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Monday, September 1, 2014
Excess sputum, i.e congestion, only symptom
i am a white male 47. smoked pack a day for 27 yrs. quit 6 months ago. now, i have one symptom. 2 to 3 hours after i get up in the morning, i have to cough in order to get up sputum (normally oatmeal colored with a little yellow, no blood)and this last for about 4 hours. then, quits till next day. antibiotics have been ineffective, chest x-rays are o.k., blood oxygen is 93%, other airflow tests were 78% to mid 80's. my hoarseness depends on that days serverity. does this sound like lung cancer in the occult stage to you? or mild emphysema? should i have further tests? if so what tests should i have?
Lung disease due to smoking broadly falls into three categories: lung cancer, emphysema, and chronic bronchitis. Chronic bronchitis is characterized by persistent and/or recurrent bouts of sputum production, often with infections and evidence of airway obstruction. Other conditions that can present as chronic excess sputum production include (but are not limited to) post-nasal drip syndrome, asthma, cystic fibrosis, and recurrent aspirations associated with esophogeal reflux. Given your limited information, I would suspect that you have chronic bronchitis. Untreated, chronic bronchitis can lead to serious detriments in gas exchange (which basically means really bad lungs). Persons with chronic bronchitis should avoid ALL tobacco exposure (as should everyone else, for that matter). There's no way to rule out lung cancer for sure, but it sounds as if you have had at least an initial evaluation (xrays, etc) and that makes cancer a little less likely. Treatment is usually medical, and includes bronchodilators and sometimes inhaled corticosteroids. If further evaluation is indicated, your doctor may recommend a bronchoscopy, which is a direct examination of your airways using a "lighted tube".
Stuart Green, MD
Assistant Professor of Medicine and Pathobiology
College of Medicine
University of Cincinnati