Every morning, I get a wake-up call from my neighbour. Like an opera, it opens with an overture of gushing tap water that signals he has entered the scene. Then, comes the aria – a solo performance of gurgling phlegm and sputtering coughs (it can be pretty drawn out on some mornings).
The lung-busting hacking feverishly crescendos until it hits a deep-chested “hwaaak”. The finale, ladies and gentlemen, is the definitive “tuk” – along with what I imagine to be a satisfying glob of sputum. End scene.
What exactly is it about the sticky stuff in the depths of our airways that makes us cough, and produce such goo and sounds? And if your throat is stuffed up with phlegm, is there a better way to cough it up than the “hwaaak-tuk” method we often hear from uncles? We find out from the experts.
“Mucus is a general term for the slippery, liquid secretion produced primarily in the respiratory, digestive and reproductive systems,” said Dr Tan Teck Shi, a consultant and the clinical lead for SingHealth Polyclinics’ Respiratory Workgroup. “Mucus in the respiratory tract is termed as phlegm or sputum.”
Essentially, said Dr Tan, both phlegm and mucus mean the same thing, though the “layman refers to the liquid secretions as mucus and the thicker, more coloured secretions as phlegm”.
(Photo: iStock/pocketlight)
Beyond its sticky, gooey appearance, mucus actually consists of water, salt, protein and protective immune cells, according to Dr Choo Chuan Gee, a respiratory physician at Mount Elizabeth Hospital.
Even when you’re well, “mucus is produced by the cells lining the surfaces of the respiratory tract, including the nostrils, bronchial tubes, air sacs in the lungs and the glands underlying the surface lining”, said Dr Tan.
“Mucus acts as a lubricant to keep moist tissues such as the sinuses, mouth and lungs from drying out,” he said.
In addition, “the purpose of the mucus in the respiratory tract forms part of our lungs’ defence mechanism”, said Dr Choo. “It helps to protect the lungs from unwanted inhaled particles, bacteria, viruses and toxins.”
This defence mechanism also consists of tiny, hair-like structures called cilia in the airways that push phlegm up and out of the body through coughing. The process helps to keep the lungs and airways clear and functioning, according to Medical News Today.
(Photo: iStock/champja)
It is inevitable for your respiratory tract to produce more mucus than usual when you’re hit with a cold, flu or allergic reaction, said Dr Tan. It is, after all, your body’s way to flush out germs and other unwanted guests such as dust and pollen.
“The thicker, coloured phlegm may point to an infection, especially in patients with chronic obstructive pulmonary disease,” he said.
Viscous phlegm that feels like a plug in your throat may induce you to “uncle cough” it out (like my neighbour does) but experts warn not to. “Excessive, forceful coughing can result in dizziness or fainting, urinary incontinence, disturbed sleep, muscle strain, or even vocal cord damage and hernia,” said Dr Tan.
Dr Choo also warned against the hacking “uncle cough" and aggressive throat clearing. “It is tiring and may sometimes aggravate chest wall discomfort,” he said. “We can clear phlegm with our cough response without excessive straining.”
(Photo: iStock/Wormphoto)
To effectively cough up your phlegm without hurting yourself, Dr Choo recommended using your abdominal muscles to “expel the air”. “This deep coughing method involves taking a deep breath, and holding it for two to three seconds. Then, use the abdominal muscles to forcefully expel the air,” he said.
It goes without saying that you should practise good hygiene while doing so by using a tissue to cover your coughs and sneezes, Dr Choo added.
Alternatively, there’s the huff coughing method. “It involves taking a breath that is slightly deeper than normal,” said Dr Choo. “Use your abdominal muscles to make a series of three rapid exhalations with your mouth opened. Follow this with controlled, diaphragmatic breathing and a deep cough.”
Not a fan of coughing? Other phlegm-removing ways to consider include hydrating well, using an air humidifier, gargling with salt water, using a saline nasal rinse, and keeping your head elevated. “These measures will help to ease the discomfort of the cold or flu,” said Dr Choo.
There is good reason why you feel phlegm in your throat because your body is trying to get rid of it. So, spitting it out is healthier than swallowing it.
But if you can’t find a bathroom nearby to spit out the phlegm after coughing it up, it’s no biggie to swallow it. After all, some of the sticky stuff is excreted in the digestive tract, said Dr Choo. Also, “it is okay to swallow phlegm as the germs will be digested by the gastric juices”.
Moreover, “mucus is continuously produced and swallowed subconsciously”, said Dr Tan.
Normal phlegm generally looks clear or partially opaque with a consistency between “viscous fluid and soft elastic solid”, said Mount Elizabeth Hospital’s respiratory physician Dr Choo Chuan Gee. However, the colour is only an indication of the possible underlying cause and isn’t specific. Here’s a look:
“Excessive and prolonged coughing is an indication to see the doctor,” said Dr Tan. Further investigations such as a chest X-ray may be needed. For smokers, a lung function test may be required to look for chronic obstructive pulmonary disease, he said.
“When a patient coughs out blood-stained phlegm or fresh blood,” added Dr Tan, “they should see a doctor, especially if they have risk factors such as smoking”.
You should also see a doctor if your coughing is prolonged (more than three weeks) and the phlegm has a sudden change in colour, advised Dr Choo.
A prompt trip to the GP’s is encouraged as well if the coughing and phlegm cause discomfort or are associated with other symptoms such as fever, breathing difficulty or weight loss, he said
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The lung-busting hacking feverishly crescendos until it hits a deep-chested “hwaaak”. The finale, ladies and gentlemen, is the definitive “tuk” – along with what I imagine to be a satisfying glob of sputum. End scene.
