Coughing up blood (blood in phlegm)

Coughing up blood can be alarming, but isn’t usually a sign of a serious problem if you’re young and otherwise healthy. It’s more a cause for concern in older people, particularly those who smoke.

The medical term for coughing up blood is haemoptysis.

You may cough up small amounts of bright red blood, or frothy blood-streaked sputum (phlegm). The blood is usually from your lungs and is often the result of prolonged coughing or a chest infection.

If the blood is dark and contains bits of food or what look like coffee grounds, it may be coming from your digestive system. This is a more serious problem and you should go to hospital straight away. Read more about vomiting blood.

What to do if you cough up blood

Call your GP surgery as soon as possible if you cough up blood, even if it’s just a few spots or specks.

Your GP will check if you might have a serious medical condition that needs to be investigated and treated.

Call NHS 111 or your local out of hours service if you can’t speak to your GP.

Call 999 for an ambulance or go to your nearest accident and emergency (A&E) department immediately if you’re coughing up a lot of blood or are struggling to breathe.

Tests that may be needed

Your GP may decide to refer you to a specialist at your local hospital for a chest X-ray or a more detailed scan, such as a computerised tomography (CT) scan.

You may be asked for a sample of your sputum so it can be checked for infection. Other tests, such as blood tests, may also be needed.

In some cases, further tests may be required to find out where the blood is coming from. For example, you may be referred to a specialist who may decide to arrange a test called a bronchoscopy (where the main air passages of your lungs are examined using a tube with a camera at one end).

This page can give you a better idea of what the cause may be, but don’t use it to diagnose yourself. Always leave that to a doctor.

Common causes of coughing up blood

The most common reasons for coughing up blood are:

• a prolonged, severe cough
• a chest infection – this is more likely if your sputum is discoloured or contains pus, you have a fever, or you have a tight feeling in your chest
• bronchiectasis – this is more likely if you’re also wheezy or short of breath

Sometimes a severe nosebleed or bleeding from the mouth or throat can cause blood to come out in your saliva when you cough.

Less common causes of coughing up blood

Less commonly, coughing up blood may be the result of:

• pulmonary embolism (a blood clot in the lungs) – this usually causes sudden shortness of breath and chest pain
• pulmonary oedema (fluid in the lungs) – your sputum will be pink and frothy, and this usually occurs in people with pre-existing heart problems
• lung cancer – this is more likely if you’re over 40 and smoke
• tuberculosis (TB) – a severe lung infection associated with fever and sweating; this is becoming more common in the UK, but can be treated with prolonged antibiotics
• cancer of the throat or windpipe
• taking anticoagulants – medications that help stop your blood clotting, such as warfarin, rivaroxaban, or dabigatran

Sometimes, no cause can be found and it never happens again.

Page last reviewed: 06 August 2018
Next review due: 06 August 2021

Bronchitis | Cedars-Sinai

Not what you’re looking for?

Overview

The bronchi are the two main airways that branch down from the trachea (the airway that starts in the back of the throat and goes into the chest). When the parts of the walls of the bronchi become swollen and tender (inflamed), the condition is called bronchitis. The inflammation causes more mucus to be produced, which narrows the airway and makes breathing more difficult.

There are several types of bronchitis:

• Acute bronchitis can last for up to 90 days
• Chronic bronchitis can last for months or sometimes years. If chronic bronchitis decreases the amount of air flowing to the lungs, it is considered to be a sign of chronic obstructive pulmonary disease.
• Infectious bronchitis usually occurs in the winter due to viruses, including the influenza virus. Even after a viral infection has passed, the irritation of the bronchi can continue to cause symptoms. Infectious bronchitis can also be due to bacteria, especially if it follows an upper respiratory viral infection. It is possible to have viral and bacterial bronchitis at the same time.
• Irritative bronchitis (or industrial or environmental bronchitis) is caused by exposure to mineral or vegetable dusts or fumes from strong acids, ammonia, some organic solvents, chlorine, hydrogen sulfide, sulfur dioxide and bromine

Symptoms

Symptoms will vary somewhat depending on the underlying cause of the bronchitis. When the bronchitis is due to an infection the symptoms may include:

• A slight fever of 100 to 101°F with severe bronchitis. The fever may rise to 101 to 102°F and last three to five days even after antibiotics are started.
• A runny nose
• Aches in the back and muscles
• Chills
• Coughing that starts out dry is often the first sign of acute bronchitis. Small amounts of white mucus may be coughed up if the bronchitis is viral. If the color of the mucus changes to green or yellow, it may be a sign that a bacterial infection has also set in. The cough is usually the last symptom to clear up and may last for weeks.
• Feeling tired
• Shortness of breath that can be triggered by inhaling cold, outdoor air or smelling strong odors. This happens because the inflamed bronchi may narrow for short periods of time, cutting down the amount of air that enters the lungs. Wheezing, especially after coughing, is common.
• Sore throat

Bronchitis does not usually lead to serious complications (e.g., acute respiratory failure or pneumonia) unless the patient has a chronic lung disease, such as chronic obstructive pulmonary disease or asthma.

Causes and Risk Factors

An infection or irritating substances, gases or particles in the air can cause acute bronchitis. Smokers and people with chronic lung disease are more prone to repeated attacks of acute bronchitis. This is because the mucus in their airways doesn’t drain well. Others at risk of getting acute bronchitis repeatedly are people with chronic sinus infections or allergies; children with enlarged tonsils and adenoids; and people who don’t eat properly.

Diagnosis

To diagnose bronchitis, a physician performs a physical examination, listens for wheezing with a stethoscope and evaluates symptoms – making sure they are not due to pneumonia. A sample of sputum from a cough may be examined because its color – clear or white versus yellow or green – may suggest whether the bronchitis is due to a viral infection or a bacterial infection, respectively. A chest X-ray may be needed to rule out pneumonia, and if the cough lasts more than two months, a chest X-ray may be done to rule out another lung disease, such as lung cancer.

