You Think It's Mucus, but It's Not

Dec. 10, 2008 -- In polite circles and among health care professionals, they tend to call it mucus. Some call it phlegm. Others may simply call it snot.

No matter which word you use, when you have a cold or flu, you usually have an increased supply of it. At your sickest, your sinuses may rev up production almost as fast as you can clear the stuff away.

Still, doctors say, all that gunk in your nose really does have a role in the body and a useful purpose during a cold.

Mucus in the nose and sinuses forms a blanket or coating over the mucous membranes lining the upper airways, explained Dr. Thomas Pasic, an ear, nose and throat specialist at the University of Wisconsin at Madison.

"It's sticky, so it's constantly trapping miniscule particles from the air you breathe in, such as allergens, pollution and dust to filter it out before it can reach the lungs," Pasic said.

Pasic added that mucus is constantly being formed, and we typically make about a quart of it a day. But we often don't notice it because we usually swallow the secretion rather than honking it out of the nose.

According to Pasic, you notice it when you make more than a quart daily or it becomes thicker, because you start to sniff. "A cold or an allergy sets mucus production out of whack."

An increase in mucus and its thickness is the way your nose and sinuses respond to the presence of an irritant, whether it's an invading virus, bacteria, or allergen.

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Inflammation in the nose and greater quantities of mucus can also be triggered by foods or things in the environment. These include cigarette smoke, chemical exposures, strong smells and perfumes, as well as substances found in milk, red wine and beer.

Does Mucus Color Matter?

There's very little that is magical about mucus, which is mostly water and salt with proteins, such as antibodies, to fight off infection mixed in. Still, people often wonder whether its color or consistency has any significance on the length or severity of their cold.

"Color is most predictive of the length of symptoms," suggested Dr. Matthew Rank, an allergist at the Mayo Clinic in Rochester, Minn. "As the mucus becomes darker in color, it may mean that the immune system is beginning to clear the infection."

But Rank is quick to point out that when it comes to a cold, "color doesn't matter for making a clinical diagnosis" and it doesn't influence his treatment decisions.

Ear, nose and throat specialists suggest that the normal color of mucus is clear. A cloudy or white nasal mucus may signal a cold.

Large amounts of yellow or green mucus tend to be a sign of bacterial infection. Occasionally, mucus takes on a brownish hue when it's tinged with a little blood, or possibly from the nostrils of heavy smokers or people exposed to lots of pollutants.

Asked whether the color or consistency of mucus had any importance, Dr. William Marshall, an infectious disease specialist at the Mayo Clinic, said it's probably not of great significance.

"I wouldn't hang my hat on it," he said. "There's not much useful information there for patients."

Mucus and Your Cold

Mucus keeps membranes moist, said Dr. Ralph Metson, a sinus surgeon at Massachusetts Eye and Ear Infirmary in Boston. It basically keeps the nose clean.

When you catch a cold and mucus production goes up, sinuses may also get blocked, so these cavities can get overgrown with bacteria that might lead to a sinus infection.

But, according to Metson, people with a cold are not most contagious to others when they are producing the most mucus. "The volume of mucus doesn't correlate with the number of viral particles shed."

Rather, Metson suggested that your level of contagion is more closely linked with where you are in the cold cycle. "People are shedding the most viral particles early on in a cold -- when you are incubating the virus and having early symptoms."

From Mucus to 'Booger'

Interestingly, Metson noted that sneezing was once thought to be the main cause of a cold spreading, but now scientists think it has more to do with hand-to-hand contact with the virus.

As for what causes those clumps of mucus, also known as "boogers," Metson explained it this way: When people breathe in, especially during the winter, they're inhaling drier air. This dries out mucus found in the front of the nose, forming a nasal crust.

Want to ease up on boogers as well as unclog a stuffed-up nose? The treatment most often recommended was nasal irrigation, or rinsing out your nose with a salt-water solution, ideally twice a day.

"I like to tell my patients, you brush and then flush," advised Metson. In other words, after brushing your teeth, you then flush out your nose with a glass of warm water and a teaspoon of salt delivered via a bulb syringe, neti pot or squeeze bottle found in nasal rinse kits sold at pharmacies.

Figuring Out Phlegm

You probably think of mucus as the substance that tends to come out of your nose, and phlegm as the stuff that come out of your mouth.

In medical speak, the term phlegm is interchangeable with sputum, and "all of it is mucus," explained Marshall.

Phlegm is a mixture of mucus and saliva and white blood cells produced by the body in response to inflammation. It brings moisture to the area and helps your body clear away infection.

And since there are mucous membranes lining the nose and sinuses, as well as the throat, esophagus, lungs and even the stomach, there's plenty of mucus around to form phlegm.

Smokers and people with a cold or lung conditions, such as emphysema or chronic obstructive pulmonary disease, produce more phlegm. Experts say that drinking milk doesn't necessarily cause your body to make more phlegm, but it may make what's there thicker and more annoying to your throat.

If phlegm gets darker in color in people with lung conditions, it could mean an infection. And sometimes, blood might discolor phlegm from coughing or a bad infection, or if it continues to occur, possibly a tumor, according to Marshall.

If you're hacking up gobs of phlegm, your best bet is to thin them out by drinking plenty of liquids -- hot or cold. Steamy, warm soups or teas often help to loosen them up.

Asked whether it was better to cough up the phlegm and spit it out (into a tissue, of course) or swallow it, Marshall replied it truly didn't matter.

"It's more an issue of personal preference," he said.

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