it is released mainly during ARVI;
Liquid, colorless characteristic of chronic processes developing in the trachea and pharynx;
Foamy, white or pinkish sputum released during pulmonary edema, which can accompany both heart disease and inhalation gas poisoning, pneumonia, and inflammation of the pancreas;
Sputum of mucopurulent nature can be released during bacterial bronchitis, complicated cystic fibrosis and bronchiectasis;
Vitreous: characteristic of bronchial asthma and COPD.

An unpleasant odor is characteristic of complicated bronchiectasis or lung abscess. A fetid, putrid odor is characteristic of lung gangrene.

If the sputum separates into two layers when standing, it is probably a lung abscess. If there are three layers (the top one is foamy, then liquid, then flaky), this may be gangrene of the lung.

What does sputum look like for major diseases?

Sputum in tuberculosis has the following characteristics:

slimy consistency;
not abundant (100-500 ml/day);
then streaks of greenish or yellowish pus and white spots appear;
if cavities appear in the lungs that violate the integrity of the tissue, streaks of blood appear in the sputum: rusty or scarlet, larger or smaller in size, up to pulmonary hemorrhage.

With bronchitis, the sputum is mucopurulent in nature and practically odorless. If a vessel is damaged, bright scarlet streaks of blood enter the sputum.

In pneumonia, if purulent fusion of the vessels has not occurred, the sputum is mucopurulent in nature and yellow-green or yellow in color. If pneumonia is caused by a virus, or the bacterial process has covered a large area, the discharge may have a rusty color or streaks of rusty or scarlet blood.

Sputum in asthma is mucous, viscous, whitish or transparent. Released after a coughing attack, it looks like molten glass and is called vitreous.

What to do if sputum appears

Contact your doctor. The first should be a general practitioner, then an otolaryngologist (ENT) or pulmonologist. The therapist will give you a referral. We also need to talk about the advisability of donating sputum.
Buy 2 sterile jars for sputum collection. Drink plenty of warm liquid throughout this day. In the morning, on an empty stomach, do 3 deep breaths and cough up (not spit) the phlegm. One jar requires more discharge (this should go to the clinical laboratory), the other requires less (to the bacteriological laboratory).
If the symptoms resemble tuberculosis, sputum must be submitted to a clinical laboratory, where Mycobacterium tuberculosis will be detected under a microscope, three times.
You don't need to do anything on your own. The maximum is to inhale with “ ” in an age-appropriate dosage (if sputum was separated after a cough) or dissolve an antiseptic such as “Strepsils”, “Septolete”, “Faryngosept” (if there was no cough). Without knowing some nuances, for example, that if you have hemoptysis, you cannot take mucolytics (carbocysteine), you can seriously harm your body.