Why Are You Coughing Up White Mucus or Phlegm?

Key takeaways:

• Coughing up white mucus is usually because of a mild, temporary issue, but it can sometimes be a sign of a more serious health problem.
• The color and consistency of your mucus can provide some clues about underlying causes.
• Knowing when your symptoms may need medical attention can help you get prompt treatment and prevent complications.

Coughing up white mucus or phlegm is a common symptom. While white mucus is most often the result of a minor irritation, it could be a sign of a more significant respiratory issue. While white mucus is frequently harmless, understanding the reasons behind it can help you manage your symptoms and decide if you need to see your healthcare provider about this. Let’s explore some common causes, related symptoms, and your available treatment options.

Is coughing up white mucus or phlegm normal?

Your body naturally produces a constant supply of mucus to trap bacteria and particles. Coughing up white mucus or phlegm may be your body’s response to an irritant of some kind, such as pollen, or it could be due to an infection, or inflammation in your respiratory system. While white mucus is often nothing to worry about, if you are constantly coughing it up or it is getting worse, it’s time to consult your physician.

Causes of coughing up white mucus

White mucus can be the result of several causes, many of which are relatively minor. Others might require you to get medical attention. Below are some common reasons:

Viral infections

Viral infections like the common cold or flu often lead to an increase in mucus production in your sinuses, throat, and bronchial tree. Most of the time, the mucus starts off clear and then turns white as your body fights the infection. The white appearance is due to the mobilization of white blood cells to the area. Typically, your symptoms should resolve within a few days to a week.

Allergies

As your immune system reacts to allergens such as dust, pollen, or pet dander, this can lead to coughing up white mucus. Allergies also usually cause nasal congestion, sneezing, and itchy eyes.

Sinusitis

Sinusitis is an inflammation of your sinuses, which are air-filled spaces in your skull located near your nose. Your sinuses produce mucus to help trap bacteria as well as other particles. If your sinuses are blocked or inflamed, this can cause white or cloudy mucus. You may also notice other symptoms such as facial pain, congestion, and pressure in your face and head.

Acid reflux

If you have acid reflux or gastroesophageal reflux disease (GERD), stomach acid can wash back (reflux) into your esophagus and throat, causing irritation. Coughing up white phlegm can be a symptom of this, especially if it occurs after you have eaten or have been lying down.

Other causes of coughing up white mucus based on mucus appearance or symptoms

The color, consistency and even the timing of mucus can give you some clues as to what might be causing it. Here’s a breakdown based on specific characteristics of the mucus:

Coughing up thick white mucus

Thick white mucus can appear as a result of dehydration or if mucus production has increased due to an infection. Drinking more fluids can help thin the mucus and make it easier to expel.

Coughing up foamy or bubbly white mucus

Foamy or bubbly white mucus can be related to acid reflux or gastroesophageal issues. In some cases, it can also be seen with respiratory infections when air mixes with mucus. Foamy or bubbly mucus is also often seen in cases of pulmonary edema (fluid in the lungs) and is accompanied by severe shortness of breath, wheezing, tightness in the chest and difficulty breathing. If you are experiencing these symptoms you should get medical attention immediately.

Coughing up chunky white mucus

Chunky or lumpy white mucus can indicate a possible accumulation of particles or cells within the mucus. This is often seen in cases of prolonged sinus congestion or infections.

Coughing up white mucus in the morning only

Morning-only white mucus can happen as a result of postnasal drip or acid reflux. Mucus builds up overnight, leading to a more noticeable cough when you wake up.

Coughing up white mucus at night only

Coughing up white mucus at night may be linked to lying down. If you have acid reflux from your stomach into your esophagus and throat, lying down makes it easier for the acid to wash back. This can initiate irritation of your tissues, leading to mucus pooling in your throat.

Coughing up white mucus after eating

Mucus after eating often suggests a problem due to acid reflux. Stomach acid irritates the sensitive lining of your esophagus and throat. The irritated tissues will produce mucus as a protective response.

