What You Need To Know About Bronchiectasis Sputum Changes

Keeping track of your sputum — mucus that comes from your lungs and airways — is a part of daily life for many people with bronchiectasis. But what changes should you look out for?

Pulmonary medicine physician Anas Hadeh, MD, talks about what your mucus can tell you about your health.

The role of sputum in bronchiectasis

Bronchiectasis damage in your airways prevents your body from clearing out mucus as it should. This can lead to a buildup that you have to use special techniques to clear out, like chest PT and nebulizer treatments.

Mucus can also trap bacteria in your lungs and airways and lead to a cycle of infections, commonly called flares.

Changes to look out for

Tracking sputum changes can help you stay on top of incoming flares. Dr. Hadeh says to take note of what’s normal for you, including symptoms that may come and go, but don’t turn into flares.

“Day-to-day ups and downs can be normal,” he notes.

Keep an eye on changes in color, consistency and the amount of sputum you’re bringing up. If you notice a lot of sputum changes over the course of a couple of days, it’s time to call your healthcare provider.

Color

Sputum can be clear or come in a spectrum of colors, including:

• White
• Green
• Yellow
• Brown

Most people, including people with bronchiectasis, have clear or lighter colors of mucus when they’re well. It often becomes darker or changes color when you’re sick.

But try not to read the tea leaves too much here.

“You may want to know that a certain color means a bacterial infection, or another means a viral infection,” says Dr. Hadeh. “But no particular color can tell you what’s causing your symptoms.”

Only a sputum test can tell you for sure.

Consistency

Sputum is usually thin and slippery. Your normal may be a little thicker than someone without bronchiectasis.

You might notice at times that your mucus becomes:

• Thicker
• Stickier
• Frothier or foamy

Dr. Hadeh says these changes in consistency can make it harder to clear out than usual. But like sputum color, a single consistency change doesn’t necessarily mean a flare’s coming on, especially if you have no other new or changing symptoms.

Volume

While all people with bronchiectasis have to pay attention to their sputum, how much you produce each day can vary from person to person.

“If you have noticeably more mucus than usual, it’s something to keep an eye on,” advises Dr. Hadeh.

If you need to perform airway clearance more often to feel like you’re getting the sputum out, that could be a sign that your body’s producing more than usual.

Blood

Blood in your sputum can be anything from a pink tinge and streaks of red to large amounts of red blood. Contact your provider if you start noticing signs of blood in your sputum.

Go to the emergency room if you’re coughing up large amounts of blood.

What sputum changes mean in bronchiectasis

Sputum changes can sometimes mean a flare is coming on. Your body will produce more mucus when it’s trying to clear out viruses, bacteria or other germs.

Color and thickness changes come from collections of immune cells that are fighting the infection. Damage and inflammation in your airways can cause bloody mucus.

But these changes don’t always mean you have an infection. And there are other symptom changes to look out for to alert you to a flare.

When to get help

Dr. Hadeh says to call your provider if you have changes in three of these six symptoms:

• Color and thickness of mucus (purulence)
• Amount of mucus (sputum volume)
• Blood in your mucus or coughing up blood
• Cough
• Fatigue
• Shortness of breath

Worsening symptoms that last 48 hours can mean you’re starting a flare and need to contact your provider’s office. The earlier you address a potential flare, the more likely you are to get through it quickly.

If you have severe or sudden difficulty breathing, you’re coughing up blood, or you’re feeling very unwell, call 911 or go to the emergency room right away.

Final thoughts

Keeping track of your sputum is an important aspect of bronchiectasis care. It’s also important to consider other symptoms to get a whole picture of your health.

Be sure to let your provider know if you have any new symptoms or changes to your usual ones. And contact them right away if you think you have a flare starting.

“Early treatment can keep you out of the hospital and may even avoid a flare altogether,” says Dr. Hadeh.