What causes chronic cough? How is it diagnosed and treated? Discover the symptoms, causes, and effective solutions for persistent coughing.

Overview

Cough into your arm to avoid spreading any germs. What is chronic cough? Chronic cough is usually defined as a cough that lasts more than eight weeks in adults and four weeks in children. Chronic cough is one of the most frequent reasons for visits to the doctor. Chronic cough isn’t a disease itself. It’s a health problem that results from other health conditions.

What causes coughing?

Your throat is a very sensitive part of the body. The lining of your throat can sense touch, temperature, taste and position. You can sense these things even while you are breathing and eating. Your throat is responsible for getting food and air into the right tubes, making sure you don’t choke. The main job of your throat is keeping your airway safe and clear so you can breathe. A cough can be either voluntary or automatic.

Coughing is one method our bodies use to keep us healthy, but a cough that lasts a long time can affect your life in many ways. Coughing can keep you up at night and make your days miserable from muscle pain and being tired. It’s important to find out why your cough won’t go away.

Who is most likely to experience chronic cough?

People who use tobacco, especially smokers, are at a high risk of developing chronic cough. There is even something called ‘smoker’s cough’ that lasts longer than three weeks. The cough begins when your body tries to clear itself of the irritants that enter when you smoke.

Other people at risk of developing chronic cough include those with certain conditions, including:

• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Bronchitis
• Bronchiectasis

Symptoms and Causes

What causes chronic cough?

There are several medical conditions that are linked to chronic cough. These include respiratory conditions, such as:

• Asthma: This is the second most frequent cause of chronic cough. Shortness of breath and wheezing happen when you have asthma. These breathing difficulties can result in a chronic cough. There is also a form of asthma (cough-variant asthma) where chronic cough may be the only symptom.
• Bronchiectasis: This condition causes coughing because mucus builds up and lung tissue gets thicker.
• Bronchitis: This condition is a known cause of coughing due the swelling that happens in the bronchial tubes and the increase in mucus production. There are two types —chronic and acute.
• Chronic obstructive pulmonary disease (COPD): COPD is actually a term that refers to a group of respiratory issues that includes chronic bronchitis and emphysema.
• Upper respiratory conditions like flu, pneumonia and colds: These infections are generally caused by viruses. Coughing is one symptom that tends to last after the others are through. The viruses attack the nose, the throat and the sinuses.

Other reasons for chronic cough include sinusitis and allergies. Sinus problems and allergies, along with upper respiratory infections, produce post-nasal drip. This drip is sometimes feels like “a tickle in the back of the throat,” and drainage can lead to chronic coughing.

Diagnosis and Treatment

How is chronic cough diagnosed?

To diagnose the cause of your chronic cough, your doctor will likely start with a physical exam and ask about your medical history. They may also order tests, such as:

• Chest X-ray or CT scan to check for lung conditions
• Lung function tests to check for asthma or COPD
• Allergy testing to identify any triggers
• Sinus imaging to look for sinus inflammation
• pH monitoring test to check for acid reflux

How is chronic cough treated?

The treatment for chronic cough depends on the underlying cause. Some common treatments include:

• Medication to treat asthma, COPD, or acid reflux
• Antihistamines or decongestants for allergies or sinus issues
• Cough suppressants or expectorants to control coughing
• Inhaled corticosteroids to reduce airway inflammation
• Lifestyle changes like quitting smoking or avoiding triggers

In some cases, chronic cough may require more specialized treatment, such as speech therapy or referral to a pulmonologist. The key is to work closely with your doctor to identify and address the root cause of your persistent cough.

Prevention and Management

How can I prevent or manage chronic cough?

Here are some tips to help prevent and manage chronic cough:

• Quit smoking and avoid secondhand smoke
• Avoid irritants like dust, chemicals, and strong smells
• Stay hydrated and use a humidifier to keep your airways moist
• Practice good posture and diaphragmatic breathing techniques
• Address any underlying medical conditions like asthma or acid reflux
• Use over-the-counter cough medicines as directed
• Get plenty of rest and stay physically active when possible

Remember, chronic cough is a symptom, not a disease. By working closely with your healthcare provider to identify and treat the underlying cause, you can find relief and improve your quality of life.

Why do I cough up phlegm every morning?

Why do I cough up phlegm every morning?

If you cough up phlegm, especially in the morning, it might be a sign of bronchitis. Acute bronchitis is the most common form and occurs when the bronchi (the airways of the lungs) become inflamed.

Do you cough up phlegm with pneumonia?

With pneumonia, you may cough up phlegm that is yellow, green, or sometimes bloody. Your symptoms will vary based on the type of pneumonia you have. Cough, fever, chills, and shortness of breath are common symptoms with all types of pneumonia.

How long should a cold last before you go to the doctor?

Most colds symptoms typically get better within a week or two. Generally speaking, you should see a doctor if symptoms last longer than 10 days without improvement.

What are the four stages of pneumonia?

The four stages of lobar pneumonia include:

• Stage 1: Congestion. During the congestion phase, the lungs become very heavy and congested due to infectious fluid that has accumulated in the air sacs.
• Stage 2: Red hepatization.
• Stage 3: Gray hepatization.
• Stage 4: Resolution.