Diagnosing coughing up white mucus

To determine the cause of white mucus production, your physician will likely perform a thorough physical exam, review your symptoms, and, if necessary, order tests such as a chest X-ray, lung function tests, or a mucus (sputum) culture. These tests can help rule out infections, chronic conditions, or other respiratory issues.

Treatment options for coughing up white mucus

Treatment will vary depending on the underlying cause. Below are some commonly recommended approaches:

At-home remedies

For minor cases, at-home remedies can be effective. Drinking plenty of fluids to stay hydrated, using a humidifier, and avoiding irritants like smoking or strong fragrances can help to reduce mucus buildup.

Over-the-Counter (OTC) medications

OTC decongestants, antihistamines, or expectorants can help reduce mucus production and help to clear congestion, especially if allergies or a cold are the culprits.

Prescription medications

In cases involving bacterial infections, your doctor will likely prescribe antibiotics. For acid reflux, they may recommend antacids, H2 blockers, or proton pump inhibitors.

When you should see a doctor about coughing up white mucus

While white mucus is typically harmless, certain situations might require medical evaluation.

You should see a doctor if:

• Your symptoms persist for more than ten days to two weeks without improvement.
• You have a recurring fever or experience other signs of infection.
• Your mucus becomes discolored, thick, or contains blood.

You should go to the emergency room if:

• You experience difficulty breathing.
• You notice a significant amount of blood in your mucus. Even if there is only a small amount of blood in your mucus, if you notice this happening more than a couple of times, you should see your physician.
• You have chest pain.

Questions to ask your doctor about coughing up white mucus

Consider asking your doctor these questions:

1. What could be causing my symptoms, and are there specific tests you would recommend?
2. Are there any lifestyle changes I should make to reduce mucus production?
3. Could any of my current medications be making the problem worse?
4. What treatment options will best address my condition?

Frequently asked questions: coughing up white mucus

Is coughing up white phlegm or mucus a sign of lung cancer?

Coughing up white phlegm alone is usually not a sign of lung cancer. However, if the cough is persistent or is associated with other concerning symptoms like weight loss, chest pain, or blood in the mucus, you should be medically evaluated.

What if you’ve been coughing up white mucus for weeks?

Coughing up white mucus for weeks could indicate a chronic issue like sinusitis, GERD, allergies, or other respiratory problem. Consulting your healthcare provider can help to identify the underlying cause.

What if you find blood in the mucus you’re coughing up?

Blood in your mucus suggests an infection, irritation, or, in some cases, a more serious condition, such as a blood clot in your lung (pulmonary embolism or PE). If you find blood in your mucus, contact your healthcare provider to determine the cause and receive appropriate treatment.

In review

Coughing up white mucus can be a minor symptom, often due to common respiratory irritants or infections. Understanding potential causes and knowing when you should get medical care can help you manage symptoms effectively and get the care you need when it matters most.

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. Lane Thaut, DO.

Sources

American Academy of Allergy, Asthma & Immunology. "Allergies Overview." AAAAI, https://www.aaaai.org/conditions-treatments/allergies/allergies-overview. Accessed 12 Nov. 2024

American College of Gastroenterology. "Acid Reflux." American College of Gastroenterology, https://gi.org/topics/acid-reflux/. Accessed 12 Nov. 2024.

Malek, R., and S. Soufi. "Pulmonary Edema." StatPearls, StatPearls Publishing, 2024, https://www.ncbi.nlm.nih.gov/books/NBK557611/. Accessed 12 Nov. 2024.

Shen, F., and C. Sergi. "Sputum Analysis." StatPearls, StatPearls Publishing, 20 Feb. 2023, https://www.ncbi.nlm.nih.gov/books/NBK563195/. Accessed 12 Nov. 2024.

Vyas, Vishal, et al. "Acute Pulmonary Embolism." StatPearls, updated 28 Feb. 2024, StatPearls Publishing, https://www.ncbi.nlm.nih.gov/books/NBK560551/. Accessed 12 Nov. 2024.