Treatment

Depending on the symptoms and cause of the bronchitis, treatment options include:

• Antibiotics may be ordered to treat acute bronchitis that appears to be caused by a bacterial infection or for people who have other lung diseases that put them at a greater risk of lung infections
• Bronchodilators, which open up the bronchi, may be used on a short-term basis to open airways and reduce wheezing
• Cool-mist humidifiers or steam vaporizers can be helpful for wheezing or shortness of breath. Leaning over a bathroom sink full of hot water with a towel loosely draped over the head can also be help open the airways.
• Corticosteroids given in an inhaler are sometimes prescribed to help the cough go away, reduce inflammation and make the airways less reactive. They are most often given when the cough remains after the infection is no longer present.
• Cough medicines should be used carefully. While they can be helpful to suppress a dry, bothersome cough, they should not be used to suppress a cough that produces a lot of sputum. When the cough is wet, expectorants can help thin the secretions and make them easier to cough up. When a lot of mucus is present, coughing is important to clear the lungs of fluid.
• For viral bronchitis, antibiotics will not be effective. If influenza causes the bronchitis, treatment with antiviral drugs may be helpful.
• Over-the-counter pain relievers, such as aspirin, acetaminophen or ibuprofen, can be used for pain relief and fever reduction. Children with bronchitis should not be given aspirin; instead they should take acetaminophen or ibuprofen.
• Plenty of fluids – enough to keep the urine pale (except for the first urination of the day, when it is usually darker)
• Rest, especially if a fever is present

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Not what you’re looking for?

Phlegm, mucus and asthma| Asthma UK

0:07
Gross as it looks
phlegm and mucus protect your body from infection.

0:11
A little bit of phlegm is totally normal but if your phlegm

0:18
changes in colour thickness or amount it could be a sign that you’re ill and your

0:20
asthma may be affected

0:23
if you find you’ve been coughing up more phlegm than

0:28
usual this could be a sign that your airways are inflamed this can cause

0:34
asthma symptoms like coughing wheezing shortness of breath or a tight chest

0:38
You should take your daily preventer inhaler as prescribed and it should help stop

0:42
these symptoms because it reduces the inflammation in your airways over time

0:47
if you’re doing this and still getting a lot of mucus on your chest you should

0:51
book an appointment with your doctor or ask the nurse

1:00
if you have yellow or green phlegm this might be a sign of an infection like a cold flu or a chest

1:04
infection these can often make asthma symptoms worse so it’s really important

1:09
to keep taking your preventer inhaler every day

1:15
if your phlegm is streaked with blood this is usually down to the pressure put on the blood vessels if

1:19
you’re coughing a lot the best thing you can do in this case is to see your

1:24
doctor to make sure it’s nothing to worry about if you have brown or black

1:28
tinged phlegm it usually occurs in smokers or if you have COPD chronic

1:34
obstructive lung disease as well as asthma when you stop smoking even just

1:40
after three days your Airways will get less inflamed and you’ll have less asthma symptoms

1:44
if you want any help or advice you can call the Asthma UK

1:50
helpline and speak to one of the nurses between nine and five Monday to Friday

Should I Worry About Coughing up Green Mucus?

Coughing is bad enough, but when green mucus comes up in the process, it can be alarming. If
you cough up mucus occasionally without any other red flags, it’s probably not serious. If your
symptoms are severe, linger on and on, or if they are accompanied by other symptoms, you may need medical treatment.

When You Smell Something

If the mucus you cough up isn’t just green but also thick and foul-smelling, call your doctorstraight away. This could indicate an infection that needs treatment. In a study published in theEuropean Respiratory Journal, researchers found that green or yellow mucus in chronicbronchitis patients was significantly more likely to be caused by bacteria compared to clearmucus. If you have such an infection, you may need antibiotics. Sinus infections can also causethick, unpleasant-smelling mucus and coughing and may also require prescription medication

When You Have Other Symptoms, Too

Green mucus may be the most surprising or unusual symptom you’re experiencing, but accompanying symptoms can be worrisome as well. If you’re also coughing up blood, have a fever, difficulty breathing, swelling around your midsection or have unintentionally lost weight, contact your doctor. These symptoms could indicate a severe infection. The same goes for sinus problems paired with a severe headache, high fever, vision changes or difficulty thinking straight. Make sure you describe to your physician all of your symptoms, versus just describing the cough and mucus alone. This will help ensure proper treatment and the likelihood that your doctor will see you swiftly, if needed.

When Your Symptoms Linger

Sometimes green mucus and coughing clear up on their own. If you’re still experiencing symptoms after 12 days or so, it may be time for a checkup. Lasting coughing and mucus could stem from an infection such as sinusitis. Ongoing symptoms may also derive from bacterial bronchitis, which can also bring a high fever and discolored mucus gathering in your lungs. As a result, you may feel a deeper cough than you would if the mucus formed in your throat. Because these infections are caused by bacteria, you may need antibiotics to heal.

Tips for Feeling Better

In addition to getting any needed medical treatment, home care can go a long way toward helping you feel better when you’re fighting a cough.

•  Stay well-hydrated. Drinking plenty of water or other fluids such as broth, can help thin down mucus.
• Avoid smoke. If you smoke, consider stopping. Regardless, avoid smokey areas. The fumes can exacerbate your symptoms.
•  Consider taking an OTC medication. Over-the-counter medications can help minimize your symptoms, making it easier to rest and recover. Mucinex^® Maximum Strength relieves chest congestion and loosens and thins mucus for up to 12 hours.
• Soak up steam. To keep your throat moist and break down mucus with steam, take a hot bath or shower. Linger in the room afterward to get maximum benefits.

References

Clearing your lungs after COVID-19

When you are discharged from hospital you may find that you are still coughing up phlegm or mucus. This is normal after a respiratory infection like COVID-19 (coronavirus). Do some exercises to clear the phlegm from your lungs. This will improve your lung condition.

Doing some exercises to expand your lungs will help your recovery by:

• increasing the amount of air inside your lungs
• improving the strength of your muscles that you use to breathe
• helping to clear phlegm and mucus from your lungs
• preventing collapse at the base of your lungs

Deep breathing technique

Deep breathing is a simple technique to expand your lungs and help clear your phlegm. You can do this many times during the day in any place or position. Make sure you are comfortable and your chest and shoulders are relaxed.

