Bringing Up White Phlegm

  • Erin SellMaster of Science - MS, Physician Associate Studies, Hull York Medical School

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Coughing up white phlegm can be worrying, particularly if ongoing for a few weeks. White phlegm results from a range of conditions. This article aims to give insight into the possible reasons for bringing up white phlegm and how you can address it. 

Phlegm can result from a range of reasons including various health conditions such as a respiratory infection or chronic acid reflux. Environmental and lifestyle factors may also play a part in phlegm production.

Whilst green or yellow phlegm often signifies the body is fighting off an infection, white phlegm may be more indicative of reflux, COPD, viral bronchitis or congestive heart failure. If any other symptoms are shown alongside white phlegm, it is highly suggested to undertake appropriate measures to determine the right cause and further guidance.

The treatment of white phlegm production depends on the underlying cause, which is discussed in further detail. If you are interested in learning more about the causes and treatment of white phlegm production, be sure to read on! 

What is white phlegm? 

Phlegm, also known as sputum, is a type of mucus that comes from the lungs and throat which helps to remove any irritants or infections from the lungs.1 It is often removed from the body by coughing. The colour of the phlegm produced can indicate the underlying cause, for example: 

  • Green or yellow phlegm is commonly associated with infection
  • Clear phlegm is commonly associated with allergies or viral infections
  • Black phlegm is commonly associated with smoking, coal dust, fungal infections 
  • Brown phlegm can often indicate old blood, which may be associated with bacterial infections of the lung, cystic fibrosis, lung abscesses or breathing in toxins
  • Bloody/red phlegm can be a sign of an infection, pulmonary embolism, tuberculosis, lung cancer or heart failure

However, white phlegm is commonly associated with various conditions such as: 

  • Gastro-oesophageal reflux disease (GERD) - a condition of chronic acid reflux, where stomach acid travels up the oesophagus, causing irritation
  • Chronic Obstructive Pulmonary Disease (COPD) - a disease of the lungs, commonly associated with chronic smoking 
  • Viral bronchitis - a viral infection of the lungs 
  • Congestive heart failure - heart muscles stop pumping blood around the body as effectively1

Treating the underlying cause of white phlegm production not only aims to reduce discomfort associated with frequently bringing up phlegm, but also vital to address the underlying problem and stop it progressing or worsening.

Understanding white phlegm 

Common symptoms 

As mentioned, there are many possible causes for white phlegm. Understanding the symptoms associated with white phlegm production can help to determine the cause. 


Persistent acid reflux can result in excess white phlegm production, particularly when the stomach acid rises into your throat. This can cause a range of symptoms:2

  • Excess phlegm production 
  • Chronic cough 
  • Sensation of needing to clear throat 
  • Hoarseness 
  • Feeling of something stuck in throat 
  • Post-nasal drip 


COPD describes a group of diseases which are associated with reduced lung function, resulting in breathlessness, usually associated with smoking.3 There are 2 main diseases, which are usually progressive such as:

  1. Emphysema - breakdown of the small sacs, known as alveoli, which are responsible for gas exchange within the lungs. With less effective gas exchange, it makes it harder to get oxygen in the body and more difficult to remove carbon dioxide
  2. Chronic bronchitis - damage to the bronchi (tubes which carry air through the lungs) and cilia (small hairs which help clear mucus from lungs), which results in excess mucus build-up

Symptoms include:

  • Chronic cough with white phlegm production
  • Breathlessness, particularly during exercise
  • Wheezing3

These symptoms can worsen when exposed to a respiratory virus or bacteria. 

Infections (such as viral bronchitis)

Viral bronchitis describes a viral infection of the bronchioles, which are the tubes in the lungs. This is a common infection which is usually self-limiting. Common symptoms include: 

  • Cough 
  • Runny nose
  • Sore throat 
  • Fevers 
  • Wheezing 
  • Feeling run down / tired

Bacterial lung infections may be more commonly associated with green or discoloured phlegm. 