When should I go to the doctor for a cough?

Call your doctor if your cough (or your child’s cough) doesn’t go away after a few weeks or if it also involves any one of these: Coughing up thick, greenish-yellow phlegm. Wheezing. Experiencing a fever.

Should you see a doctor if you are coughing up phlegm?

Call your doctor if your cough lasts longer than 3 weeks or if it’s accompanied by symptoms like: fever. discolored mucus.

What is a bronchitis cough like?

The main symptom of bronchitis is a hacking cough. It is likely that your cough will bring up thick yellow-grey mucus (phlegm), although this does not always happen. Other symptoms of bronchitis are similar to those of other infections, such as the common cold or sinusitis, and may include: sore throat.

Chronic Cough: Causes, Diagnosis & Treatment

Overview

Cough into your arm to avoid spreading any germs.

What is chronic cough?

Chronic cough is usually defined as a cough that lasts more than eight weeks in adults and four weeks in children. Chronic cough is one of the most frequent reasons for visits to the doctor. Chronic cough isn’t a disease itself. It’s a health problem that results from other health conditions.

What causes coughing?

Your throat is a very sensitive part of the body. The lining of your throat can sense touch, temperature, taste and position. You can sense these things even while you are breathing and eating. Your throat is responsible for getting food and air into the right tubes, making sure you don’t choke. The main job of your throat is keeping your airway safe and clear so you can breathe. A cough can be either voluntary or automatic.

Coughing is one method our bodies use to keep us healthy, but a cough that lasts a long time can affect your life in many ways. Coughing can keep you up at night and make your days miserable from muscle pain and being tired. It’s important to find out why your cough won’t go away.

Who is most likely to experience chronic cough?

People who use tobacco, especially smokers, are at a high risk of developing chronic cough. There is even something called ‘smoker’s cough’ that lasts longer than three weeks. The cough begins when your body tries to clear itself of the irritants that enter when you smoke.

Other people at risk of developing chronic cough include those with certain conditions, including:

Symptoms and Causes

What causes chronic cough?

There are several medical conditions that are linked to chronic cough. These include respiratory conditions, such as:

• Asthma: This is the second most frequent cause of chronic cough. Shortness of breath and wheezing happen when you have asthma. These breathing difficulties can result in a chronic cough. There is also a form of asthma (cough-variant asthma) where chronic cough may be the only symptom.
• Bronchiectasis: This condition causes coughing because mucus builds up and lung tissue gets thicker.
• Bronchitis: This condition is a known cause of coughing due the swelling that happens in the bronchial tubes and the increase in mucus production. There are two types —chronic and acute.
• Chronic obstructive pulmonary disease (COPD): COPD is actually a term that refers to a group of respiratory issues that includes chronic bronchitis and emphysema.
• Upper respiratory conditions like flu, pneumonia and colds: These infections are generally caused by viruses. Coughing is one symptom that tends to last after the others are through. The viruses attack the nose, the throat and the sinuses.

Other reasons for chronic cough include sinusitis and allergies. Sinus problems and allergies, along with upper respiratory infections, produce post-nasal drip. This drip is sometimes feels like “a tickle in the back of the throat,” and drainage can lead to chronic cough. This “tickle” happens when the amount of draining mucus is larger than usual.

Many people might worry about cancer if they have a chronic cough. It’s possible that coughing that won’t stop is a sign of cancer of the lung or upper airway, but that isn’t the most likely cause.

Finally, chronic cough is a well-known side effect of angiotensin-converting enzyme (ACE) inhibitors, a specific group of drugs used to treat high blood pressure. These drugs may be used for other things, like preventing kidney damage if you have diabetes. Some common ACE inhibitors are:

• Benazepril (Lotensin®, Lotensin® Hct).
• Captopril (Capoten®).
• Enalapril (Vasotec®).
• Fosinopril (Monopril®).
• Lisinopril (Prinivil®, Zestril®).
• Moexipril (Univasc®)
• Quinapril (Accupril®).
• Peridopril (Aceon®).
• Ramiparil (Altace®).
• Tandolapril (Mavik®).

If you have a chronic cough and you take one of these medications, you shouldn’t just stop taking the medication on your own. Talk with your healthcare provider about what’s going on. They’ll probably be able to recommend a different medication.

What other symptoms might you have if you have a chronic cough?

Some symptoms can be more common and less likely to be serious, such as:

• A runny or stuffy nose.
• Post-nasal drip (‘tickle’ in the back of the throat).
• Wheezing or shortness of breath.
• Heartburn.
• Sore throat or frequent throat clearing.
• Fever (higher than 101°F).

Other symptoms might be more serious, such as:

• Weight loss without any effort.
• Coughing up phlegm or blood.
• A hoarse voice that does not go away.
• A drenching overnight sweat.

What are the complications of chronic cough that goes untreated?

Chronic coughing can affect your life in negative ways that disrupt your daily routine. The most obvious is that you can become extremely tired because you can’t sleep (insomnia). Coughing nonstop can also make your muscles hurt and break your ribs.

You might also find that you have:

Diagnosis and Tests

What tests will be used to diagnose the cause of chronic cough?