1. Sit or lie in a comfortable position.
2. Put one hand on your tummy just below your ribs and the other hand on your chest.
3. Take a deep breath through your nose, and let your tummy push your hand out. The hand on your tummy should move more than the hand on your chest.
4. Breathe out through pursed lips as if you were whistling. Feel the hand on your belly go in, and use it to push all the air out.
5. Do this breathing 3 to 5 times. Take your time with each breath.

Watch a demonstration of deep breathing.

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Breath stacking technique

Breath stacking is a technique that can be used to:

• help expand your lungs
• keep the muscles flexible
• help you have a stronger cough to clear your secretions

Wait for an hour after having food or drink before you perform these exercises. If you have any chest pain during the exercise, stop the exercise.

1. Breathe out fully.
2. Take a small breath in through your mouth, nose or both and hold.
3. On top of the air already in your lungs, take another small breath.
4. Repeat until you feel you cannot take in any more air and hold for 2 to 5 seconds.
5. Exhale the air out of your mouth. This will feel like a large breath out with a greater force.

Watch a demonstration of breath stacking.

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Non-urgent advice: Phone your GP and stop these exercises if:

your breathing pattern is changing or becoming unusual when not doing the exercises

Clearing phlegm from your lungs (postural drainage)

Your lungs have 5 lobes and phlegm can be in any of these.

Positioning exercises using gravity to help clear phlegm that has built up in your lobes.

How effective they are will depend on the thickness or stickiness of your phlegm. It may be harder to clear thick phlegm. These exercises may not work if your phlegm is very thick and sticky.

Wait for at least 1 hour after a large meal before starting these exercises. Stop this exercise if you have heartburn or feel sick during it.

Positioning exercise 1

1. Lie on your back with your head flat and your knees bent.
2. Place pillows under your hips and knees so that your hips are higher than the level of your chest.
3. Stay in this position for at least 5 minutes if you are able to and try doing some deep breaths.

Demonstration of positioning exercise 1

Positioning exercise 2

1. Lie on one of your sides with your head flat.
2. Place a pillow under your hip to raise it above the level of your chest. You can put your hands under your head for comfort.
3. Remain in this position for 5 to 10 minutes if you are able to and try to do some deep breaths.
4. Repeat this on your left and right side.

Demonstration of positioning exercise 2

Marvels of Mucus and Phlegm

August 2020

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The Slime That Keeps You Healthy

Mucus has several names. Snot, the sticky goo that pours from your nose during a cold. Or phlegm, the gunk that can clog your lungs and make you cough. You probably aren’t a fan of the stuff. But mucus is so much more than a runny nose. Your body is making mucus all the time. And it plays an important role in keeping you healthy.

“Mucus and phlegm get sort of a bad reputation,” says Dr. Richard Boucher, a lung expert at the University of North Carolina. “People think about it as something you’re supposed to cough up and get out. That it’s a bad thing. But in truth, mucus really is the interface between you and the outside world.”

Mucus lines the moist surfaces of your body like the lungs, sinusesThe hollow spaces in your skull around your nose, eyes, and forehead., mouth, stomach, and intestines. Even your eyes are coated with a thin layer of mucus. It serves as a lubricant to keep tissues from drying out. It’s also a line of defense.

“Mucus is very important for filtering out materials that you breathe in through your nose, such as dust and allergens and microorganisms,” says Dr. Andrew Lane, an ear, nose, and throat expert at Johns Hopkins University. “Anything that you breathe in gets stuck in the mucus, like flypaper.”

Mucus at Work

In the next hour, you’re going to inhale thousands of bacteria. But you’ll never know it. Bacteria land on the mucus-lined surface of the lungs and get trapped. Then little hairs called cilia go to work. They push the mucus up and out of the lungs with all the trapped bacteria, viruses, and dust.

“It comes up at sort of a nice slow rate to the back of the throat,” Boucher says. “And if you’re normal and healthy, you never feel it and you just swallow it.”

The mucus, together with the bacteria and other trapped substances, then goes to the stomach and eventually pass out of the body.

Your body makes a lot of mucus, although no one’s quite sure how much. Mucus is mostly water. But it also contains special proteins, sugars, and molecules that help the body control harmful germs.

Usually you’re not aware of all the mucus that slowly flows through your body. That is, until you get sick.

Too Much Mucus

You usually only notice mucus when you’re making too much of it. Or if it changes consistency.

An infection can make mucus thicker and stickier. Infections also lead to inflammationHeat, swelling, and redness caused by the body’s protective response to injury or infection. in the mucous membranes that line the nose and the rest of your airway. This can cause certain airway glandsOrgans that produce and release substances into the body. to make more mucus. That mucus can get thick with bacteria and cells that arrive to fight the infection. That can stimulate even more mucus production.

“When mucus is particularly excessive, it can be bothersome in terms of runny nose, clogged nose, and post-nasal drip,” says Dr. Bruce Bochner, an allergy expert at Northwestern University. Post-nasal drip is when excess mucus from the back of the nose gathers and drips down the back of the throat. It’s a common cause of a cough.

Allergies can also cause your body to make extra mucus. When you have an allergy, your immune systemThe system that protects your body from invading viruses, bacteria, and other microscopic threats. overreacts to a harmless substance, like pollen, dust, or animal dander. Cells in your airway then release substances, like histamine.

Histamine can make you sneeze. It also causes the mucous membranes in the nose to swell and the glands to make more mucus. Bochner’s team studies how certain proteins on immune cells control allergies and inflammation. They’re also looking at how certain components of mucus might help fight inflammation.

“There are two general types of secretions that that are made in the nose,” Bochner explains. Things like allergies, eating spicy food, and being outside in the cold can result in a more watery nasal leakage.

Your body usually makes thicker mucus when you have a cold (caused by viruses) or sinus infection (caused by bacteria).

Most mucus problems are temporary. But producing too much mucus contributes to some serious conditions. This includes cystic fibrosis, a genetic disorder that causes mucus in the lungs to become thick and glue-like. Boucher and his colleagues are working to find new treatments for cystic fibrosis and related lung diseases.

Colors of Mucus

Mucus can come in a range of colors. This won’t surprise you if you’ve ever looked closely at your tissues after blowing your nose.

