Why Are You Coughing Up Orange Mucus or Phlegm?

Key takeaways:

• Orange mucus is often the result of dried blood somewhere in the respiratory tract.
• Areas outside the lungs (such as the sinuses and the gastrointestinal tract) could also play a role in coughing up orange mucus.
• Coughing up orange mucus with associated shortness of breath warrants urgent medical evaluation.

Mucus is a gel-like substance that coats the surfaces of the body that aren’t protected by skin. This includes the inside of the nose, stomach, lungs, mouth, and intestines. Mucus’s function is to keep tissues moist so they don’t dry out. The mucus that coats the lungs is known as phlegm. It protects the lungs by filtering out harmful particles that you breathe in.

Coughing up mucus or phlegm is usually a sign that your sinuses and lungs are functioning normally. But when it’s a color (instead of the usual white or clear), it’s likely to grab your attention. When mucus is orange, for instance, it can have several different causes. Some of these can be managed at home with over-the-counter remedies, while others require more involved treatment. In this article, we review some of the most common causes of orange mucus. We also discuss when you should be concerned and what you can do about this symptom.

Is coughing up orange mucus or phlegm normal?

Orange mucus is not typically considered “normal,” but it isn’t necessarily serious either. It’s often the result of dried blood from somewhere in your respiratory tract, which includes all the organs involved in breathing.

This could be from something as simple as blowing your nose too hard when you have a cold or are suffering from allergies. Bleeding may occur as a result of infection, inflammation, or chronic conditions. Experiencing prolonged periods of orange mucus is not normal and should be evaluated by your healthcare provider.

Causes of coughing up orange mucus

Coughing up orange mucus can be from a range of different causes. Following are some of the most common:

Respiratory infection

Respiratory infections such as the common cold, bronchitis (lung inflammation), and pneumonia are some of the most likely causes of coughing up orange mucus. Infections can cause inflammation in the airways, which leads to irritation and rupture of blood vessels. Depending on whether the blood is old or new, your mucus can range in color from red to orange to brown. Certain pathogens can also alter the color of mucus. Some studies have found that lung infections caused by a bacteria known as Legionella pneumophila can cause orange phlegm.

Sinus-related causes

Sometimes, the phlegm you’re coughing up isn’t from the respiratory tract at all; it’s from the sinuses. If you have a sinus infection or any type of sinus inflammation, this can cause an overproduction of mucus. The mucus drains down the back of your throat in the form of post-nasal drip. The sinus inflammation can sometimes lead to bleeding. This, in turn, causes red, orange, brown, or blood-tinged nasal sputum. If this drips down the back of your throat and triggers a cough response, you may cough up orange mucus.

GERD

Gastroesophageal reflux disease (GERD) may be the culprit behind your coughing up orange mucus. Commonly known as acid reflux or heartburn, GERD can lead to the secretion of mucus in the respiratory tract. This, in turn, causes you to cough up clear, yellow, or orange phlegm. The discoloration may be from the presence of bile and other stomach acids in the mucus. The orange color may also be due to bleeding in the GI tract from damage caused by chronic acid exposure.

Causes of coughing up orange mucus or phlegm based on the mucus’s appearance or other symptoms or situations

To identify the cause of coughing up orange mucus or phlegm, you need to look beyond just the color and examine other aspects of the mucus.

Coughing up thick orange mucus

Mucus that’s thicker than normal usually means that your respiratory tract is trying to clear itself of irritants. These irritants may be infectious pathogens (germs) or air pollutants that cause orange discoloration of the mucus.

Coughing up chunky orange mucus

Chunky mucus may be due to mucus plugs. These result from extremely thick mucus that gets trapped in the air sacs of the lungs. Mucus plugs are common among people with chronic lung conditions such as chronic obstructive pulmonary disease (COPD), emphysema, chronic bronchitis, and cystic fibrosis.

Coughing up dark orange or brown-orange mucus

Dark orange or brown-orange mucus could indicate that the mucus contains older blood or dried blood. This may happen after a respiratory infection or if the airways are irritated from smoking or chronic lung disease.

Coughing up light orange or yellow-orange mucus

Mucus tends to turn colors like yellow, orange, or green when it’s trying to fight off an irritant in the respiratory tract. When any foreign substance enters the respiratory tract including infections and non-infectious irritants, white blood cells rush to the area to try and fight it off. As white blood cells die, this can cause the mucus to become a yellow, orange, or green color. This may also be seen in chronic lung conditions such as COPD.