Diagnosing the cause of chronic cough can be difficult. This may be because many patients have more than one thing causing their cough. Therefore, many types of tests are used to diagnose the causes. The other symptoms will help determine which tests are needed.

For both adults and children, but especially for children, the answers to questions your healthcare provider asks will provide clues about the cause. They’ll ask questions such as when the coughing started, what seems to trigger the cough, and questions about the nature of the cough (like is it a dry cough or does it produce mucus). The answers will suggest what kind of testing is needed.

Lab tests help determine if bacteria are present (a sign of an infection) and are causing the cough. The most common of these involve blood tests. Others might test mucus that you cough up.

Lung function tests are tests that tell your healthcare provider how well your lungs are working. They are also called pulmonary function tests. These measure your breathing patterns — from inhaling to exhaling. Spirometry is one type of lung function testing, while others are lung volume testing, gas diffusion studies and the six-minute walk test.

Imaging tests include X-rays, CT and MRI scans, ultrasound and nuclear testing. X-rays reveal the more common reasons for chronic cough, such as a build-up of fluids in the areas that help breathing, as well as lung diseases and lung cancer. All of the other imaging tests provide more detailed views of areas of the body that affect breathing.

Scoping studies are tests that use a scope. This is an instrument that combines a camera and a long tube. To find the reason for a chronic cough, a scope is passed into certain areas of the body that might reveal a problem. For example, a scope can be passed:

• Up through the nostrils to look for signs of infection or blockages in the nasal passages.
• Through the nose into the voice box area to look for signs of acid reflux, post-nasal drip and abnormalities in the upper airway.
• Down the esophagus and into the stomach to measure the level of acid, which would help determine if acid reflux is the cause of chronic cough.
• Down the windpipe and into the bronchial tubes to look for blockages and signs of infections in the lung.

In terms of diagnosis, there’s one last thing you might hear. Sometimes, the cause of chronic cough cannot be found, so the cough is said to be idiopathic. (This is the medical term used when a cause is unknown and stays that way.) The cough that can’t be stopped might also be called unexplained chronic cough or chronic refractory cough.

Management and Treatment

How is chronic cough treated?

Your healthcare provider will discuss a treatment plan that will be based on your needs and the cause of the cough.

Possible treatments include new or different medications. If you are having chronic cough due to ACE inhibitors, your doctor might prescribe a different type of medication for your high blood pressure. It’s important to note that you shouldn’t just stop taking a medication without discussing it with your healthcare provider or pharmacist.

Drug treatments for asthma include inhaled bronchodilators and/or steroids. These drugs help reduce airway inflammation and wheezing.

For infections such as bacterial pneumonia or bronchitis, your provider might prescribe antibiotics, such as azithromycin (Azithrocin®, Zithromycin®), cefuroxime (Ceftin®) or cefprozil (Cefzil®), are prescribed.

For some conditions, like GERD, your provider might suggest a combination of non-drug treatments and prescription medications. Non-drug treatments include:

• Using pillows to prop up your head when you’re lying down.
• Avoiding foods that cause acid reflux (such as chocolates, colas, red wines).
• Not eating right before bedtime.

Prescription medicines that treat GERD by reducing stomach acids include:

• Cimetidine (Tagamet®).
• Famotidine (Pepcid®).
• Ranitidine (Zantac®).
• Esomeprazole (Nexium®).
• Lansoprazole (Prevacid®).
• Omeprazole (Prilosec®).

If the cause is post-nasal drip, over-the-counter decongestants, such as diphenhydramine or pseudoephedrine, may help relieve symptoms. Antibiotics may be prescribed if the cause of the chronic cough is sinusitis. Nasal spray, such as ipratopium (Atrovent®) can relieve a runny nose, sneezing and post-nasal drip. A nasal glucocorticoid, such as fluticasone (Flonase®), can also reduce post-nasal drip.

In the case of unexplained chronic cough (UCC), your healthcare provider might suggest that you see a speech/voice pathologist. Voice therapy for coughing is called behavioral cough suppression therapy (BCST).

The therapy will start with education and by explaining cough hypersensitivity reflex — that some people just cough more easily because their body is more sensitive to things that make people cough. Many people with UCC have triggers that make them cough like talking or laughing, environmental stimuli like sprays or aerosols, and even smaller changes in air temperature or the position of the body (laying down or bending over) bother these more sensitive people. BCST teaches you how to control the urge to cough through various behavioral techniques.

In therapy, you will learn how to do other things with the muscles you use for coughing. Those are the muscles that bring your vocal cords together, along with the muscles in your throat used for swallowing and breathing.

There are other next-level treatments for UCC such as oral medications:

• Neuromodulators (amitriptyline, gabapentin) or tramadol, a pain reliever.
• A superior laryngeal nerve block with steroids.
• Laryngeal onabotulinumtoxinA (Botox®) injections.

Sometimes more holistic treatment such as acupuncture can also be helpful. If other treatments have failed and the chronic cough is severe, a cough suppressant such as codeine may be prescribed.

Prevention

What can I do to prevent or relieve the symptoms of chronic cough?

To prevent chronic cough:

• Quit smoking, or don’t start smoking, since this is the most common reason for chronic cough.
• Avoid contact with anyone you know who may have bronchitis or pneumonia.
• Eat fruit and foods that contain fiber. Research suggests that a combination of fiber and flavonoids found in fruit may prevent chronic cough.