Mucus is normally clear. During a cold, you may find that your snot is cloudy or yellowish. Proteins released by the cells that cause inflammation can get stuck in the mucus and give it this color, Lane explains. He’s currently studying how cells in the nose and sinus are involved in long-term inflammation, called chronic sinusitis.

Brown or black mucus is more common in heavy smokers and some types of lung disease. Greenish, brownish, or bloody colors may signal a bacterial infection.

But that’s not always the case. It can be difficult to figure out what’s wrong simply by your mucus color. Since many things can cause your body to make too much mucus, doctors rely on other clues to diagnose and treat the problem.

Wonders of Mucus

While excess snot and phlegm aren’t pleasant, you wouldn’t want to go without mucus.

“Mucus creates a layer of protection between the outside world and you. So it’s very, very important,” Lane says.

It’s not just important for people. It’s also the slime that allows a snail to move across the ground. It’s the slippery coating that protects fish against bacteria in the water. “It’s a really wonderful material,” Boucher says.

But maybe your mucus isn’t feeling so marvelous. If excess mucus is getting you down, see the Wise Choices box for tips on getting rid of it.

Bronchiectasis – causes, symptoms, treatment

Bronchiectasis is a long term lung condition where damaged airways cause mucus build-up and repeated, serious lung infections.The main symptom of bronchiectasis is a wet, chesty cough.

Treatment is likely to include antibiotics and other medications, while physiotherapy is used to remove mucus from the lungs. It has been estimated that around one in 550 New Zealanders live with severe bronchiectasis.

Causes

Within the lungs, air passages called bronchi form a tree-like structure through which air flows in and out. The bronchi are lined with tiny hair-like projections called cilia, which work to sweep mucus upwards within the lungs, allowing it to be easily coughed out. 

Bronchiectasis is a lifelong condition in which some of the bronchi have become scarred and permanently enlarged. During the disease process the cilia are damaged so that they are unable to effectively sweep away the mucus. 

As a result, mucus accumulates in parts of the lung that are affected and the risk of developing lung infections is increased. Recurrent infections can then cause further scarring of the bronchi and the condition can get progressively worse. 

About one-third of adult cases of bronchiectasis are due to a severe lung infection that occurred in childhood. Prior to the introduction of the national immunisation programme, bronchiectasis often occurred as the result of infection with measles or whooping cough. Today, bronchiectasis more commonly occurs as the result of pneumonia. 

Other causes include: 

• Cystic fibrosis
• Immune deficiency
• Inhaling stomach contents into the lungs
• Inhaling a foreign object into the lungs (if left untreated)
• Inhaling harmful chemicals eg: ammonia
• In rare cases it may be congenital (present at birth).

In many cases the underlying cause of the condition is unable to be identified. 

Signs and symptoms

The main symptom of bronchiectasis is a wet cough, which is a cough that brings up mucus (also known as phlegm or sputum). The cough is usually worse in the mornings and is often brought on by changes in posture. The mucus may be yellow-green in colour and foul smelling, indicating the presence of infection. 

Other symptoms may include: 

• Coughing up blood (more common in adults)
• Bad breath
• Wheezing chest – a characteristic crackling sound may be heard when listening with a stethoscope. 
• Recurring lung infections 
• A decline in general health
• In advanced bronchiectasis, breathlessness can occur.

The onset of symptoms often occurs slowly. As the disease progresses, coughing worsens and increasing amounts of mucus are produced. 

See a doctor if you or your child develops a persistent wet, chesty cough that lasts four weeks or more.

Diagnosis

An initial diagnosis of bronchiectasis is based on the patient’s symptoms, their medical history, and a physical examination. 

Further diagnostic tests may include:

• Chest x-ray
• CT (computerised tomography) scan 
• Blood tests
• Testing of the mucus to identify any bacteria present (sputum test)
• Checking oxygen levels in the blood
• Lung function tests (spirometry). 

Treatment

Bronchiectasis is a chronic (long-term) condition that requires lifelong maintenance. Good management of the condition is vital to prevent ongoing damage to the lungs and worsening of the condition. The ultimate goal of treatment is to clear mucus from the chest and prevent further damage to the lungs. 

The two main types of treatment are:

Medications

• Antibiotics are used to treat acute lung infections. Where the infection is severe, treatment with intravenous antibiotics in hospital may be required. 
• Bronchodilators (as used in people with asthma) to improve the flow of air to the lungs.
• Medicines that reduce inflammation in the lungs.
• Occasionally, medicine to thin the mucus may be used.
• Vaccination against influenza (flu) and pneumococcal pneumonia.

Physiotherapy and exercise

Chest physiotherapy and postural drainage are used to remove mucus from the lungs. An individual programme is usually developed where exercise and breathing techniques to clear the lungs of mucus are practiced. 

Other factors important in managing the condition include avoiding dust, smoke, and other respiratory irritants, and maintaining a balanced nutritious diet.

It is also important to identify and treat any underlying conditions that lead to the development of bronchiectasis.

In some cases of severe bronchiectasis, surgery may be suggested to remove the affected portion of the lung. However, this is only an option if the disease is localised in one or two small areas. 

Prevention

The Ministry of Health recommends the following measures to help prevent bronchiectasis in children: 

• Stop smoking (especially during pregnancy) and have a smoke-free home
• Breastfeed your children
• Eating a healthy balanced diet
• Exercising regularly
• Early detection and treatment of chest infections
• Making sure homes are warm and dry (making chest infections less likely)
• Immunise children for diseases like measles and whooping cough, which can lead to bronchiectasis.
• Get an influenza (flu) vaccine every year.
• Prevent infants and children from inhaling foreign objects such as food particles (e.g. avoid giving a bottle to a baby who is lying down and ensure infants are sitting up while eating)
• Seek medical assistance right away if a foreign object is inhaled into the lungs.

