Monday, May 12, 2008

Spit or swallow? The phlegm debate.

I have a cold – AGAIN – and this time around I’m experiencing some nice juicy coughs and a plethora of phlegm. Matt has come down with the cough as well and during our weekend of hacking and building snotty-tissue mountains I started to ruminate on the everlasting spit or swallow debate. And of course by this I mean whether or not you spit out the phlegm that you cough up or do you swallow it.

Matt is a spitter: hocking great mounds of mucus onto sidewalks or into wadded tissues – and there’s nothing wrong with that. I’m a swallower. I’ve always been a swallower and for years as a child I was berated for this and told that I was making myself even sicker for not spitting that phlegm out. “It’s just going to come right back if you swallow it – you have to spit it out.” my parents would say. And I believed them for several years and I made valiant efforts to spit. But I’m not a good spitter. It’s not a skill that comes naturally to me, and when I attempt to spit it usually ends up as an embarrassing and messy scene involving spittle trails on my chin and an ineffectual wad of saliva and mucus a mere 2 cm. from the toe of my shoe.

So for years I swallowed in shame. Convinced that I was making myself even more ill, until one day when I finally realized that it was all just a scam, a myth, an urban legend. Let’s think about it people: phlegm comes from your lungs, or more accurately from your trachea. When you cough it up it dislodges and lands in your throat or the back of your mouth. When you swallow it goes down your esophagus and into your stomach. Therefore it’s been cleared from your lungs and in effect you’ve accomplished the same goal as spitting. You’ve removed the phlegm from the trachea.

Why is there still this belief that if you swallow the phlegm that you’re somehow being unhealthy? Is it ignorance? A gross out factor? It seems that a lot of people think it’s gross to swallow phlegm. My question is, how is it any worse than spitting it out? The phlegm is inside my body anyway, and sure it’s nasty, but I’d rather swallow it quickly in a fraction of a second and allow my digestive track to dispose of it, than to have it travel over my tongue (and taste buds) and teeth and shoot it out between my lips.

I searched online for medical proof that swallowing phlegm was detrimental to your health and I found none. Everything that I found backed up my belief that it doesn’t matter whether you spit or swallow, just as long as you remove the phlegm from the trachea. And yet I ran across several message boards and question and answer sites where the same old adage, “if you swallow it, it will just come back” was repeated by the ignorant masses.

I’m thinking of starting some sort of public educational campaign. I need to stamp out the ignorance and let people know that it’s okay to swallow, though I’m not sure I’d get good reactions If I made posters that said “There’s no shame in swallowing!” or “You don’t have to spit – you can swallow!” and posted them up on Laundromat and YMCA cork boards.

178 comments:

fatjoez said...

actually you're being a bit naieve there mate

"Don't swallow that phlegm if you want to get rid of it. Phlegm functions as a sticky film, filled with infection fighting substances like glycoproteins and immunoglobulins, which attaches itself to the lining of your bronchial tubes and lungs. Generally speaking, when phlegm starts to get coughed up, it means that the substance has served its purpose and needs to be expelled. Spit that phlegm into a tissue rather than trying to swallow it, because swallowing often times reintroduces the phlegm back into your pulmonary (lung) system. "

Rachel said...

But wouldn't it enter your GI system (not your lungs) if you swallowed it?

Anonymous said...

To fatjoez

r u dumb??? When you swallow food it doesn't go down ur lungs u idiot... it goes down ur STOMACH where there's a lot of acid to digest whateva crap u just took in... phlegm not excluded

Anonymous said...

Fatjoez was right and wrong. By swallowing the phlegm, you reintroduce it into your system (not back down the trachea though) because it goes into your digestive tract where it can then be absorbed into your body (which is already weakened against the intruders in the first place) where it can then have a hand in causing the infection to remain in your body longer than it would have had you expelled it from your body. Here's a question though: once you do fight off the infection(if you're a swallower), is your immune system against that infection all the more stronger than if you had always spit?

Anonymous said...

"Here's a question though: once you do fight off the infection(if you're a swallower), is your immune system against that infection all the more stronger than if you had always spit?"

Huh. Good question hehe

Anonymous said...

If theres any research students out there looking for a worthy field for their PhD, this has got to be one ... a common issue and a dearth of genuine research

Cynthia said...

Some people just can't spit it out you know?? Whenever I try to spit it out I end up not spitting any phlegm and almost vomiting. What do we do if we don't swallow it? There's really no other alternatives you know

Kim in Nevada said...

I too am a phlegm swallower. I can never seem to get it far enough out into my mouth to spit it out. So I just end up swallowing it. I too was always told you better spit it out or you'll just get worse...so I finally asked my doctor and she told me that it won't make you more sick, but it can affect the PH balance of your stomach and cause it to be upset.

stepdav said...