Coughing up red-orange or bloody-orange mucus

If you’re coughing up mucus with visible blood, or the mucus has a red-orange tint, it could be a sign of bleeding in the lungs or airways. Conditions like bronchitis, pneumonia, or tuberculosis can lead to blood in mucus. This can also be seen in cases of pulmonary edema, which is fluid in the lungs. This is a more concerning symptom and requires medical attention.

Coughing up orange mucus or phlegm in the morning only

Mucus that is orange to brown in color usually indicates the presence of dried blood. If you’re coughing up orange mucus in the morning, it may be from post-nasal drip accumulation in the back of the throat overnight. Or, it could result from chronic conditions such as COPD.

How the cause of coughing up orange mucus is diagnosed

To diagnose the cause of coughing up orange mucus, your healthcare team will first take a detailed history and perform a thorough physical exam. They will pay close attention to your lungs, throat, and sinuses. They may also order diagnostic studies such as a chest X-ray, CT scan, or sputum analysis. Another possibility is a bronchoscopy, which allows your doctor to look directly into your lungs for abnormalities.

Treatment options when you’re coughing up orange mucus or phlegm

The treatment that’s recommended for coughing up orange mucus will depend on what tests show the underlying cause to be. Following are some common approaches to treatment. These include some remedies you can use at home, and others that need guidance from your doctor.

At-home remedies

If the cause of your orange mucus is found to be viral or allergic, home remedies may soothe the symptoms. Increasing hydration, getting plenty of rest, and using a humidifier to lubricate your airways can be helpful. Putting air purifiers in your home can also eliminate breathing in allergens and air pollutants that might be causing (or contributing to) your symptoms.

Medication

In cases of bacterial sinus or lung infections, your doctor will prescribe antibiotics. Certain chronic lung conditions may also require prescriptions for steroid treatments and/or inhalers. Medications that reduce acid production can be helpful if the cause is acid reflux.

Lifestyle changes

Certain lifestyle choices, like cigarette smoking, can lead to chronic lung diseases. COPD is one example. It causes chronic inflammation that can lead to bleeding in the respiratory tract and increases your risk for bacterial infections – both of which can cause orange mucus. Giving up smoking is one of the best things you can do to improve your lung health. If your symptoms are caused by GERD, making dietary changes to eliminate foods that trigger acid production is another lifestyle change that may help.

When you should see a doctor about coughing up orange mucus

Coughing up orange mucus does not always mean you need medical attention. However, there are some signs and symptoms that should prompt you to see your doctor.

You should see a doctor if:

• You’ve been coughing up orange mucus for more than a week;
• You have additional symptoms (such as fever and body aches) that could indicate an infection;
• You are a smoker and would like to discuss smoking cessation techniques.

You should go to the emergency room if:

• You have significant shortness of breath;
• You’re having chest pains;
• You’re coughing up a large amount of blood along with orange mucus.

Questions to ask your doctor about coughing up orange mucus

• What could be causing my symptoms?
• Is orange mucus a sign of lung cancer?
• Do I need to take antibiotics to manage my symptoms?
• What type of diagnostic tests can be done to diagnose the cause of my symptoms?

Frequently asked questions about coughing up orange mucus

If the mucus or phlegm you’ve been coughing up is any color other than clear or white, you may have some additional questions. Here are the most frequently asked questions about orange mucus and what it could mean.

Is coughing up orange mucus or phlegm a sign of a chest infection?

Not necessarily. If you’re coughing up discolored mucus, an infection should always be considered – but the infection may not originate in your chest. Sinus infections should be considered as well. If you’re coughing up orange mucus but have no symptoms of an infection (such as fever, fatigue, weakness, or aches), you should seek medical care.

What if you’ve been coughing up orange mucus for a week or longer?

If you notice any abnormality in your respiratory mucus for a week or longer, including an orange color, consult with your doctor for further evaluation.

Finding answers

If you are coughing up orange mucus, pay attention to other clues that can help you navigate this symptom. If you’ve been coughing up orange mucus for more than a week or have other symptoms such as fever or shortness of breath, definitely seek medical care. Your doctor can order tests to determine what could be causing your symptoms and what kind of treatment would work best for you.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Pallabi Sanyal-Dey, MD.

Sources

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