References

Asher I., Edwards, E. (2013). Bronchiectasis (Web Page). Starship Clinical Guidelines. Auckland: Starship Children’s Health. https://www.starship.org.nz/guidelines/bronchiectasis/ [Accessed: 17/02/20] 
KidsHealth (2017). Bronchiectasis (Web Page). Paediatric Society of New Zealand (Christchurch) and Starship Foundation (Auckland). https://www.kidshealth.org.nz/bronchiectasis [Accessed: 17/02/20] 
Ministry of Health (2018). Bronchiectasis (Web Page). Wellington: New Zealand Ministry of Health. www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/bronchiectasis [Accessed: 17/02/20] 
NHS (2018). Bronchiectasis (Web Page). Redditch: National Health Service (NHS) 
England. https://www.nhs.uk/conditions/Bronchiectasis/ [Accessed: 17/02/20]
O’Toole, M.T. (Ed.) (2017). Bronchiectasis. Mosby’s Dictionary of Medicine, Nursing & Health Professions (10th ed.). St Louis, MI: Elsevier. 
Barnard, L. T., Zhang J. (2018). The impact of respiratory disease in New Zealand: 2018 update (Report PDF). Dunedin: University of Otago. https://s3-ap-southeast-2.amazonaws.com/assets.asthmafoundation.org.nz/images/NZ-Impact-Report-2018_FINAL.pdf

Last Reviewed – February 2020

90,000 TOP-7 mistakes in cough treatment. What really needs to be done with phlegm?

Cough is a symptom of a wide range of respiratory diseases. It is a reflex mechanism for cleaning them. In most cases, the cough occurs involuntarily, but sometimes a person can cause it on their own. Acute lasts up to three weeks, subacute – up to eight weeks, chronic – more than eight weeks.

What is sputum?

Sputum is a substance that accumulates on the walls of the respiratory system in case of illness.The secret in the lungs and bronchi is always produced and leaves in small quantities without irritating the cough receptors.

But in the conditions of the development of the pathological process, it becomes too much. Sputum varies in composition and happens:

• for inflammatory process or bronchial asthma – mucous membranes;
• for bacterial diseases – purulent;
• with pulmonary edema – serous;
• for tuberculosis or cancer of the respiratory system – bloody.

In any case, it must be removed from the respiratory tract. Its accumulation is fraught with bronchial obstruction. If their lumens are blocked, respiratory failure will occur, which is a threat to life.

Types of cough

By the number of secretions, productive and unproductive coughs are distinguished. The first is accompanied by sputum discharge and, in fact, performs its main function. The second is dry. At the initial stage of the disease, it is so due to the increased viscosity of the sputum.But it can also arise under the influence of other irritants of cough receptors (inflammatory process or flowing nasal secretions).

Usually, the cough is unproductive at first, and becomes moist as the sputum liquefies. This is inconvenient, but necessary for recovery. However, unpleasant sensations and ignorance of the principle of action of the cough mechanism make people make serious mistakes in treatment.

Common misconceptions in the treatment of cough

We have collected the most common mistakes that are made when fighting a cough.By avoiding them, you can recover faster and prevent complications.

Misconception 1. Suppression of the cough reflex during sputum discharge

This error is caused by a misunderstanding of the nature of the cough. People believe that the problem lies precisely in him, therefore, they strive to eliminate the unpleasant symptom. However, coughing is not a disease, but a mechanism for clearing the airways. It helps to fight the consequences of the disease in the form of sputum accumulation.

But sometimes understanding the need to clear your throat does not help.The patient takes means to suppress this reflex, get rid of discomfort. With a wet cough, it feels like a person is about to choke. I want to prevent this.

But taking antitussive drugs in this case is unacceptable, otherwise sputum will accumulate in the lungs. The respiratory tract must be cleared. This will help mucolytic and expectorant drugs.

Misconception 2. Antibiotic cough treatment

In the view of many, antibiotics are a miracle remedy that saves from advanced diseases.If the cough is very strong or does not go away for a long time, then it can only be cured with antibiotics. But this is not a mistake – this is a choice that can lead to serious side effects:

• suppression of intestinal microflora;
• vitamin deficiency;
• liver dysfunction;
• violation of the renal structures.

Antibiotics are prescribed to treat complications of the disease that caused the cough. And only if they are of a bacterial nature (for example, pneumonia).But the symptom itself is never caused by bacteria.

Therefore, antibiotics can only be taken when indicated. It is better not to resort to them without the supervision of a doctor. Without medical knowledge, it will not be possible to properly build supportive therapy.

Misconception 3. Taking mucolytic drugs for dry cough of a non-viral nature

Many believe that a dry cough is always a symptom of the onset of a viral respiratory illness. But it can be caused by other reasons as well.It happens that there is no excess phlegm in the body, and there is simply nothing to dilute with mucolytic drugs.

For the correct selection of the necessary medications, you need to establish the cause of the cough:

• if it is a nasal drip, treat a runny nose;
• if it is an allergic reaction, take antihistamines;
• if it is a reaction to dry air – humidify it;
• if it is a cough neurosis – take a course of psychotherapy.

In such cases, the use of traditional antitussive drugs does not work.People begin to suspect complications and take strong medications that are harmful to the body. To prevent this, it is best to consult a doctor immediately, who will find the cause of the cough.

Misconception 4. Use of ineffective folk remedies

Here we will look at four common mistakes at once, find out their nature and determine the correct procedure.

Correct cough treatment

The main task in the treatment of respiratory disease is to free the lungs from phlegm. In the first few days, it can build up, causing a dry cough. But in the future, the secret should be liquefied and excreted from the body.

If this does not happen, it is necessary to take mucolytic (thinning phlegm) and secretomotor (stimulating its discharge) medications.It is better to select them under the supervision of a doctor.

According to the observations of pulmonologists, sputum is best released in the morning when lying on its side. Do not take expectorant drugs at night, otherwise you will not be able to sleep.

If a dry cough is not caused by a respiratory illness, but a sore throat or allergy, the treatment strategy will be different. It is permissible to suppress the cough reflex here. However, this does not negate the need to combat the disease that caused it.

What if the sputum does not come off?

This substance accumulates pathogens. In addition, in large quantities, it interferes with breathing. Therefore, phlegm should not be allowed to accumulate in the lungs. If medications do not help, you can stimulate its passage with additional means:

• with plenty of warm drink;
• inhalations;
• herbal preparations;
• the use of ginger;
• breathing exercises.