To relieve the symptoms of chronic cough:

• Drink plenty of water (at least eight 8-ounce glasses a day).
• Gargle with warm saltwater to help remove any mucus.
• Inhale steam.
• Avoid inhaling dust, smoke or other pollutants as much as possible.
• Use extra pillows at night to prop up your head and upper body.
• Try cough lozenges.
• Try over-the-counter cough medicines that contain guaifenesin and/or dextromethorphan.

Living With

When should I call my doctor about a chronic cough?

Call your doctor if you are:

• Coughing up blood or phlegm.
• Wheezing.
• Running a fever (temperature greater than 101°F).
• Losing weight without trying.
• Having a drenching sweat overnight.

A note from Cleveland Clinic

Chronic cough is one that lasts longer than eight weeks in an adult and four weeks in a child. If coughing is having a negative impact on your life, contact your healthcare provider to find a cause. Finding a cause will let you find a treatment, so you can go back to sleeping, eating, moving and feeling well.

Green phlegm and snot ‘not always a sign of an infection needing antibiotics’ : Sunderland LPC

Public Health England Advice on European Antibiotics Awareness Day (18 November 2014) to raise awareness of the risks of inappropriate use of antibiotics.

Having green phlegm or snot is not always a sign of a bacterial infection that will require antibiotics to get better, says Public Health England (PHE) and the Royal College of General Practitioners (RCGP).

This advice is issued on European Antibiotics Awareness Day (18 November) which aims to raise awareness of the risks associated with the inappropriate use of antibiotics and how to use them responsibly.

Research by PHE’s Primary Care Unit has found that 40% of the general public believed that antibiotics would help a cough with green phlegm get better more quickly rather than clear phlegm (6%).

White blood cells are produced by the body to attack any foreign materials the body does not recognise such as pollutants, dirt, pollen or microbes, and are carried in your phlegm and snot. Some white blood cells contain a green substance (a protein) so if more of these cells are present the greener your phlegm or snot will be.

Phlegm therefore comes in a range of colours from white to mustard-yellow to varying shades of green. Coloured phlegm or snot does not mean you need antibiotics.

In most healthy people, phlegm or snot production with or without a cough will stop as your cold or flu-like illness clears up, although it may take up to 3 to 4 weeks.

Dr Cliodna McNulty, head of PHE’s primary care unit said:

It’s a prevailing myth that anyone with green phlegm or snot needs a course of antibiotics to get better. Most of the infections that generate lots of phlegm and snot are viral illnesses and will get better on their own although you can expect to feel pretty poorly for a few weeks. There are plenty of over-the-counter medicines which are very effective in managing the symptoms of these illnesses and can reduce headache, muscle soreness, fever and sore throats.

The problems of antibiotic resistance are growing. Everyone can help by not using antibiotics for the treatment of uncomplicated infections. Any antibiotics we take will also kill many of our normal bacterial flora in the gut. Antibiotics also encourage other bacteria in our gut to develop resistance to antibiotics by changing their genetic makeup. These resistant bacteria can then in turn pass their resistance genes on to other bacteria, or they can be passed to other people we have close contact with. In the long run, this will mean our antibiotics become less effective, or in the worse case scenario, not effective at all.

Many people have a good understanding of what antibiotic resistance is but when it comes to their own illnesses still believe that antibiotics can help to treat what can be severe cold and flu symptoms. This is not the case and we must get away from believing this to preserve these precious medicines for when we really need them.

Dr Maureen Baker, Chair of the RCGP, said:

The statistics from Public Health England are not surprising. Many patients expect their GPs to prescribe antibiotics, even for cases that will get better naturally or respond better to other treatments.

This guidance will go a long way to bust the myths surrounding antibiotics and promote more effective alternatives, which can often be easily managed by patients.

Overuse of antibiotics is a serious public health concern and a clinical priority for the RCGP. Infections adapt to antibiotics used to kill them and can ultimately make treatment ineffective so it’s crucial that antibiotics are used appropriately. That’s why we have recently updated our comprehensive TARGET toolkit, developed in collaboration with PHE, to include new guidance for GPs and their patients on the appropriate prescription of antibiotics so that they do not build up an immunity for the future when they might really need them.

Background

Who doesn’t usually need antibiotics when they have coughs with or without phlegm?

• In otherwise healthy non-smoking individuals who have no underlying health problems, having an acute cough with phlegm of any colour is not necessarily a sign of infection and any small possible benefit from antibiotics is likely to be outweighed by the side effects.
• If you are a smoker with no diagnosis of chronic obstructive pulmonary disease (COPD) then you are not in any greater need of antibiotics than non smokers.
• If you are an adult or a child with asthma and have a cough with phlegm you do not need antibiotics to get better but you may need extra asthma treatment.

Who may need antibiotics if they have a cough with or without phlegm?

• If you have chronic obstructive pulmonary disease (COPD) with green phlegm you should see your doctor as you may have an infection. People with COPD are more likely to be/have been smokers and green phlegm in this group is more indicative of a sign of infection.
• If you have had a recurrent chest infections you should also see your doctor for a clinical review as you may have an infection.
• Those who are older (over 65) or who have other chronic lung and heart conditions may need to seek advice about treatment.