I was looking in the net for the disadvantages of swallowing phlegm and i found this post XD
very helpfull indeed....
i shall continue being a swallower as i seriously cant spit...
Doesnt seem to have any negative effects =]

Angel said...

I couldn't have written this article better myself! The only difference for me is I can spit. I don't consiously either. Usually though I spit only when outside. I just don't think about it either way. Although I wanna add this. My mom had asthma while growing up. Everyday she would keep a paper towel around that she would spit in ever so neatly in a row folding it over and over. And if it wasnt laying somewhere next to her it was in her pocket waiting for the next unsuspecting idiot that would reach into it. Namely me wanting the car keys. GROSS!!! Now tell me that wads of paper towels or germy kleenexs or handkercheifs is better then swallowing. At least I'm only keeping myself sick not spreading my germs onto everything my spit touches.

Andrea said...

LOL! I was just looking this up because I have a respiratory infection and I'm glad I'm not alone in being unwilling (and barely able) to spit out phlegm. I really don't want to taste the stuff any more than i have to!! I've also always thought that the bacteria and viruses that attack your lungs probably get pretty well broken down in your stomach acid...not to mention that there is often a greater potential to spread it to other people through spitting. Glad to see other people feel the same way. blech!

Mar said...

I do both. I am reasoning that my GI can handle it, otherwise why would it be so easy to swallow? I don't want to swallow, since I've been 'infected' with the swallowing-is-bad notion, and I certainly don't like the taste or feeling. But what do I do at work, in class? This is just lingering stuff from a week-old cold, mainly sinusitis. But am I still contagious? If I have to agonize over spit/swallow, should I not be exposing myself?

JerseyCynic said...

after I read this --


toplung doc advocates picking nose and eating....
I wondered about "The phlegm debate" (LOL!!) and found your post.

I'm thinking it's safe to swallow AND good for you
also?

Peach said...

Well personally I would rather swallow since I think spitting in public is gross and also spreads germs, but if I swallow too much I end up vomiting. So now I swallow if it's a one time deal but if I'm sick and it's not gonna stop there I spit.

Anonymous said...

I just started a nasal spray and nasal cleansing with saline and I'm finding a lot of mucus is loosening and I'm swallowing it. I didn't think anything of it until my stomach started feeling nauseated. I did some research online and although nasal sprays have side effects like nausea, I saw a lot of sites that agreed swallowing mucus can cause an upset stomach...so...I'm not sure how everyone else doing research online missed all those sites...

Tim said...

I swallow too. Swallowers Unite!

Anonymous said...

It won't hurt you to swallow.
However, when you do swallow mucus it does not digest but, just goes through your intestines as mucus. This is not a bad thing considering your stomach is lined with mucus anyway as protection from stomach acid. An excess in your stomach can lead to discomfort, but I believe that's the only negative side to swallowing.

Anonymous said...

im glad im not alone. i wd really love to spit it out but i cant, just as i cant roll my tongue.some can do it and some cant. its comforting to know that im not in serious danger for not being able to join my spit out folks.

Anonymous said...

I've also wondered this a few times when I've gotten sick. I both spit and swallow, depending on how gross it feels, and when I did my research I couldn't find anything to say that it was actually bad for you to swallow the phlegm, however, variations in color in your phlegm mean different things in regards to your illness, and having blood in your phlegm is a sign of a serious illness like tuberculosis. So while the act of actually swallowing your phlegm doesn't hurt you, you could be missing out on hints as to more serious conditions if you don't take an occasional peek by spitting it out. :)

Anonymous said...

Oh yay, I'm not alone ;)
Right now I have the worst cold ever & i decided to swallow my phlegm because simply, I'm way too lazy to get up and walk to the sink/grab a tissue and spit it out. plus, sometimes when i spit it out, i feel like gagging.
Now that i swallowed a whole lot of phlegm, my stomach isn't doing so well...so it is fine to swallow it but be aware that you'll have an upset stomach for an hour at the most... :)
just be careful with the amount of phlegm you swallow...i've been a swallower for years and it seems that my stomach feels really bad after swallowing a few big wads.

Anonymous said...

Oh yay, I'm not alone ;)
Right now I have the worst cold ever & i decided to swallow my phlegm because simply, I'm way too lazy to get up and walk to the sink/grab a tissue and spit it out. plus, sometimes when i spit it out, i feel like gagging.
Now that i swallowed a whole lot of phlegm, my stomach isn't doing so well...so it is fine to swallow it but be aware that you'll have an upset stomach for an hour at the most... :)
just be careful with the amount of phlegm you swallow...i've been a swallower for years and it seems that my stomach feels really bad after swallowing a few big wads.

Anonymous said...

