Sticky Business: Mucus and Phlegm

The term “phlegm” comes for the Greek words for inflammation and humour caused by heat. This is consistent with the traditional Chinese medicine (TCM) view of phlegm, in which phlegm that is green and sticky is associated with exogenous (outside the body) wind-heat patterns.

Mucus (snot) and phlegm are different. Mucus is a normal protective layer around the airway, eyes, nasal turbinate, and the urogenital tract.

[IMAGE] Mucus is a normal adhesive viscoelastic gel produced in the airway by submucosal glands and goblet cells. It is mainly water, but also contains high-molecular weight mucus glycoproteins that form linear polymers (for the science geeks reading this). Besides the airway, mucus is also found in the eyes, nasal turbinate, and the urogenital tract.

Phlegm (seen at left), on the other hand, is a secretion in the airway during disease and inflammation. Phlegm usually contains mucus with bacteria, debris, and sloughed-off inflammatory cells. Phlegm is composed of water, glycoproteins, immunoglobulins, lipids and other substances. Once phlegm has been expectorated by a cough and mixed with saliva it becomes sputum.

Under normal circumstances, your nose and sinuses make a liter of mucous a day. At 34 ounces, that's a lot of snot and phlegm. (A Big Gulp is 28 ounces.) Of course, when you get a cold the amount ramps way up. Moreover, because the cilia - little hair-like structures that undulate back and forth to move mucus out of the sinuses and nose - become inflamed during a cold, the movement slows way down so it’s more difficult to discharge.

It hardly seems fair; you’d think our bodies would help us get rid of all of that extra snot when we’re sick!

The purpose of mucus is to keep the lining of the nose moist. It protects the surfaces of your nose and mouth by trapping bacteria and allergens before they can attack your airways and cause symptoms. The body responds to the virus that causes a cold by making lots of snot and phlegm. While unpleasant to look at, snot and phlegm are actually replete with all kinds of potent antibacterial, antiviral, and other protective chemicals.

Sneezes travel 30 to 60 miles an hour, and can fly 30 feet through the air. If you cover your mouth when you sneeze and then touch a surface such as a phone, computer, or kitchen counter, a virus in your mucus can live for up to 24 hours. When someone else touches the infected surface and then touches their face, they can get sick. This is why regular hand-washing is so important.

But let’s end one myth right here. If mucus and phlegm are green it does not necessarily indicate a bacterial infection. When germs that cause colds first infect your nose and sinuses you make clear mucus to wash them out.

After two or three days, the immune cells fight back and the mucous changes to a white or yellow color. As bacteria in the nose return, they may also be found in the mucous, which changes it to a greenish color, a normal process. When snot is watery and clear and stays that way, it's a viral process. But even yellow or green mucus or phlegm can still indicate virus verses bacteria. So other signs and symptoms are taken into account (fever, enlarged lymph nodes, etc.). This is why symptoms of abnormal severity or duration should be evaluated by a competent care practitioner. And remember, antibiotics will be of no help if the basis of your cold is viral.

Red mucus, or redness inside otherwise healthy-looking mucus, is usually a sign of bleeding. This may have a benign cause, such as a nosebleed or a cut in the nostril from scratching or rubbing, or even coughing really hard over several days. A high concentration of blood in the mucus, or small spots or streaks of blood over a long period of time, may indicate something more severe, such as bleeding in the lungs, bronchitis, or pneumonia, or even tuberculosis. This would be important to have evaluated by a physician.

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