Who should go to the doctors more urgently?

• If you have difficulty breathing, breathing quickly, have chest pain or are coughing up blood, or feeling confused or are very drowsy.

What can patients do to get better with coughs– now and in the future?

• Try not to cough: although this may sound easier said than done, you may be able to cough less often by trying not to cough, because our desire to cough can sometimes be influenced by our brain.
• Home remedies: try simple home remedies, such as ‘honey and lemon’ – just add freshly squeezed juice from 1 lemon and a teaspoon of honey to a mug of hot water. Drink enough fluids to avoid feeling thirsty and suck lozenges.
• Stop smoking: smoking is one of the commonest reasons for a chronic cough. Stopping smoking – or at least smoking less – not only improves your cough, but also benefits your health in other ways (reducing the risk of heart attack, stroke, and lung cancer, for example).
• Cough mixtures: there is little evidence to say whether over the counter medicines are effective for relieving cough symptoms. Despite the lack of research evidence, you may still get some subjective benefit from over the counter preparations – speak to your pharmacist.
• Paracetamol: paracetamol can help relieve symptoms that may accompany a cough, such as a sore throat, fevers, and not feeling well.

PHE are encouraging GP staff to discuss the need for antibiotics with their patients using an antibiotic information leaflet available on the TARGET antibiotics website.

See Earl Howe’s statement supporting European Antibiotic Awareness Day on the Self Care Forum website.

More information about European Antibiotic Awareness Day, or EAAD

The data on public attitudes to antibiotics is available from the Journal of Primary Care

Materials for GP staff to share with patients is available on the RCGP website, including an antibiotic information leaflet and a list indicating when patients should call their doctor or contact NHS 111.

The following symptoms appears in order of urgency, with the most urgent symptoms listed first. If you develop these symptoms, call your GP or contact NHS 111:

• if you develop a severe headache or are sick
• if your skin is very cold or has a strange colour, or you develop an unusual rash
• if you feel confused or have slurred speech or are very drowsy
• if you have difficulty breathing. Signs that suggest breathing problems can include:
  • breathing quickly
  • turning blue around the lips and the skin below the mouth
  • skin between or above the ribs getting sucked or pulled in with every breath
• if you develop chest pain
• if you have difficulty swallowing or are drooling
• if you cough up blood
• if hearing problems develop or if there is fluid coming out of your ears

Public Health England’s mission is to protect and improve the nation’s health and to address inequalities through working with national and local government, the NHS, industry and the voluntary and community sector. PHE is an operationally autonomous executive agency of the Department of Health. www.gov.uk/phe Follow us on Twitter @PHE_uk

The Royal College of General Practitioners is a network of more than 46,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.

Infections press office

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Coughing up Brown Mucus | Causes for Different Phlegm Colors

Bronchitis

Acute bronchitis is an inflammatory reaction to an infection in the airways. Most cases of acute bronchitis are caused by a viral infection, although some cases may be due to a bacterial infection.

Symptoms include an acute-onset cough with or without sputum production, low-grade fever, shortness of breat..

Smoking-induced cough

The airways are lined with tiny cells called cilia, whose function is to catch toxins in air that is inhaled and push them up towards the mouth. When smoke is inhaled, the cilia are paralyzed for a short while, so toxins are allowed to enter the lungs and create inflammation. During the night, the cilia repair themselves and begin to push up all the accumulated mucus and toxins, causing an increase in cough in the morning.

Rarity: Common

Top Symptoms: cough

Symptoms that always occur with smoking-induced cough: cough

Symptoms that never occur with smoking-induced cough: fever

Urgency: Self-treatment

Bacterial pneumonia

Bacterial pneumonia is an infection of the lungs caused by one of several different bacteria, often Streptococcus pneumoniae. Pneumonia is often contracted in hospitals or nursing homes.

Symptoms include fatigue, fever, chills, painful and difficult breathing, and cough that brings up mucus. Elderly patients may have low body temperature and confusion.

Pneumonia can be a medical emergency for very young children or those over age 65, as well as anyone with a weakened immune system or a chronic heart or lung condition. Emergency room is only needed for severe cases or for those with immune deficiency.

Diagnosis is made through blood tests and chest x-ray.

With bacterial pneumonia, the treatment is antibiotics. Be sure to finish all the medication, even if you start to feel better. Hospitalization may be necessary for higher-risk cases.

Some types of bacterial pneumonia can be prevented through vaccination. Flu shots help, too, by preventing another illness from taking hold. Keep the immune system healthy through good diet and sleep habits, not smoking, and frequent handwashing.

Rarity: Common

Top Symptoms: fatigue, cough, headache, loss of appetite, shortness of breath

Symptoms that always occur with bacterial pneumonia: cough

Urgency: In-person visit

Viral pneumonia

Viral pneumonia, also called “viral walking pneumonia,” is an infection of the lung tissue with influenza (“flu”) or other viruses.

These viruses spread through the air when an infected person coughs or sneezes.

Those with weakened immune systems are most susceptible, such as young children, the elderly, and anyone receiving chemotherapy or organ transplant medications.