Congestive heart failure

Heart failure occurs when the heart muscle stops pumping as effectively, which means the body struggles to get enough oxygen. Common symptoms include:4

  • Feeling short of breath
  • Pitting oedema - swelling of the legs due to fluid build-up 
  • Weight gain 
  • Waking up feeling short of breath at night time 
  • Dry cough 
  • Weight gain
  • Chest pain

Diagnosing white phlegm 

Other than understanding the symptoms associated with white phlegm production; physical examination and diagnostic tests can further help determine the causes of white phlegm production. Medical examination may involve: 

  • Listening to the chest 
  • Monitoring weight 
  • Looking for any signs of fluid overload in the legs (swelling, oedema) 
  • Measuring the respiratory rate
  • Listening to the heart 

Diagnostic tests 

Determining what diagnostic tests to carry out will depend on the specific symptoms and examination findings which may include: 

  • Blood tests - can indicate infection or heart failure 
  • Sputum culture - determine if any microorganism is causing the phlegm 
  • Chest X-ray - look for signs of infection in the lungs, can also be useful in heart failure diagnosis
  • Lung function tests - determines whether there is any sign of COPD or asthma by looking at how effectively air is moved in and out of the lungs 
  • Stool sample - if considering GORD, a stool sample may be sent to determine whether a specific bacteria known as H. pylori is causing the symptoms 
  • Endoscopy - to confirm a diagnosis of acid reflux5

Treatment and management 

Given the range of potential causes of white phlegm production, treatment depends on the cause. Options may include: lifestyle changes, medications and surgical options. 

Lifestyle changes 

Stopping smoking is one of the biggest lifestyle changes that might be effective for reducing white phlegm production, no matter the cause. This may be effective if white phlegm is resulting from a lung cause or from reflux. Further lifestyle changes for acid reflux include:

  • Avoiding foods that exacerbate reflux, such as acidic foods, chocolate and high-fat foods 
  • Avoid alcohol 
  • Lose weight (if overweight) 
  • Eat smaller meals
  • Don’t lay down soon after eating5

Medications and home remedies

Medications can be used, again depending on the cause of the phlegm production. Examples include:

  • GERD - using acid-reducing medications, known as proton pump inhibitors, reduce stomach acid production and help to reduce reflux symptoms 
  • COPD - using inhalers to open the airways and reduce disease (bronchodilators and steroids)6
  • Viral infection - over-the-counter decongestants can help with phlegm production
  • Heart failure - medications prescribed from the doctor to help restore the heart function

Surgical opinions

If there is no improvement in the medical management of such conditions, some surgical options may be available, particularly in heart failure. 


Respiratory hygiene and avoiding irritants

Avoiding irritants, such as dust, air pollution, dyes and paints as well as second-hand smoke may be effective at reducing the risk of lung diseases and potentially exacerbating a cough with white phlegm.6 Further, wearing masks may be effective when around people with respiratory illnesses to reduce the chance of becoming ill. 

Vaccinations and healthy lifestyle 

Preventing infections is vital in order to reduce phlegm production in healthy people and also in people with COPD. Examples of vaccinations include pneumococcal, flu, pertussis, shingles and COVID-19.6

When to seek medical attention

White phlegm production may not be any cause for concern. However, if it is lasting longer than a few weeks, especially when associated with other symptoms such as a cough, it is important to visit your doctor. 

You should seek advice from a medical professional at any time if you notice high fevers, blood in the phlegm, chest pain, shortness of breath or if you feel generally unwell. 


In conclusion, white phlegm has a variety of potential causes, ranging from lung infections, COPD, GERD and heart failure. Taking a concise history and examination, as well as utilising diagnostic tools can help determine the cause of white phlegm and further guide treatment.

It is vital to consult with a medical professional if you are worried about constant white phlegm production or have any associated symptoms. Options for treatment may be medical or surgical. Lifestyle changes and preventative vaccines or medications can help reduce the incidence of white phlegm production. 


  1. Coughing Up Phlegm: Causes and Treatment. Cleveland Clinic n.d. (accessed October 2, 2023).
  2. Laryngopharyngeal Reflux (LPR): The Other Reflux. Cleveland Clinic n.d. (accessed October 4, 2023).
  3. COPD: Causes, Symptoms, Diagnosis, Treatment & Prevention. Cleveland Clinic n.d. (accessed October 4, 2023).
  4. Congestive Heart Failure: What Does It Mean? Cleveland Clinic n.d. (accessed October 5, 2023).
  5. UpToDate n.d. (accessed October 6, 2023).
  6. UpToDate n.d. (accessed October 6, 2023).

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Erin Sell

Master of Science - MS, Physician Associate Studies, Hull York Medical School

I have a BSc in Biomedical Sciences from the University of Bath and an MSc Physician Associate Studies from the Hull York Medical School. I worked as a Physician Associate in an NHS GP surgery where I developed my clinical knowledge.

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