However, you should first consult your doctor. He will tell you the optimal composition of the collection or the substance for inhalation. It is important that they do not reduce the effectiveness of the main therapy and do not cause individual reactions.

If self-coughing is not possible, sputum is removed using an aspirator. This measure is used for muscle weakness.

Gatalova Dagmara Sulimovna, internist, endocrinologist, doctor of medical offices 36.6

& nbsp

THERE ARE CONTRAINDICATIONS, BEFORE USING IT IS NECESSARY TO CONSULT A SPECIALIST

90,000 Dry cough is all about the symptom: what does it indicate, how to treat it?

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Contents

• What is a dry cough?

• What diseases can cause cough?

• Dry cough in children

• Diagnostics and treatment

• Dry cough therapy at the Ear, Throat and Nose Clinic

Cough is a natural protective reflex of the body, the contraction of the muscles of the chest in response to the action of any stimulus.Normally, it helps to cleanse the mucous membranes of the respiratory tract from dust, mucus, harmful microorganisms.

There are two types of cough: wet (productive) and dry (unproductive). In the first case, sputum discharge occurs, and the cough ultimately brings relief to the person. In the second, the cough is long and painful, without sputum separation, and is perceived by a person much more painful. Most often, the disease begins with a dry cough, after which it transforms into a wet cough, but sometimes this does not happen.A dry cough can be a symptom of many pathological conditions in the body – from mild colds to serious illnesses. When it appears, even without signs of a cold or any other manifestations, you need to consult a doctor for a diagnosis. This will be a guarantee of the earliest possible cure for dry cough, identification of the underlying disease or indications for lifestyle correction.

What is a dry cough?

Depending on its specifics, it can be:

• Long-term.Usually it does not take at least a few minutes.
• Paroxysmal. It is accompanied by difficulty breathing, severe wheezing, a feeling of squeezing in the chest.
• “Barking”. It is named so due to the similarity with the sounds made by animals.
• Choke. It is accompanied by the inability to breathe air, usually for a few seconds. This is the most dangerous condition that requires urgent help.
• Night. It makes you wake up and does not go away for a few minutes.Asthma attacks may appear.

This classification is needed so that you can describe your symptoms to your doctor in detail. It is important to talk about the time of onset of seizures, their duration, pain or lack thereof, return to adjacent parts of the body, and other details.

What diseases can cause cough?

Dry cough may result from:

• Inflammation of the larynx. In this case, the sound is “barking”, the voice becomes hoarse, and the attacks themselves often occur at night.
• Inflammation of the trachea and bronchi. A dry cough lasts 2-3 days, after which it turns into a wet one, and sputum begins to separate.
• Tuberculosis. A TB cough does not end for several weeks in a row, despite taking any medication. The cough characteristic of this disease is frequent, dry and abrupt, intensifies over time, accompanied by wheezing and phlegm, and may be accompanied by hemoptysis.
• Pneumonia. At first, it is “barking” and dry, from the 2-3rd day of the disease, sputum begins to stand out, sometimes with an admixture of blood.
• Bronchial asthma. The cough is excruciating, with attacks of suffocation. The condition is dangerous, as with any attacks of suffocation.
• Malignant tumors in the respiratory system. In oncology, cough may be mild, depending on the type of tumor and its size. Shortness of breath is characteristic, pain in the chest is possible, expectoration with blood. Any oncology is accompanied by weight loss, weakness.
• Whooping cough. The cough is violent and paroxysmal, often ending in vomiting.It is not blocked by any dry cough medicine and can last for several months.
• Corey. Concomitant symptoms are fever and skin rashes.
• Ingress of foreign bodies into the respiratory tract. In this case, emergency medical care is important, since the condition can cause suffocation.
• Allergies. An allergic dry cough occurs directly upon contact with an allergen – dust, pollen, gases, chemicals, household chemicals.May develop in industrial workers by inhalation of dust and small particles. This condition is usually accompanied by an allergic rhinitis without other signs of a cold. In the absence of exposure to the allergen, it stops.
• Smoking. “Smoker’s cough” usually appears in the morning, it can be prolonged, dry, with poor expectoration.
• Pleurisy. The cough is very painful, to the point that it is difficult for a person to change the position of the body, it gives off severe pain in the chest.Fever, chills, shortness of breath, weakness appear.

Dry cough in children

If a child suddenly began to suffer from a dry cough, this must be taken very carefully – this may be due to a foreign body entering the respiratory tract. If you have a severe suffocating cough, call an ambulance. If a child has a dry cough periodically for several days, you need to see a doctor, and not wait until it goes away on its own, even if the condition seems mild.

Diagnostics and treatment

To identify the root cause, the doctor may prescribe the following examinations:

• roentgen;
• fluorography;
• bronchoscopy;
• auscultation;
• percussion;
• blood tests for allergens.

The main goal of the treatment of dry cough is to convert it to wet – productive cough with sputum discharge. Complex treatment, with the use of drugs, physiotherapy, in some cases, traditional medicine.

Drug therapy includes: antiviral, antitussive, antihistamines, mucolytic agents, antibiotics. It is important to know that taking antitussive drugs without a doctor’s instructions is strictly prohibited – this can cause accumulation of secreted sputum in the airways and lead to stagnation of sputum in the lungs, and this will lead to serious complications.

Physiotherapy treatments include:

Dry Cough Therapy at the Ear, Throat and Nose Clinic

If you have a dry cough, make an appointment with our doctors.In our medical center, we use the most accurate medical equipment for diagnosis and treatment. Experienced and attentive ENT doctors will be happy to assist you.

90,000 To treat or not to treat cough. Doctor’s blog

Cough is not a disease, but a reflex act aimed at cleansing the body of foreign bodies, dust, microorganisms, phlegm. This is our protection. The cough does not need to be treated, it is necessary to treat the disease that led to the cough. Let’s eliminate the cause, the cough will stop.

How to fix it? In case of a bacterial infection, we will prescribe an antibiotic, in case of allergies – an antiallergic drug, in case of a viral infection, we will simply wait until the body cope with the virus itself.

But what if, while we wait, coughing interferes with life?