Symptoms may be mild at first. Most common are cough showing mucus or blood; high fever with shaking chills; shortness of breath; headache; fatigue; and sharp chest pain on deep breathing or coughing.

Medical care is needed right away. If not treated, viral pneumonia can lead to respiratory and organ failure.

Diagnosis is made through chest x-ray. A blood draw or nasal swab may be done for further testing.

Antibiotics do not work against viruses and will not help viral pneumonia. Treatment involves antiviral drugs, corticosteroids, oxygen, pain/fever reducers such as ibuprofen, and fluids. IV (intravenous) fluids may be needed to prevent dehydration.

Prevention consists of flu shots as well as frequent and thorough handwashing.

Rarity: Uncommon

Top Symptoms: fatigue, headache, cough, shortness of breath, loss of appetite

Urgency: Primary care doctor

Acute viral sinusitis

Acute viral sinusitis, also called viral rhinosinusitis or “sinus infection,” occurs when viruses take hold and multiply in the sinus cavities of the face.

It is most often caused by the same viruses that cause the common cold and spreads the same way, through an infected person’s coughing or sneezing.

Because children have small, underdeveloped sinuses, this illness is far more common in adults.

Symptoms include clear nasal discharge (not greenish or yellowish,) fever, and pain if facial sinuses are pressed.

If there is rash, severe fatigue, or neurologic symptoms (seizures, loss of sensation, weakness, or partial paralysis,) see a medical provider to rule out more serious conditions.

Diagnosis can usually be made through history and examination alone.

Antibiotics only work against bacteria and cannot help against a viral illness. Therefore, treatment consists of rest, fluids, and fever/pain reducers such as ibuprofen. (Do not give aspirin to children.) Symptoms of viral sinusitis last for about seven to ten days. As with the common cold, the best prevention is frequent and thorough handwashing.

Rarity: Common

Top Symptoms: headache, cough, sinusitis symptoms, sore throat, congestion

Symptoms that always occur with acute viral sinusitis: sinusitis symptoms

Symptoms that never occur with acute viral sinusitis: being severely ill

Urgency: Self-treatment

Common cold

The common cold is a viral infection of the upper respiratory tract, which includes the nose, mouth, sinuses, throat, and larynx. There are over 200 viruses that can cause upper respiratory infections, and usually the exact virus behind a cold is never known.

The common cold is, of course, very common..

Bronchiectasis

Bronchiectasis is destruction and widening of the large airways. Mucus builds up in these airways and can get infected, causing a pneumonia.

Rarity: Rare

Top Symptoms: cough, shortness of breath, wheezing, runny nose, mucous dripping in the back of the throat

Urgency: Primary care doctor

Lung abscess

A lung abscess is a large collection of pus in the tissue of the lungs that results from a bacterial infection. Bacteria that should not normally be found in the lungs causes inflammation that leads to a breakdown of the lung tissue, thus producing the pus.

Symptoms vary depending on whether the abs..

10 Ways To Get Rid Of Phlegm

Do you feel you have constant phlegm at the back of your throat?

You’re probably wondering what exactly is causing this build-up of gunk to hang around in your airways?

In this post, we uncover the important purpose of this gooey substance.

And if clearing your throat continuously just isn’t cutting it, you may be interested in our handy tips on how to get rid of phlegm, including foods that can help.

What is phlegm?

Phlegm is a jelly-like liquid that you cough up from your lungs.

Compared to the mucus that’s excreted from your nasal passages (what we commonly refer to as snot), it’s a thicker, stickier substance.

With every breath in, you potentially inhale dust, debris, allergens, pollutants and viruses.

The primary purpose of the gluey mucus in your airways is to trap as many of these irritating particles as possible. Then, phlegm becomes the vehicle for their exit from the lower respiratory tract.

In short, this icky substance helps to keep your lungs clear of the germs that enter your airways.¹

Summary

• Phlegm is a thick, gluey mucus produced by your lungs
• Its primary purpose is to trap virus-carrying bacteria, germs and allergens
• This helps to keep your lungs clear of these unwanted invaders

Is throat mucus the same as phlegm?

Mucus and phlegm are similar substances. As a result, often the terms are used interchangeably.

But, if you want to be accurate with your terminology, there are subtle differences between the two.

• If the liquid is thinner and comes from your nose and sinuses, it’s mucus.
• The thicker, stickier substance found in your throat as it’s expelled from your lungs is phlegm.²

What causes phlegm?

A certain amount of mucus is needed by our bodies, but too much can be uncomfortable. There are a number of reasons why you may produce excessive phlegm.

A surge in phlegm production is most often an immune response in reaction to a respiratory infection (such as the common cold).³

For example, when suffering with a cold, your body produces more mucus as it’s forced to work harder to trap and expel an influx of infection-spreading invaders.⁴

But other causes of phlegm are an allergic reaction or a response to irritation of some kind in your airways.^5,6

For example, this could be contact with an allergen or exposure to cigarette smoke.

People with asthma can also find they cough up lots of phlegm and it’s occasionally a sign of a more serious condition.  

Summary

• Phlegm is thicker and stickier than the type of mucus that’s produced in your nasal passages
• Excess phlegm is often produced in response to a respiratory infection
• Your body may also produce more of this mucus in reaction to exposure to an allergen or a pollutant

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What is excess mucus in our throat?