Glad I found help in this matter; I'm sick with the flu and my doctor said "as long as the phlegm is not green, you're fine" - the problem is I can't spit it out! I try, and try and just end up gagging on top of the sink hoping some phlegm will come out so I can see its color; it's been frustrating... at least I'm glad I'm not the only one.

Anonymous said...

I am a swallower too. I think I rather swallow it in a split second instead of trying to gather them with that weird throat noise and everyone around me is going to notice.

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Anonymous said...

I'm on the fence right now about whether or not it's harmful to swallow; however, it is helpful to spit in order to see the phlem's color because it gives a warning sign that other infections may have set in (just had that idea from reading info on causes/symptoms of bronchitis).

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Anonymous said...

i had read that by swallowing phlegm, the infections can be absorbed through your stomach walls and into your body. Making it harder to get over your cold. Whether this is accurate or not i am not certain. Howeverrrr; on the contrary, I have read that by swallowing it, it doesn't do any harm, except maybe an imbalance of your ph levels within your stomach? Also not sure on the accuracy, but i do know a little stomach ache isn't that bad of a repercussion of swallowing. So the question for me still exist, what the fuck do i do with the Phlegm. hahaha

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Juuuuulieg said...

I must say that I also am comforted to hear that there are others out there who simply cannot spit out phlegm. No matter how much I have (bronchitis phlegm even) I can't spit it out without nearly vomiting and not really even spitting anything out anyway. It's like it can't come that far up into my mouth. In any event, my biggest stressor about it is that I really think my doctor (who is likely an easy spitter)may think I must be a whiner if my cough isn't even "bad enough to spit". Ya know? I can't say what color it is...no matter how hard I might try. Doc uses the color as a major evaluative tool and I can't say "Why, yes, it is green"...so, how can he know?? I know I taste blood often...but have for years. I think I am pretty healthy, but have some mild asthma that occasionaly causes me to cough really hard. It is these times that I taste blood. But I can't really say "I'm coughing up blood"...because I don't cough up ANYTHING enough to say it was coughed "up". Sure, I feel it come "UP"....but it seems the medical community only considers it coughing "up" if you also spit it out. So, since for me spitting is out of the question...to worry, or not to worry--is the question I have.

Fetal said...

I am no doctor or specialist on the matter but would guess that the answer depends on the circumstances.

Does the phlegm contain any living infection?

Has the disease passed through your GI track already?

The pro for swallowing is that it forces the disease through your GI track where your immune system is very strong. This could help your body identify & create antibodies / antigens for the diease.

The con is if there is still living disease in the phlegm and your body has not already identified it, you run the possibilty of it spreading to some other area of the body.

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Leon said...

It took me almost my whole life to learn how to cough my phlegm up. I've always had an excess of mucus; when my seasonal allergies attack my nasals are clogged like hell. When I'm sick, I've got craploads of mucus in my throat and nasals. So because I couldn't spit it out, I had to swallow the phlegm in my throat. Now I guess I'm a pretty rare case because unlike you guys who don't seem to have problems with swallowed phlegm, after 2-3 days of swallowing phlegm I'd throw it all up. I know it's the phlegm that I'm throwing up because there's a unique feeling that comes from your stomach when it's overloaded with the damn stuff... and you can see the gooey mass after you've hurled it all out. >_< But like I mentioned at the start, I've learned how to cough it up now and I ALWAYS spit it out whenever I can.

Anonymous said...

So I guess we shouldn't wash our snotty hands or cover our coughs or sneezes. Only healthy components r in phlegm? Think again. It's filled with nasty nasty germs and dead white blood cells. Swallowing will give you an upset stomach and make the recovery longer. I spit my whole but gave this a try. It's terrible. Coughing out mucus is as easy as blowing your nose. You people are strange... There's only two things people should swallow haha or maybe 3 if you're bi

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Tori said...

I am a swallower always have been. It's comforting to know many people do it too but honestly even if it was bad for me I would probably still do it.. I can't spit .. I can't force something to come up through my throat and out my mouth. I also find spitting repulsive and disgusting.

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the two issues i was always concerned with were:
1. does consistantly swallowing promote a static buildup of mucus in the throat, possibly being ripe for infection, turn the cold into a cough, etc.

2. does going to great lengths to clear the mucus out of the throat actually damage the throat enough that more mucus is created to soothe it, thus creating a particularly gross throat-clearing, spitting, neverending spiral.

just for the record i spit easily, and i've never gotten an upset stomach by swallowing too much phlegm, so i think you're all crazy :)

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And you all think YOU have a problem with this topic ... Check out the thinking from a Muslim point of view - VERY interesting debate.
What is the ruling on swallowing phlegm during prayer?.