Symptomatic treatment aimed at increasing the effectiveness of the cough. Cool, humid air will prevent the phlegm and mucous membranes from drying out. Drinking plenty of fluids helps maintain and restore sputum rheology by ensuring normal blood rheology.If liquid sputum is easy to cough up, the cough is effective; if thick sputum leaves with difficulty, the cough is not very effective.

If this is not enough for you, and you still ran to the pharmacy to buy an expensive “cough medicine”, then be careful!

There are two main groups of drugs:

• Group 1 “cough drugs” – antitussives, those drugs that remove cough.
• Group 2 “expectorants” – medicines that improve cough.

Antitussive drugs reduce the excitability of the cough center and the sensitivity of nerve endings, thereby “turning off” the cough. Such drugs are needed when a cough is not needed, does not contribute to recovery, but only interferes. There are few such situations, so the indications for the use of antitussive drugs are limited (whooping cough, dry pleurisy, irritating cough, cough in case of lung cancer, during surgical and otolaryngological procedures). Antitussives should be prescribed by a doctor and used under constant medical supervision.

“Expectorants” – the main task of these funds is to clear the respiratory tract from phlegm, and coughing is a way of clearing it, so it intensifies. These drugs reflexively act on the cough center, as a result of which the contractility of the bronchi increases, the cilia of the epithelium work more actively, the sputum moves faster, the bronchial glands form more mucus. There are also mucolytics – drugs that have “secretolytic activity”, that is, the ability to thin phlegm, which facilitates its discharge.They are advisable precisely when there is thick, viscous sputum.

The combination of antitussives and expectorants is unacceptable, and the combination of antitussives and mucolytic agents is doubly unacceptable!

And it should be remembered: “the effectiveness of expectorants in comparison with heavy drinking has not been proven.” Better see a doctor.

Article prepared by Natalia Mikhailovna Mekhanoshina .

Why does cough occur and should it be treated?

A cough is a body defense reaction that occurs in response to an irritant.Coughing often disturbs the child and may require intervention.

The main thing is that cough is not treated, but its cause! The ways in which the cough is affected depends on where it is located.

With a “central” cough, the cough center of the brain is directly irritated – the focus of excitation is in the brain (whooping cough, epilepsy, neoplasms). In this case, the cough is strong, painful, paroxysmal (especially with whooping cough). A “central” cough is the only situation where drugs to stop the cough may be needed.In any other case, they are not used and only cause harm.

With a “local” cough, the cough center is irritated indirectly – the focus is in the respiratory tract (rhinitis (runny nose), pharyngitis, laryngitis, tracheitis, bronchitis, pneumonia, foreign body of the respiratory tract). This cough is typical for most viral and bacterial respiratory tract infections (DP), it cannot be stopped, because it performs its main function – cleansing the DP of mucus. If such a cough is blocked, then saliva and mucus will flow freely into the lower parts of the lungs, remain there and lead to an inflammatory process – pneumonia.

You cannot stop the cough, but you can and should make the child feel better and influence the cause that caused it with the help of the following actions and drugs :

• A high pillow, humidifying the air, lowering the air temperature to 19–20 degrees, plentiful warm drink – should be used for any cough to facilitate breathing. Especially effective for coughs caused by mucus running down the back of the pharynx with a runny nose.

• Bronchodilators (Ventolin, Berodual) are used in the presence of bronchial obstruction (dry, wheezing cough)

• Inhaled steroids (Pulmicort) are used for bronchial obstruction and laryngeal stenosis (stenosing laryngotracheitis, false croup – dry, barking, hacking cough)

• Steam inhalation – breathing in a bathroom filled with steam.Letting the child “breathe over a pot of potatoes” is not worth it – the risk of burns to the face and upper respiratory tract is too great. Children over 5 years old can be offered to breathe over a plate (!) With boiled potatoes or rice – the starch contained in them often “softens” the throat with laryngitis.

• Bronchoscopy to remove a foreign body

What should not be used in children with cough :

• Expectorant medicines, herbal preparations, combined preparations
• Mucolytics (drugs that thin sputum)
• Blockers for “local” cough

It is important to understand that coughing is not an indication for antibiotics.A cough is just a symptom. Most often it happens with ARVI, and ARVI is not treated with antibiotics.

Cough

Throughout life, all people experience at least one coughing fit, but nevertheless this is a very common painful condition in humans. Of course, coughing itself is a defense mechanism for clearing the airways. Frequent coughing is always a symptom of the disease. It can be very different in nature, intensity, can be accompanied by shortness of breath, suffocation.For example, a barking cough is a resonant, thundering, hoarse cough. It refers to the symptoms of croup, a childhood illness with varying degrees of respiratory distress. Croup is most commonly seen in boys and especially in winter. It can be repeated in a child several times. Since the airways of children and infants are smaller in diameter than those of adults, airway occlusion occurs more quickly in young patients, and this is already a life-threatening condition.

The mechanism of barking cough is the result of edema of the larynx and surrounding soft tissues.The reasons for this are inhalation of a foreign body, infectious or viral (for example, whooping cough) tracheolaryngitis, false croup (can develop during sleep, without fever) If you witness an attack of barking cough in a child, you must:

Dry cough – violent loud release of air from the lungs, in which sputum does not flow. The most frequent symptom in patients with diseases of the lower respiratory tract. It can even cause damage, such as tearing the lung tissue.A dry cough that turns into a wet cough is a classic sign of progressive respiratory illness. The cough may occur one or more times, intensifying with increasing frequency. A sudden attack of coughing may go away on its own. A cough that lasts more than a month is considered chronic and is often a consequence of smoking. A wet cough is a violent exhalation of air from the lungs, accompanied by the release of sputum or blood (or both, depending on the cause. It can be a symptom of cardiovascular or respiratory disease, acute infection, inhalation of antigenic or irritating substances, lung cancer, larynx) …Harsh wet cough accompanies the “smoker’s” bronchitis.

Many patients underestimate or ignore chronic wet cough, getting used to it as normal. At the same time, shortness of breath, hemoptysis, chest pain, weight loss, or frequent respiratory infections may gradually join the cough. If you start coughing, try to see your doctor.

MedLab will help you quit smoking with acupuncture.In addition, genetic testing will help determine the risk of developing lung cancer and other serious diseases of the lower respiratory tract. Based on this study and standard diagnostic methods, the “MedLab” pulmonologist and our general practitioners will select for you an individual program for the prevention and effective treatment of an already existing disease.