If your body produces too much phlegm, you may feel it rise into your throat. This creates the feeling of excess mucus in your throat.

Why do we get phlegm in our throat?

To get the bad stuff away from your lungs, phlegm has to keep moving. Tiny hairlike structures called cilia cover the inside of your lungs.

It’s their job to persistently usher mucus out of the respiratory tract.

As a result, the gloop often ends up being forced upwards, becoming throat phlegm. This process is officially called mucociliary clearance.⁷

Why am I clearing my throat constantly?

As your body thrusts excess mucus up and out of your respiratory system, you’ll probably want to hack it up, spit it into a tissue and throw it in a bin.

Hence that feeling of wanting to clear your throat continuously.

It may not be pleasant, but the good news is by doing this, you’re helping the phlegm protect your lungs from further infection.

Summary

• If your body produces too much phlegm, it can be thrust up into your throat
• This mucociliary clearance process is a way your body defends your lungs from infection
• The presence of mucus in your throat will probably prompt throat clearing
• It may also cause you to cough phlegm up

Why do I get phlegm in my throat every morning?

While you’re still and sleeping, phlegm can pool and settle in your lungs and throat. Once you become active in the morning, it breaks up and starts to move again.

This can cause you to cough up the excess phlegm that’s gathered overnight.⁸

Excess mucus after drinking alcohol

Do you feel congested after drinking alcohol?

Regular or heavy drinking could mean your mucociliary transport system isn’t clearing mucus out of your airways as efficiently as it should.

This makes it harder for you to keep a healthy airway, encouraging a build-up of phlegm.⁹

Handpicked content: Alcohol – How much is too much?

Is it normal to have phlegm everyday?

To fulfil an infection-fighting role, your body constantly produces phlegm.

For context, our lungs create about 100 millilitres of this mucus per day – that’s just slightly less than a third of a can of fizzy drink.¹⁰

But it’s often only when you’re not feeling well that you notice it.

Summary

• To keep us healthy, our lungs constantly produce phlegm
• But most of us will only notice it when mucus production increases when we’re not feeling well
• Some people find they need to clear their throat more in the morning
• Heavy drinking may cause a build-up of phlegm

How to get rid of phlegm

So, you’re probably wondering how to get rid of throat mucus? First of all, you don’t necessarily have to do anything.

In most cases, phlegm is normal and helps with the healthy function of your respiratory system. Nevertheless, many people find dealing with a surplus of throat mucus unpleasant.

Fortunately, if you want to thin it or remove it from your body, there are a number of things you can do.

10 ways to get rid of phlegm

1. Drink lots of fluids

By not drinking enough fluid, you could be making it easier for excess phlegm to build up in your airways.

Sipping on water, juice or even chicken soup can help make mucus looser and keep it moving. This can help flush out any excess phlegm that’s built up in your respiratory system.¹¹

Handpicked content: 13 easy ways to drink more water

2. If you smoke, stop

Studies show smoking cigarettes can cause the body to produce more phlegm.¹²

This link suggests quitting the habit could support the mucus clearing process.

3. Use a nasal spray or solution

If you’ve got a blockage of mucus in your nose or throat, you could try clearing it using nasal spray. These can either be medicated or simply a sterilised saline solution.

4. Invest in a humidifier

A dry environment can contribute to the build-up and thickness of phlegm, so introducing extra moisture may help.¹³

For example, you could try using a humidifier or taking a streamy shower to open up and moisturise airways. The steam could also aid with breaking down thick mucus making it easier to cough it up.¹⁴

5. Apply a warm compress

Another way to combat the irritating effects of breathing in dry air is to use a warm compress.

For example, breathing through a warm wet cloth provides a moist heat source that can help with thinning mucus.¹⁵

6. Cough it up

Coughing is the body’s natural way of keeping phlegm out of the lungs and throat. It’s also one of the simplest ways to get rid of excess mucus.

7. Gargle salt water

Gargling water is thought to helps loosen mucus so it’s easier to get rid of phlegm.

In fact, a study found this simple home remedy could help to prevent upper respiratory tract infections.¹⁶

8. Avoid drinking alcohol or caffeine

Drinking a lot of either of these beverages can cause dehydration. This will lead to lower moisture levels throughout your body.

If you’re struggling with phlegm, instead choose warm, non-caffeinated drinks.

9. Try a decongestant

As it says on the tin, these are designed to decongest your nasal passages.

If you have a persistent cold and phlegm that refuses to budge, it might be time to make a trip to your local pharmacy to pick up a decongestant or vapor rub.

10. Use eucalyptus as a natural alternative

Although the science to support it isn’t conclusive, many people will swear that applying eucalyptus to the chest helps to relieve discomfort from a build-up of mucus.

Alternatively, you could try adding a few drops of oil to a diffuser or a warm bath.

How to cough up phlegm in throat

As a general rule, try not to hack.

Also, resist the urge to constantly clear your throat as a way of clearing throat mucus.

Instead, try the following coughing technique to help with getting rid of phlegm.

A deep cough method for mucus clearing

Hold it for a few seconds. 

