Overview
Does it ever concern you when your mucus is brown and not the usual clear or slightly yellow in colour? If it does, this article will uncover whether brown spots in mucus are a sign of a serious problem and whether you should seek your doctor or not.
What does brown mucus mean?
Brown spots in mucus indicate the presence of blood which means there are possible bleeding occurrences in your respiratory organs - medically termed as haemoptysis.
The amount of blood coughed up in the mucus is useful to determine the underlying cause of the problem.1 The more brown mucus is exonerated, the more severe the condition is.
Sometimes, patients with significant chronic conditions coughed up really dark brown phlegm. There could be a variety of causes but the most prevalent cause of brown phlegm are as below:
Irritant causes
- Smoking - an important risk factor in developing mild haemoptysis especially in patients suffering from deteriorating lung conditions.2 Cigarettes contain tar which is carcinogenic in nature. It damages your lungs by narrowing the small tubes (bronchiole) that absorb oxygen. It also damages the small hairs (cilia) in the lungs that give protection against dirt and infection. This can lead to a range of lung diseases such as chronic obstructive pulmonary disease (COPD) and emphysema
- Pollution - places with high levels of pollution increase risk of brown mucus as smog can deposit in your nose, mouth, and air passage
Infectious causes
- Pneumonia - a condition where the lung tissues are inflamed following a bacterial or viral infection. The air sacs in the lungs fill up with fluids, causing brown phlegm production, chest pain and breathing difficulties3
- Bronchitis - an infection of the bronchi, causing the airways to be irritated and inflamed. Acute bronchitis would have similar symptoms to a common cold or sinusitis while shortness of breath is more common in chronic bronchitis4
- Tuberculosis (TB) - a severe bacterial infection characterised by persistent cough over 3 weeks with the presence of blood in phlegms5
Common causes
- Chest infections - from pneumonia, bronchitis and TB amongst other lung infections
- Cystic fibrosis (CF) - CF patients are highly susceptible to lung infection and an increase in infections leads to inflamed blood vessels, causing them to burst and exonerate brown phlegm6
Other causes
- Pulmonary embolism - an uncommon cause of coughing blood in mucus which is a condition where the blood vessels in the lungs are blocked7
- Lung cancer - coughing blood is a common clinical manifestation of lung cancer patients. The rate of bleeding depends on the type of malignancy and the location of the tumour8
Condition affected by brown mucus
List of conditions
- Lung infections - brown mucus is a common clinical manifestation for lung infections. Some common infections are:
- Chronic Obstructive Pulmonary Disease (COPD)
- Drug use
- Trauma
- Lung abscess
- Parasitic infection
- Vaginal discharge - a normal occurrence where fluids and mucus gets secreted to keep the vagina moist and protect it against infections.it is often clear or white with a slightly sticky texture. If there is a presence of brown mucus in the discharg, it is highly likely to be an infection, usually gonorrhoea or chlamydia14
Treatment and home remedies
In order to treat brown mucus production, the best way is to treat the root cause by introducing medical treatments as well as home remedies.
Pneumonia can be treated at home with antibiotics and it usually takes 6 months to fully recover. To alleviate symptoms, painkillers such as ibuprofen are highly recommended, and cough medicines are avoided as they are not proven to be effective. However, pneumonia can sometimes be severe and may need to be treated in hospital.9
Most bronchitis conditions can also be treated at home with non-steroidal anti-inflammatory drugs such as ibuprofen, aspirins etc. It is advisable to check with doctors if: 4
- you have a persistent fever of 38℃ or above for more than 3 days
- you cough up blood-containing mucus
- you have prior heart or lung diseases e.g asthma, heart attack, stroke or emphysema
- you're breathing rapidly, for about 30 breaths a minute, or developing chest pains
- you become drowsy or confused
- you've had recurring episodes of bronchitis
Tuberculosis (TB) is a severe lung infection where potent antibiotics are required as treatments. Common medications prescribed by doctors are:10
- 2 antibiotics e.g isoniazid and rifampicin for 6 months
- 2 extra antibiotics e.g pyrazinamide and ethambutol for the first 2 months of the 6-month period of treatment
Cystic fibrosis (CF) is an inherited disease that leads to congestion of lungs and digestive system. Currently, there are no treatments that can cure CF. However, preventive measures include prescribed medications and lifestyle changes such as:11
- Exercising, as physical activities are known to help clear mucus from lungs and improve health in general
- Regularly practising airways clearance techniques i.e active cycle of breathing techniques (ACBT), autogenic drainage, and airway clearance device
- Practising a high-caloric diet with adequate vitamins and mineral supplements
Pulmonary embolism is a condition where there is a block in the lung vessels. Doctors will prescribe anticoagulant tablets e.g warfarin for 5 months to prevent blood clots7
It is important to always combat chest infection to prevent massive brown mucus production. Here are some at home tips to quickly recover from chest infections:12
- Get adequate rest and sleep
- Try to drink a lot of water to help loosen the mucus and make it easier to cough up
- Elevate your head up while sleeping using extra pillows to make breathing easier and clear your chest of mucus. However, using too much pillows will lead to pain discomfort and mild body aches
- Consume painkillers in the event of a fever to reduce the temperature, ease headaches and muscle pain
- Preferably staying at home and avoiding contact with other people if you are not feeling well enough to do normal activities
When to see a doctor?