If you witness an attack of a barking cough in a child, you must:

1. 1. Find out if the child played with small objects that he could swallow.

2. Call an ambulance quickly.
3. Before the arrival of the brigade, try to provide air access to the child’s lungs, or at least try to use inhalation, oxygen difflector.

The tactics for adults are the same.

What is the difference between dry and wet cough? How is a cough treated?

03/18/2020

Cough is one of the most common complaints when visiting a doctor (J. Murtagh. “General Practitioner’s Guide”. M.: Practice. 1998)

For the body, coughing is a defensive reaction. So it removes phlegm, dust or foreign particles from the respiratory tract.

• After SARS, the cough sometimes persists for several weeks. This is caused by an increase in the sensitivity of the bronchi to various stimuli.
• Cough, especially at night, is also observed in chronic sinusitis, when sweat from the nasal appendages flows down to the back of the pharynx into the larynx.
• Nocturnal cough is characteristic of bronchial asthma.
• Cough can also have psychogenic causes, for example, with anxiety.
• For a smoker’s cough, it is important not to miss a more serious problem – lung cancer.

To deal with causes of cough will help a questionnaire (J. Murtagh. “Handbook of a general practitioner.” M .: Practice. 1998):

• How long have you had a cough?
• Does sputum come out during coughing?
• What is the amount and color of sputum?
• Is there blood in the sputum?
• Is the cough accompanied by a sore throat?
• What else is accompanied by a cough?
• Is there any chest pain?
• Was there a fever, chills, sweating?
• Are there any attacks of choking or wheezing?
• Do you have lacrimation and runny nose in the spring and summer?
• Do any of your relatives have bronchial asthma or tuberculosis?
• Have you lost weight lately?
• Do you have to deal with smoke and strong odors at work?
• Do you have birds or other animals in your home?
• Could a small object, such as a grain or seed, accidentally enter the respiratory tract?
• Have you had surgery recently?
• Have you had to lie down for a long time recently due to illness?

These questions will help the doctor understand the causes of the cough, make the correct diagnosis and prescribe timely treatment.

Separate dry and wet (productive) cough

Dry cough is often unpredictable. It is not accompanied by sputum production and does not clear the airways.
A dry cough injures the mucous membrane and forms a “vicious circle”: it strengthens and supports itself.

Occurs when:

• upper respiratory tract infections
• smoke or dust inhalation
• ingress of a foreign body into the respiratory tract
• whooping cough, etc.

Wet cough (productive) easier to control. Sputum separation brings relief.

Occurs when:

• chronic bronchitis
• broncho-ecstasy
• pneumonia
• bronchial asthma, etc.

Cough treatment

At home, you can relieve a patient’s cough with syrups and inhalation. Products such as codeine preparations and steam inhalation are considered obsolete.Warming up with cans and mustard plasters should be done with caution, since there is a risk of burns and allergic reactions.

But modern cough syrups, for example “Renaissance. Tussstart” and “Renaissance. Tussstop” have a complex anti-inflammatory and antitussive effect. They can be selected depending on the type of cough.
Cough syrup “Renaissance. Tussstop” relieves a painful dry cough.
A “Renaissance.Tussstart “ improves sputum discharge in case of wet cough.

An important advantage of cough syrups “Renaissance. Tussstart” and “Renaissance. Tussstop” is their natural composition. They are made on the basis of plant extracts with the addition of vitamin C. All components of the syrups are well studied and have a favorable safety profile.

Among the plant components of cough syrups “Renaissance. Tussstart” and “Renaissance.Tussstop “ can be especially highlighted extract of herb creeping thyme, or thyme. This plant has long been used both in cooking and in folk medicine. Creeping thyme has a bactericidal, sedative, analgesic and wound healing effect. It is part of expectorant preparations prescribed for acute and chronic diseases of the respiratory tract, bronchial asthma and tuberculosis.In some peoples, with the help of thyme, rooms and property are fumigated for disinfection.It is used in rituals to scare away evil spirits.

Also in cough syrups “Renaissance. Tussstart” and “Renaissance. Tussstop” extracts of other medicinal plants are used: plantain, coltsfoot, elecampane, licorice, sage, Echinacea purpurea, etc.

Cough syrups “Renaissance. Tussstart” and “Renaissance. Tussstop” are recommended to be taken orally 10 ml 3 times a day with meals. The duration of the course of admission is 2 weeks.
If during this time there is no improvement, you must definitely consult a doctor!

By the way

Some breathing exercises from yoga and qigong also improve lung function and help to normalize breathing.

90,000 symptoms, causes of appearance, diagnosis, treatment

A cough in an adult or a child is always a concern. You should not let the treatment take its course, and when choosing syrups and cough drops, you need to carefully study their composition.

Airway inflammation associated with coughing is one of the most common diseases in children. Cough is the most common symptom of inflammation and is common in other diagnoses.Even a mild cough is a problem that should not be underestimated.

Two main types of cough

An unproductive, dry cough is characterized by sharp and convulsive attacks, often the attack has a long duration, which is very tiring. The cough itself has practically no discharge of any mucus from the lungs. This type of cough can be caused by cigarette smoke, dust, various gases, or chemical vapors. Also, a dry cough occurs in the early days of a cold or beginning infection.

Productive, moist cough, characterized by the secretion of special mucus of a different nature. It can have a different consistency, it can be transparent or viscous. This type of cough is indicative of an approaching recovery. During this period, the patient is prescribed therapy that accelerates the discharge of sputum from the lungs. Stagnation of mucus and microbes in the body creates an ideal environment for disease-causing bacteria. A productive cough helps clear mucus from the lungs naturally.

Antitussives and expectorants

Antitussives suppress coughs and are used to treat aggressive, suffocating dry coughs.The use of antitussives relieves coughing and reduces the number of paroxysmal coughs. Many of these products are made from plant extracts, such as ivy extract. Available in syrup and tinctures.

It is very important when choosing suitable syrups or drops to look at the composition of the medicine – it should not contain irritants, preservatives, alcohol and sugar.

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