What exactly is it about the sticky stuff in the depths of our airways that makes us cough, and produce such goo and sounds? And if your throat is stuffed up with phlegm, is there a better way to cough it up than the “hwaaak-tuk” method we often hear from uncles? We find out from the experts.
WHAT IS PHLEGM? HOW IS IT DIFFERENT FROM MUCUS?
“Mucus is a general term for the slippery, liquid secretion produced primarily in the respiratory, digestive and reproductive systems,” said Dr Tan Teck Shi, a consultant and the clinical lead for SingHealth Polyclinics’ Respiratory Workgroup. “Mucus in the respiratory tract is termed as phlegm or sputum.”
Essentially, said Dr Tan, both phlegm and mucus mean the same thing, though the “layman refers to the liquid secretions as mucus and the thicker, more coloured secretions as phlegm”.
(Photo: iStock/pocketlight)
WHY DO WE PRODUCE MUCUS EVEN WHEN WE’RE NOT SICK?
Beyond its sticky, gooey appearance, mucus actually consists of water, salt, protein and protective immune cells, according to Dr Choo Chuan Gee, a respiratory physician at Mount Elizabeth Hospital.
Even when you’re well, “mucus is produced by the cells lining the surfaces of the respiratory tract, including the nostrils, bronchial tubes, air sacs in the lungs and the glands underlying the surface lining”, said Dr Tan.
“Mucus acts as a lubricant to keep moist tissues such as the sinuses, mouth and lungs from drying out,” he said.
In addition, “the purpose of the mucus in the respiratory tract forms part of our lungs’ defence mechanism”, said Dr Choo. “It helps to protect the lungs from unwanted inhaled particles, bacteria, viruses and toxins.”
This defence mechanism also consists of tiny, hair-like structures called cilia in the airways that push phlegm up and out of the body through coughing. The process helps to keep the lungs and airways clear and functioning, according to Medical News Today.
(Photo: iStock/champja)
SHOULD WE TRY TO COUGH UP PHLEGM? IS THERE A PROPER WAY TO DO IT?
It is inevitable for your respiratory tract to produce more mucus than usual when you’re hit with a cold, flu or allergic reaction, said Dr Tan. It is, after all, your body’s way to flush out germs and other unwanted guests such as dust and pollen.
“The thicker, coloured phlegm may point to an infection, especially in patients with chronic obstructive pulmonary disease,” he said.
Viscous phlegm that feels like a plug in your throat may induce you to “uncle cough” it out (like my neighbour does) but experts warn not to. “Excessive, forceful coughing can result in dizziness or fainting, urinary incontinence, disturbed sleep, muscle strain, or even vocal cord damage and hernia,” said Dr Tan.
Dr Choo also warned against the hacking “uncle cough" and aggressive throat clearing. “It is tiring and may sometimes aggravate chest wall discomfort,” he said. “We can clear phlegm with our cough response without excessive straining.”
(Photo: iStock/Wormphoto)
To effectively cough up your phlegm without hurting yourself, Dr Choo recommended using your abdominal muscles to “expel the air”. “This deep coughing method involves taking a deep breath, and holding it for two to three seconds. Then, use the abdominal muscles to forcefully expel the air,” he said.
It goes without saying that you should practise good hygiene while doing so by using a tissue to cover your coughs and sneezes, Dr Choo added.
Alternatively, there’s the huff coughing method. “It involves taking a breath that is slightly deeper than normal,” said Dr Choo. “Use your abdominal muscles to make a series of three rapid exhalations with your mouth opened. Follow this with controlled, diaphragmatic breathing and a deep cough.”
Not a fan of coughing? Other phlegm-removing ways to consider include hydrating well, using an air humidifier, gargling with salt water, using a saline nasal rinse, and keeping your head elevated. “These measures will help to ease the discomfort of the cold or flu,” said Dr Choo.
IS IT OKAY TO SWALLOW PHLEGM?
There is good reason why you feel phlegm in your throat because your body is trying to get rid of it. So, spitting it out is healthier than swallowing it.
But if you can’t find a bathroom nearby to spit out the phlegm after coughing it up, it’s no biggie to swallow it. After all, some of the sticky stuff is excreted in the digestive tract, said Dr Choo. Also, “it is okay to swallow phlegm as the germs will be digested by the gastric juices”.
Moreover, “mucus is continuously produced and swallowed subconsciously”, said Dr Tan.
WHAT DO THE DIFFERENT PHLEGM COLOURS MEAN?
Normal phlegm generally looks clear or partially opaque with a consistency between “viscous fluid and soft elastic solid”, said Mount Elizabeth Hospital’s respiratory physician Dr Choo Chuan Gee. However, the colour is only an indication of the possible underlying cause and isn’t specific. Here’s a look:
- Yellow mucus: Cold-like illness
- Green mucus: Bacterial infection
- Brown mucus: Dried blood in the nose or inhaled pollution or dirt
- Reddish or pink mucus: Blood from the mouth or breathing tract
WHEN SHOULD WE SEE A DOCTOR?
“Excessive and prolonged coughing is an indication to see the doctor,” said Dr Tan. Further investigations such as a chest X-ray may be needed. For smokers, a lung function test may be required to look for chronic obstructive pulmonary disease, he said.
“When a patient coughs out blood-stained phlegm or fresh blood,” added Dr Tan, “they should see a doctor, especially if they have risk factors such as smoking”.
You should also see a doctor if your coughing is prolonged (more than three weeks) and the phlegm has a sudden change in colour, advised Dr Choo.
A prompt trip to the GP’s is encouraged as well if the coughing and phlegm cause discomfort or are associated with other symptoms such as fever, breathing difficulty or weight loss, he said
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