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What causes greenish phlegm in the throat upon waking up?

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General & Family Physician
Practicing since : 1991
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What does yellow or green mucus tell about a cold or sinus infection? YYYY@YYYY

Fri, 18 May 2018 in Ear, Nose and Throat Problems
Answered by Dr. Bonnie Berger-Durnbaugh 48 minutes later
Brief Answer:
Questions so that I can advise

Detailed Answer:
Hello Mr. XXXX,

Can you tell me more about your current symptoms?
1. You mention you don't have a dry cough. Do you have any cough, and what are you coughing up?
2. Is the yellow/green mucus from your nose?
3. Do you have sinus pressure? How many days have you had this infection?
4. Fatigue?
5. Shortness of breath or difficulty with your breathing that is more since your infeciton?
6. Is the discolored mucus only when you first get up or is it discolored all day?
7. Do you have any underlying illnesses - specifically diabetes, heart disease, autoimmune disorders, asthma or COPD? Name of the cough medicine?

I can advise more after I hear back. Sorry for so many questions but it will help me advise.
Above answer was peer-reviewed by
Follow-up: What causes greenish phlegm in the throat upon waking up? 3 hours later
Answers to Doctors questions.
1. no dry cough 2.very little mucus from nose. 3. some sinus pressure Illness for days. 4. Yes fatigue. 5 No shortness of breath. (Dr. checked lungs.) 6. Discolored mucus early in A.M. and again with I get up later in A.M. 7 Did Not accept the dry cough med. as I don't have a dry cough only cough when mucus in my throat be it colored or clear.
Answered by Dr. Bonnie Berger-Durnbaugh 13 minutes later
Brief Answer:
Information and suggestions

Detailed Answer:
Thank you for the additional information.

It is not unusual for mucus to be discolored green or yellow when you get up. This color change is from the mucus sitting there for a while and collecting and being processed. If the mucus is discolored all day, it is more typical of a bacterial infection.

Newer recommendations are to not give an antibiotic unless an infection shows signs of being bacterial (persistent fever and the mucus being discolored all day, or an abnormal chest X-ray) or has persisted for more than 2 or 3 weeks. This is because most sinus infections and colds are caused by viruses which an antibiotic won't help. In addition, use of antibiotics inapropriately increases the risk of development of "superbugs" that are resistant to antibiotics in the future. Also, the risk to benefit ratio needs to be considered, and if there isn't a high suspicion for a bacterial infection, the risks to the patient outweigh the benefits.

So - given that the discoloration is after having been lying down only, no fever, no lower respiratory symptoms, and the symptoms (pressure, discharge) have been for a few days rather than weeks, and no underlying illnesses (which I listed above) that would increase the chances of complications from an upper respiratory infection, an antibiotic would not be appropriate.

If your sinuses are congested, consider using a nasal steroid spray such as Flonase, which you can get over the counter. It can take a couple of days for it to kick in well. You can also consider irrigating with saline, such as with a Nettipot, or ready made saline spray. That can help relieve some of the symptoms. Don't use the steroid and saline within a couple hours of each other as then you won't get the most benefit out of the steroid spray.

If your symptoms become worse in the ways that I described above, then time to go back to the doctor (fever, shortness of breath, symptoms don't resolve, etc).

I hope this information helps. Please let me know if I can provide further information or clarification.
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