In most cases, bleeding stops on its own and treatments for the cause are readily accessible. However, you should not be coughing up brown mucus more than just a few spots and streaks. This condition will require immediate medical attention.
If a small amount of blood is present, it is advisable to get an appointment immediately. If you are coughing blood together with extreme chest pain, having an increased heart rate and difficulty breathing, you should be directly admitted to the emergency department.13
Doctors would ask you to get tested on a few things: bronchoscopy, chest x-ray and even ask for information about your medical history, including previous or current drug prescriptions.
Summary
Brown mucus is a serious condition that needs immediate medical attention as it could indicate a critical disease.
Regular phlegm should never contain blood. In most cases, brown mucus should stop after a few weeks and you would recover soon after with proper self-medication and a good amount of rest.
However, if your mucus still contains blood, you need to get an appointment with the doctor immediately.
Although most conditions related to brown mucus are treatable with medications, a healthy lifestyle and constant medical intervention, some cases are lethal without apparent cure.
Therefore, it is important always to be cautious and keep your eyes on those tissues the next time you cough or blow your nose.
References
- Corey R. Hemoptysis. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations [Internet]. 3rd ed. Boston: Butterworths; 1990 [cited 2022 Oct 28]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK360/
- Bidwell JL, Pachner RW. Hemoptysis: diagnosis and management. afp [Internet]. 2005 Oct 1 [cited 2022 Oct 28];72(7):1253–60. Available from: https://www.aafp.org/pubs/afp/issues/2005/1001/p1253.html
- Pneumonia | nidirect [Internet]. 2017 [cited 2022 Oct 28]. Available from: https://www.nidirect.gov.uk/conditions/pneumonia
- Bronchitis [Internet]. 111.wales.nhs.uk. [cited 2022 Oct 28]. Available from: http://111.wales.nhs.uk:82/bronchitis/
- Tuberculosis (Tb) | nidirect [Internet]. 2018 [cited 2022 Oct 28]. Available from: https://www.nidirect.gov.uk/conditions/tuberculosis-tb
- Team E. Why do people with cf experience hemoptysis? [Internet]. Cystic-Fibrosis.com. [cited 2022 Oct 28]. Available from: https://cystic-fibrosis.com/hemoptysis
- Pulmonary embolism [Internet]. nhs.uk. 2017 [cited 2022 Oct 28]. Available from: https://www.nhs.uk/conditions/pulmonary-embolism/
- Gershman E, Guthrie R, Swiatek K, Shojaee S. Management of hemoptysis in patients with lung cancer. Ann Transl Med. 2019 Aug;7(15):358.
- Pneumonia - treatment [Internet]. nhs.uk. 2017 [cited 2022 Oct 28]. Available from: https://www.nhs.uk/conditions/pneumonia/treatment/
- Tuberculosis (Tb) - treatment [Internet]. nhs.uk. 2018 [cited 2022 Oct 28]. Available from: https://www.nhs.uk/conditions/tuberculosis-tb/treatment/
- Cystic fibrosis - Treatment [Internet]. nhs.uk. 2017 [cited 2022 Oct 28]. Available from: https://www.nhs.uk/conditions/cystic-fibrosis/treatment/
- Chest infection [Internet]. nhs.uk. 2017 [cited 2022 Oct 28]. Available from: https://www.nhs.uk/conditions/chest-infection/
- Chlamydia [Internet]. nhs.uk. 2017 [cited 2022 Oct 28]. Available from: https://www.nhs.uk/conditions/chlamydia/
- Coughing up blood (Blood in phlegm) | nidirect [Internet]. 2017 [cited 2022 Oct 28]. Available from: https://www.nidirect.gov.uk/conditions/coughing-blood-blood-phlegm