Sputum is the pathological contents of the respiratory tube, represented by the discharge of glandular cells of the mucous membrane of the trachea and bronchi with an admixture of saliva, nasopharyngeal secretion. Coughing up of sputum occurs during infectious and inflammatory processes of the upper and lower respiratory tract, allergies, inhalation of irritating substances. Radiation studies of the chest, bronchoscopy, and laboratory tests help to identify diseases in which sputum appears, to establish the causes of the formation of pathological mucus. The choice of treatment tactics depends on the nature of the underlying pathology.
In the lumen of the tracheobronchial tree of a healthy person, up to 10 ml of transparent mucus is collected during the day, which has bactericidal properties, is involved in metabolism, elimination of infectious agents and small foreign particles from the respiratory tract. Secretion formation does not cause coughing or discomfort and goes unnoticed. Sputum is secreted in excess in diseases of the nose, its paranasal sinuses, respiratory and digestive organs.
The volume of discharge varies depending on the pathological process, in some diseases it reaches 400 ml per day. Sputum can be easily separated or coughed up with difficulty. Mucus often contains blood impurities, foreign inclusions (dust, metal particles, microliths). In most cases, the bronchial secret is odorless, the nature of the underlying disease affects the color.
The consistency of sputum is thick, viscous and liquid watery. When settling, it in some cases is divided into 2 or 3 layers. According to physical properties (color, smell, transparency, other macroscopic characteristics), the following types of sputum are distinguished:
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The appearance of purulent yellow or yellow-green discharge indicates the presence of a severe acute respiratory infection or an exacerbation of a chronic inflammatory disease of the respiratory tract. Purulent fetid sputum secreted with a cough accompanies various destructive processes of the lungs, it is observed with stagnation of pathological contents in bronchiectasis. The most common causes of purulent secretion are:
Coughing up of viscous mucus or mucopurulent secretion occurs in most diseases of the bronchopulmonary system. Any acute respiratory pathology manifests as an unproductive cough with thick light or yellowish sputum. Chronic diseases are accompanied by the release of a viscous secret during remission. The most common coughing up of thick mucus is observed in the following pathologies:
Some diseases of the respiratory system are manifested by the discharge of liquid watery mucus. Sometimes such sputum is secreted by single spitting, but in a number of diseases there is a lot of it. Cough with mucus is often observed in acute infections of the airways. Mucous sputum, the causes of which are associated with chronic pathology, is coughed up during remission. Excessive production of clear mucus occurs against the background of the following conditions:
Often the sputum secreted by the patient turns yellow due to the activation of the bacterial microflora. The appearance of such mucus in the morning may occur due to the admixture of nasal secretion, which flows into the trachea during sleep. Sometimes sputum acquires a rich yellow tint due to food coloring, an increased content of eosinophils. The main diseases with the release of yellow sputum:
Expectoration of mucus with pus indicates an acute advanced stage of bronchopulmonary disease. Sometimes mucopurulent sputum is rusty in color and may contain streaks or droplets of blood. Simultaneously with the appearance of pathological impurities, the volume of the discharge increases. The main diseases in which there is a release with a cough of mucopurulent contents:
A strong unpleasant odor of sputum is due to stagnation of the contents of the cavity formations of the lungs, putrefactive processes associated with the activity of anaerobic microflora. When such a cavity is drained into the bronchus, a fetid semi-liquid secret is coughed up in large quantities. Morning sputum sometimes smells strongly due to impurities from the discharge of the nasopharynx. The main pathologies accompanied by this symptom include:
Green sputum is the result of bacterial infection and stagnation of secretions in the respiratory tube, bronchiectasis, and cavity formations. Such discharge usually has a purulent, mucopurulent character, sometimes has an intense putrefactive odor. Coughing up green contents may indicate a serious bronchopulmonary disease, often observed in pathologies such as:
Diagnosis of diseases in which sputum is separated is carried out by pulmonologists or therapists. During the survey, the duration of the disease, the presence of occupational hazard, and the relationship with smoking are specified. Examination reveals signs of hypoxia, symptoms of distal hypertrophic osteoarthropathy. To finally find out why the patient coughs up sputum, the following methods help:
Sometimes, when coughing with sputum, spirometry, body plethysmography, and allergy diagnostics are additionally performed. To exclude syphilis, helminthic invasions, pulmonary mycoses, serological tests are performed. For the diagnosis of hereditary pathology, molecular genetic methods and special studies are used. To confirm tuberculosis, the Mantoux test, diaskin and quantiferon tests can be used.
Bronchoscopy is performed for both diagnostic and therapeutic purposes.
Long-lasting, regularly expectorated sputum is a reason for a mandatory visit to the doctor. When coughing up liquid purulent contents with a full mouth, hemoptysis or rusty sputum, a visit to a medical facility should be urgent. Before establishing a diagnosis, it is recommended to drink plenty of warm alkaline drinks, expectorant herbal preparations and medicines, and breathing exercises.
There are a large number of pathologies in which sputum is coughed up, treatment depends on the etiology and mechanism of the development of the disease. Conservative measures include the use of pharmacological agents and physiotherapeutic procedures, physiotherapy exercises. Medicines can be divided into the following groups:
In a number of pulmonary diseases, physiotherapy is actively used. Patients are prescribed medicinal inhalations, breathing exercises. Sputum is well coughed up after percussion massage of the chest. Patients are trained in postural drainage techniques. If necessary, sanation bronchoscopy is performed.
Surgical treatment is subject to patients with abundantly secreted purulent sputum, which is formed during suppurative-destructive diseases, as well as patients with lung tumors. The volume of the operation depends on the prevalence and nature of the pathological process. Segmental resections, lob-, bilo- and pulmonectomy are carried out. With pyothorax, drainage of the pleural cavity is performed.