See also: Expectorants
Mucus and Catarrh
The phlegm, or more correctly sputum, is the pathological secretion of the glands present in the respiratory mucosa.
Under normal conditions, this viscous liquid - called mucus - is produced in quantities ranging from 20 to 100 ml / day, necessary to humidify the respiratory tract and capture dust and microorganisms.
Causes of Catarrh
The increased production of mucus is a common symptom of various diseases of the respiratory tract, some as trivial as the classic cold, others less so, such as chronic bronchitis or tuberculosis. The mucus produced under inflammatory stimulation is called catarrh, because it is more abundant than the norm (up to 400/500 ml / day), but also because it is different in its composition, which makes it more dense and sticky.
Consequences
Since the abnormal production of phlegm is an obstacle to the circulation of air in the airways, the body tries to expel the excess through involuntary movements of the eyelashes and coughs (expectoration), hence the term sputum.
Sputum examination
The analysis of the phlegm, subjected to chemical-physical and bacteriological examination is able to provide important indications on the nature of respiratory disease.
The simple observation of its macroscopic characteristics (odor, color, consistency) provides the doctor with useful elements for a general classification of the disease.
White and Foamy phlegm
A liquid, foamy and whitish catarrh is mainly made up of mucus, a sign of a non-specific bronchial irritation, not supported or in any case only partially, by pathogens. It is typical of smokers, allergies, but also of asthmatics and subjects with COPD (in the latter two categories of patients it can be particularly dense).
Yellow Catarrh
A viscous and yellowish-greenish catarrh is caused by an infection of the nose and / or the respiratory tract; more dense, it is difficult to expectorate and is characterized by the presence of purulent material (pus), rich in leukocytes; it is typical of bacterial infections (when the anaerobes are greenish).
Green phlegm
A green catarrh is an indication of a prolonged stagnation of purulent mucus in the bronchi, which in addition to the typical color also acquires a fetid smell (gangrenous sputum). It is typical of pulmonary abscesses and gangrene, or bronchiectasis caused by repeated bacterial infections.
Reddish phlegm
The presence of blood streaks in the sputum may be the consequence of micro-lesions of the respiratory mucosa produced during coughing efforts. In any case, it is a symptom that should not be underestimated, as it is also common in neoplasms, pulmonary infarcts and bacterial pneumonia of various kinds [in these cases the catarrh takes on a color ranging from pink (typical of pulmonary edema) to red rust (typical of pneumococcal pneumonia), due to the simultaneous presence of blood and purulent material)].
Currant jelly phlegm
Currant gelatin phlegm is typical of Klebsiella pneumoniae pneumonia
Blackhead phlegm
A blackish catarrh is typical of anthracosis, an occupational disease - rare today - caused by prolonged inhalation of particles of coal dust.
Catarro and Cough
Another useful feature for diagnostic purposes is the way in which excess phlegm is eliminated; in fact, in fact, it is expelled without coughing when it comes from the nose or pharynx, and through coughing (sputum or sputum) when it is produced and accumulated at the bronchial level.
Examination of the Expectorate
If the appearance of the phlegm and other clinical signs suggest the possible presence of a bacterial infection, the microbiological examination allows a more precise diagnostic classification, useful for choosing the antibiotics active towards those particular microorganisms.
The cytological examination of the sputum, aimed at the search for neoplastic cells, can highlight the presence of a lung carcinoma. However, this test - due to its lack of sensitivity - cannot be used as a screening test for lung cancer.
Finally, in asthma, bronchial asthma is used to evaluate sputum eosinophils to appreciate and monitor the degree of bronchial inflammation and the response to pharmacological treatments over time.
Expectorants
Expectorants (such as guaifenesin) are drugs used to eliminate catarrhal secretion produced and accumulated excessively in the respiratory tree, while mucolytics (such as carbocysteine) increase the fluidity of the phlegm, facilitating its elimination.
The roots of licorice and those of Polygala, rich in triterpene saponins, are widely used in the phytotherapy field; in the presence of phlegm it is also useful to take essential oils (eucalyptus, thyme, pine, fir or niaouli) in the form of tisanes (attention to the irritating effect on the oral mucosa), coated tablets, capsules or inhaled (always taking note that fumigations with essential oils can cause allergic reactions, bronchospasm and asthma attacks especially in the youngest ones).
