Brown Phlegm: Causes, Concerns, and Next Steps

The sputum is brown?

Hello Doctor, I apologize for this question, but I'm not sure where to ask it.
I have been experiencing phlegm production for a long time, and sometimes it is brown in color.
When I wake up in the morning and brush my teeth, the phlegm is often black or brown.
Other than that, I have no other uncomfortable symptoms, but I am very worried.
Over the past month, I have seen various specialists, undergone gastroscopy, nasal endoscopy, and chest X-rays, all of which showed no issues except for mild inflammation in the stomach and acid reflux, but overall, everything seems fine.
Could you please advise me on how to resolve this issue? Which specialist should I consult? Thank you, I am very troubled!

Xiansheng, 20~29 year old female. Ask Date: 2017/06/16

Dr. Chen Taicheng reply Family Medicine

● First, determine if there is a tendency to bleed easily or if there are any periodontal issues (for example, if the gums bleed easily when brushing teeth); also check for conditions like allergic rhinitis or asthma that may cause frequent nose blowing or forceful coughing, which can lead to minor mucosal bleeding.
● Generally, black or brown sputum raises suspicion of bleeding.
The nasal endoscopy and gastroscopy you have undergone can help rule out bleeding from the nasal cavity or the esophagus, stomach, and other parts of the gastrointestinal tract.
However, if you notice black sputum only after brushing your teeth in the morning, consider whether there might be sinusitis causing post-nasal drip leading to black sputum.
● Additionally, the most likely source is the thoracic cavity; for instance, smokers may have darker tracheas and sputum.
Other conditions such as bronchitis, pneumonia (bacterial or viral infections), and lung abscesses can also result in darker sputum.
● If there are no coagulation or periodontal issues, it is advisable to first consult an otolaryngologist to ensure there are no problems with the nose, nasopharynx, or oropharynx, and then proceed to a pulmonologist for further evaluation, such as bronchoscopy or other imaging studies.
● Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital Family Medicine Department cares about you~

Reply Date: 2017/06/16

More Info

Brown phlegm can be concerning, especially when it persists over time. The color of phlegm can often provide clues about what might be happening in your respiratory system. Brown or coffee-colored phlegm typically indicates the presence of old blood or other substances that have been in the lungs for a while. This can be due to several factors, including smoking, exposure to pollutants, or chronic respiratory conditions.

Given that you have already consulted multiple specialists and undergone various tests, including an endoscopy and a chest X-ray, it seems that serious conditions have been ruled out. However, it is still important to consider a few potential causes for your symptoms:
1. Chronic Bronchitis: If you are a smoker or have been exposed to secondhand smoke, chronic bronchitis could be a possibility. This condition is characterized by inflammation of the bronchial tubes, leading to increased mucus production and a persistent cough.

2. Environmental Factors: Exposure to dust, chemicals, or other irritants can lead to the production of brown phlegm. If you work in an environment with such exposures, it might be worth discussing this with your doctor.

3. Gastroesophageal Reflux Disease (GERD): Since you mentioned having some degree of gastric inflammation and acid reflux, it's possible that stomach acid could be irritating your throat and lungs, leading to the production of phlegm. This could also explain the brown color if the acid is causing some bleeding in the esophagus or throat.

4. Infection: While you have not reported any other symptoms, some infections can cause changes in phlegm color. A chronic infection, such as a fungal infection, could lead to brown phlegm.

5. Pulmonary Conditions: Conditions such as bronchiectasis or pulmonary fibrosis can also lead to the production of abnormal phlegm. These conditions often require specific imaging studies or tests to diagnose.

Next Steps
Given your ongoing symptoms and the fact that you have seen multiple specialists, I recommend the following steps:
- Pulmonologist Consultation: If you haven't already, consider seeing a pulmonologist (lung specialist). They can perform specific tests, such as a CT scan of the chest, pulmonary function tests, or even a bronchoscopy if necessary, to get a clearer picture of what might be causing your symptoms.

- Lifestyle Modifications: If you smoke, quitting can significantly improve your lung health. Additionally, avoiding known irritants and allergens can help reduce symptoms.

- Manage GERD: If GERD is a contributing factor, managing it through dietary changes, medications, or lifestyle adjustments can help alleviate symptoms.
- Hydration and Humidification: Staying well-hydrated and using a humidifier can help thin mucus, making it easier to expel.

- Monitoring Symptoms: Keep a diary of your symptoms, noting when they occur, their severity, and any potential triggers. This information can be valuable for your healthcare provider.

Conclusion
While brown phlegm can be alarming, it is often manageable with the right approach. Since you have already taken significant steps to investigate your symptoms, continuing to work with a specialist who can focus on lung health will be crucial. Remember, it’s important to communicate openly with your healthcare providers about your concerns and symptoms to ensure you receive the best care possible.

Similar Q&A

Understanding Phlegm Color: Is It Normal to Cough Up Brown-tinged Mucus?

Waking up to cough up phlegm that is transparent but mixed with a slight light brown color, followed by clear phlegm, can be concerning. Given that you have chronic rhinitis, this could be related to post-nasal drip, which often leads to the accumulation of mucus in the throat. T...

Dr. Zheng Jueyi reply Otolaryngology
Hello, if you continue to have colored sputum, it is advisable to seek medical evaluation to check for infections or other conditions. Wishing you safety and health. Sincerely, Dr. Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health an...

Understanding the Causes of Red or Brown Specks in Phlegm

The presence of small red or brown particles in phlegm can indicate several conditions. These discolorations may be due to the presence of blood, which can occur from various sources such as irritation of the respiratory tract, infections, or more serious conditions like bronchit...

Dr. Xie Rongyuan reply Internal Medicine
Hello: Regarding your inquiry, here are my recommendations: 1. Undergo a chest X-ray at the hospital. 2. Visit the pulmonary medicine outpatient clinic for treatment. Thank you for your message!

Persistent Throat Discomfort and Brown Mucus: Possible Causes and Solutions

Hello Doctor, I have been experiencing a persistent sensation of something stuck in my throat along with phlegm for nearly two months. The phlegm does not resemble the typical yellow or green color seen in common colds; instead, it is transparent with brownish, fibrous or chunky ...

Dr. Ji Zhaoyun reply Otolaryngology
Hello, based on the symptoms you described, you have undergone a series of evaluations, including assessments from otolaryngology, pulmonology, and gastroenterology, and it has been found that you have moderate gastroesophageal reflux disease (GERD). Here are some possible causes...

Understanding Brown and Yellow-Green Mucus: Causes and Concerns

Hello! I usually exercise regularly and stay hydrated, and my daily routine is quite normal. However, I often notice that my nasal mucus and phlegm are brown or yellow-green in color. What could be the issue? Thank you!

Dr. Chen Zonglin reply Family Medicine
Based on the information you provided, the phlegm is often brown or yellow-green, which may indicate post-nasal drip. It is recommended that you seek further evaluation from a family medicine or otolaryngology specialist.