Praise be to Allaah.
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Ibn Qudaamah (may Allah have mercy on him) said:

If it was najis (impure), he would not have told him to rub it with his garment during prayer or to put it beneath his foot. It makes no difference whether the phlegm comes from the head or the chest. He also said:

Phlegm is one of the two types of sputum and is similar to the other. If it was najis, the mouth would be made impure by it, … and there is no report from the Sahaabah (may Allah be pleased with them) to that effect, even though it is a common problem. End quote.

Al-Mughni (1/415)

Swallowing phlegm during prayer does not come under the same ruling as food and drink, because it is not food or drink.

Shaykh Ibn ‘Uthaymeen (may Allah have mercy on him) was asked:

The fuqaha’ said that sputum invalidates the fast of a fasting person. Is it possible to draw an analogy with prayer, i.e., does sputum invalidate the prayer?

He replied:

Firstly:

The fuqaha’ are not unanimously agreed on this. Rather the madhhab of Imam Ahmad has two opinions as to whether it breaks the fast or not.

Secondly:

What is meant by the kind of sputum that breaks the fast is that which reaches the mouth. As for that which appears in the throat and goes down into the chest, that does not break the fast. I do not think the sputum reaches the mouth of anyone and is then swallowed, because it is off-putting. But whatever the case, most of the Hanbali fuqaha’ say that if sputum reaches the mouth and is then swallowed, it invalidates the fast.

With regard to the analogy of that, that if that happens during prayer, it invalidates the prayer, if we say that this is like food. But I have not come across anyone discussing this issue with regard to prayer. Moreover the idea that it breaks the fast if it reaches the mouth then is swallowed is subject to further discussion, because this is not regarded as eating or drinking. It did not enter his body from outside, rather it is still inside him, and the mouth is regarded as part of the outside, not part of the inside. End quote.

Liqa’ al-Baab al-Maftooh, 116/17

As phlegm is taahir and is not food or drink, and does not come under the same rulings as food and drink, if a person swallows whilst praying, his prayer remains valid, especially if he could not help it and was not able to spit it out into a handkerchief and the like. Swallowing phlegm is usually of-putting, and what is prescribed is to spit it out into a handkerchief and the like, not swallow it.

And Allah knows best

Anonymous said...

I don't think it's unhealthy to swallow it, but if I swallow a lot it makes me nauseous, especially if I haven't eaten.

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Anonymous said...

when u spit it out it you feel alot more sanitary because you are getting rid of bacteria. it would be like eating your poop.

katherine said...

Personally I can't spit it out, but I have been swallowing copious amounts as I am sick at the moment, and I have had the worse Diahorrea. So be warned !

Anonymous said...

I am sick at the moment and have been swallowing copious amounts of phlegm, it has given me terrible Diahorrea...Be warned!

Anonymous said...

I'm sure we all agree that overall, it's preferable to spit. Even the one's who can't, would probably prefer to spit. But sometimes that's just not possible. Whether it's because you aren't physically capable, or you might be in a situation where you have to swallow (such as, in public [no one wants to witness that!] or too busy at that second). I do both. I don't like swallowing, but sometimes I do, in small quantities. But what I always try to do is spend some time getting the most of it out. Usually I'll start by taking a cough medicine with expectorant, then I'll have a cough drop with menthol (even though I hate the taste), chest rub if I have it (just don't go outside until you've showered it off), warm blanket, and a vaporizer with VapoSteam. Breathe this in for a bit, practicing breathing in deeply, and exhaling as much as I could (which usually gets the coughing really fired up). Eventually the rattling gets louder, and I head to the bathroom (and this is the only way I'll spit). I lean over the toilet, do my breathing exercises (deep breath in, let out as much as possible).. Gravity helps when the coughing starts. The toilet is perfect anyway, because you can examine it (yuck), there's TP nearby for any accidents, you're free to cough without infecting anyone else and then you can flush it bye-bye! I usually do this when it's at its worst, usually evenings and mornings.

Anonymous said...

and what about swallowing sperm? I don't spit about my phlegm, it's gross. And I don't swallow sperm because that is gross!!!!

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MaggieS said...

having had a bad cough for about a month now, I think that when I swallow all that post nasal drip, it slides slowly down my esophogus...and when I cough, the air that comes up from the trachea into the back of my throat pushes that slime back up again, into my mouth if it hasn't made it all the way down. It makes for quite a rattle. Ihave started spitting it out when convenient, just so I don't have to "deal with it" twice.

MaggieS said...

The comments about leaning upside down over the toilet after getting "Fired up" to spit are interesting to me because I've looked up therapeutic yoga postures for colds and coughs and many of them involved hanging upside down, head below the heart. This seemed terrible to me because when you are sick, who wants to put that kind of pressure into your head but apparently it has some beneficial effect. as I started getting better, I started doing some of that, to sort of help get more of the phlegm up and out of my system.

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