Coughing is the body’s natural defense system to clear the lungs. A thin layer of mucus normally lines the airways, keeping them moist and well-lubricated; this is also called sputum. This makes it easier to breathe and it also traps any pathogens that try to enter the lungs. But what happens if you get sick? 

Certain conditions may change the usual consistency of phlegm, making it thick and globular. You might notice changes in color, as well as other symptoms that accompany the cough, such as coughing up solid sputum. Read on to learn more about why you are coughing up lumps of jelly and simple measures that you can take to address your symptoms.

Common Causes of Solid Round Sputum

Diseases can affect the color and consistency of mucus. These may cause conditions that vary from mild and easily managed to debilitating and life-altering. Depending on the signs and symptoms you are experiencing, your doctor may request a bevy of tests to determine the underlying disease causing you to cough up lumps of jelly. Lifestyle choices can also impact your lung health in ways that lead to productive coughs with thick, lumpy mucus. Here are just some of the most common culprits that can affect the normal characteristics of your phlegm.

Respiratory Infections

Lung diseases are naturally the most often implicated when it comes to coughing up phlegm. Bronchiectasis, in particular, is a respiratory infection that presents with a persistent cough and copious amounts of phlegm¹. The mucus can range from clear to yellow-green in color, and be associated with wheezing, difficulty breathing, chest pain, and joint pain. 

Cystic Fibrosis

Other conditions of the lungs can also cause you to cough up lumps of jelly. Cystic fibrosis is an inherited pulmonary disease in which there is an abnormal thickening and increased viscosity of mucus². This can clog the airways and make it extremely difficult to breathe. People with cystic fibrosis may also cough up blood mixed in with thickened sputum.

Chronic Obstructive Pulmonary Disease (COPD)

People with chronic obstructive pulmonary disease (COPD) also experience the same struggle brought about by an excess in phlegm production³. This can clog the airways and appear jelly-like when coughed up.

Tonsil Stones

When food debris gets trapped in your throat, it may harden and form tonsil stones⁴. When you cough, they may be dislodged and appear as whitish or yellow lumps⁵. Tonsil stones do not usually cause symptoms but if they build up over time, they may cause irritation of the lining of the throat, visible white lumps on your tonsils, halitosis (bad breath) and a bad taste in the mouth from the accumulation of bacteria⁶, and difficulty swallowing⁴. 

Allergies

When you’re allergic to something you breathe in, your airways tend to hyper-respond to the stimuli. . Triggers such as dust, pollen, pet dander, and even changes in the weather can lead your lungs to produce excessive mucus that may build up enough to cause coughing⁷. Common symptoms of allergies include a runny nose, sneezing, watery eyes, itchy throat, and congested or blocked ears. 

Aspiration

Many of us have probably experienced swallowing food that goes “down the wrong pipe.” The sensation is usually very unpleasant and is followed by a bout of coughing in order to clear the airways. This is called aspiration⁸. You may cough up whatever it is that accidentally entered your lungs, which can look like a clump of jelly as it is typically chewed and covered with respiratory mucus. It is important to try to cough it up – when food and drink particles reach your lungs (where they should not be), this causes inflammation and infection. These are ripe conditions for the development of fever, cough, and wheezing that may progress to full-blown pneumonia⁹.

Fungal Diseases

Aspergilloma is a fungal infection of the lungs that commonly affects people with lowered immunity, like people with HIV and transplant patients¹⁰. One of the key symptoms of aspergilloma is a fungus ball, which can be identified on CT scans¹¹. While uncommon, you may cough up sputum that contains this fungus and looks like “balls”, which are made up of the fungi, blood clots, and white blood cells. 

COVID-19

Emerging data is showing that “thick, gummy respiratory secretions” play a central role in COVID-19, the disease that started the latest pandemic¹². The sputum is so thick that patients were noted to be “drowning” in their own respiratory secretions, which are particularly difficult to remove. They would then require mechanical ventilation to help the patient breathe. The cough typically contracted with COVID-19 is dry, making it hard to cough up this thick mucus. If you do develop a protracted, dry cough, take a COVID-19 test; it is better to catch this disease early to have more treatment options. If you have COVID-19 and start having a productive cough, you may cough up some of this mucus, which may look like jelly. At this point, go to your doctor to begin discussing treatment options, as developing the thick mucus can be a sign of severe COVID-19.

Smoking

Apart from diseases, the choices we make daily can also impact our health. Smoking leads to long-term damage of the lungs, making them susceptible to disease like the ones we just discussed¹³. Growing research has found that smoking tends to increase the thickness of mucus¹⁴ due to dehydrating it¹⁵ and contribute negatively as well to the development of other illnesses¹⁶.

Dehydration

Interestingly, dehydration can also cause you to cough up lumps of jelly by making your phlegm more viscous¹⁷. This is why it is important to drink plenty of water, especially while exercising or if you have a lung condition. 

Color Changes in Phlegm

The color of your phlegm can also be an important clue to the underlying disease as well as give an idea of its course¹⁸. Whitish or clear phlegm could denote airway inflammation related to an asthma flare that has moved the secretions from your nose to the back of the throat. Yellow-greenish phlegm may denote a bacterial infection of the lungs. This may be associated with other symptoms such as fever, chest tightness, and difficulty breathing. Blood-streaked or reddish phlegm is seen in numerous conditions such as bronchitis, pneumonia, tuberculosis, or bleeding from coughing too much¹⁹. Smoking may cause black or brownish phlegm due to the deposits that have accumulated in the lungs. When in doubt, consult your physician. 

Learn more: Coughing Up Mucus - What Could It Mean?

Home Remedies for Coughing up Lumps of Jelly

Treatment when you are coughing up lumps of jelly will ultimately depend on the underlying cause²⁰. If it is due to asthma, your doctor may prescribe corticosteroids or decongestants to address the symptoms. If you have an infection in the lungs, antibiotics may be warranted. Quitting smoking may also be recommended to lessen the damage to your lungs. 

In general, home remedies for coughing up phlegm involve reducing your cough and to keeping your immune system up to help the body combat disease. Here are some recommendations:

• Drink plenty of water – Water is a quick and easy solution to help thin out viscous secretions. This will also prevent dehydration. 
• Gargle saltwater – In a glass of warm water, add ½ tablespoon of salt and gargle to loosen up phlegm. 
• Use a humidifier – This will keep the air in your home moist and make it easier to breathe.
• Exercise regularly – Exercise will not only strengthen the respiratory muscles, but also positively impact your physical and mental health. 
• Get enough sleep – A good night’s sleep can work wonders on your health, mood, and overall productivity.

These are just some of the simple but effective ways you can lessen coughing up jelly. Usually, a mild condition will last for a few days but you should take note of several signs that may tell you it is time to consult your doctor²¹. These include a bluish tinge to your skin or lips, fever, rapid or labored breathing, chest pain, and confusion. If you notice any of these, proceed to the emergency department immediately. 

Summary

Coughing is the body’s normal response to invading pathogens. However, numerous factors can change the appearance and characteristics of your phlegm. It might even cause you to cough up lumps of jelly. Conditions like bronchiectasis, COPD, asthma, and even COVID-19 can make your phlegm thicker in consistency. Lifestyle habits such as smoking and not drinking enough can also affect your sputum. Simple home remedies such as drinking plenty of water, using a humidifier, and regular exercise can help alleviate symptoms. However, the presence of alarming signs and symptoms such as bluish discoloration of the skin and lips, difficulty breathing, and worsening cough should prompt you to consult your doctor immediately.

Mikaela Millan

Mikaela is a dentistry clinician at the University of the Philippines.

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