Use your abs to push out the air.¹⁷

Summary

• Phlegm helps with the healthy function of the respiratory system, but some people find dealing with it unpleasant
• There are a number of things you can do to make it easier to get rid of phlegm
• Introducing moisture is the key to thinning gloopy mucus so that it can flow with more ease
• A deep cough can also help get rid of phlegm without hacking and continuous throat clearing

9 foods that get rid of phlegm

What you eat can encourage phlegm to thrive. Dairy products, certain grains, sugary treats, red meat, and caffeinated drinks are all examples of foods that have the potential to ramp up mucus production.¹⁸

In addition, allergy-triggering foods are also common culprits.

So, for some people, eating eggs, wheat, dairy, tree nuts and gluten will be linked to a rise in mucus.¹⁹

However, some foods can help in your fight against phlegm.

1. Ginger

This spicy root has natural anti-inflammatory properties.²⁰ Drinking a few cups of ginger tea is a pleasant way to open up inflamed airways and help your body flush out excess mucus.

2. Cucumber

Being rich in water, potassium, and vitamin C, cucumber offers a helping hand with cleansing the body of excess mucus. 

3. Pineapple

The bromelain in pineapple offers up a powerful antidote to inflammation which could help open clogged up airways.²¹

4. Onions

With an ample supply of the bioflavonoid quercetin, onions have a lot to offer when it comes to breaking down mucus and flushing out phlegm.²²

5. Broccoli

Broccoli is fibre rich, which a 2004 study showed can be a valuable asset when it comes to reducing mucus levels in the body.²³

6. Garlic

Certain fruits and vegetables, such as garlic, come with extra phlegm-reducing qualities.

For example, Centers for Respiratory Health lists watercress, celery, garlic, pickles, onions, lemons and parsley in its anti-mucus food list.²⁴

7. Apple cider vinegar

It can be used as a natural decongestant. In addition, apple cider vinegar comes with some punchy antiviral and antibacterial properties.

By helping to fight off infection, it also supports your efforts to reduce excessive phlegm production.

8. Turmeric

The curcumin in turmeric can help fight off infection that may be triggering mucus production.

It’s also shown to aid with decongesting airways, supporting the excretion of excess mucus.²⁵

9. Broth soups

Warm fluids are a great dietary asset in the fight against phlegm.

They can help break-up mucus, promote hydration and flush out toxins.²⁶

As a result, clear broth soups (so no dairy) and teas (caffeine-free naturally) can be great for getting gunk off your chest.

Summary

• What you eat can influence phlegm production
• Some foods, such as dairy products, encourage mucus to thrive
• Foods with anti-inflammatory properties can help with opening clogged up airways
• Certain fruits and vegetables also aid with reducing and breaking down thick mucus

Conclusion: How to stop phlegm in the future

In this article, we’ve talked about what causes excess mucus in the throat and various ways you can get rid of phlegm.

This included dietary ideas, as well as some other ways to help jam the brakes on spiraling mucus production.

But how can you stop phlegm in the future?

Producing excess mucus is most often caused by a cold-like infection. So, the most obvious answer to how to reduce phlegm is to give your immune system the best support you can to fight off infection.

Many of the anti-mucus foods we mentioned above, are a great basis for supporting a healthy immune system.

But if you don’t think you can get the nourishment you need from diet alone, why not check out our guide to supporting your immune system? 

Guide to supporting your immune system

Everything you need to know about how to support your immune system, with tips on diet, vitamins and minerals, and exercise. 

Read more

Guide to supporting your immune system

The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.

Last updated: 24 November 2021

5 Scary Reasons Why You Might Be Coughing So Much

This article was written by Hallie Levine and provided by our partners at Prevention.

Ah, the chronic cough. It’s the number-one reason people visit a doctor’s office, and most of the time, the cause is benign or easily treated (think bronchitis, allergies, asthma, or even GERD). Every now and then, however, a nagging cough instead indicates a potentially life-threatening condition, says Raja M. Flores, MD, chairman of the Department of Thoracic Surgery and the Steven and Ann Ames professor in thoracic surgery at the Icahn School of Medicine at Mount Sinai Hospital in NYC. Got a cough that’s lasted for more than two weeks? Get checked out. It might not turn out to be serious, but in the worst-case scenario you could get one of these scary diagnoses. (Heal your whole body with Rodale’s 12-day power plan for total body health!)

Whooping cough (pertussis)

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Yes, we’re serious. While this disease was basically eradicated after the introduction of vaccines in the 1940s, it’s now making a recurrence, thanks in large part to people refusing to get vaccinated, according to an Emory University study published in JAMA last year. In 2012, 48,277 cases of pertussis were reported to CDC—the highest number since 1955—and 20 people died from it. 

Be concerned if… 
You have a severe hacking cough that ends with a whooping sound as you breathe in. While initially the disease starts with cold-like symptoms such as a runny nose, a mild cough, and fever, after a week or two the tell-tale cough will appear, sometimes so intensely that you throw up during or after your coughing fits. If you think you have it, get prompt medical attention: Untreated pertussis can lead to pneumonia. Whooping cough is diagnosed with blood tests and a chest X-ray and treated with antibiotics.

RELATED: The 10 Most Painful Conditions

Lung cancer

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Sixty-five percent of people with lung cancer have a chronic cough at the time of diagnosis, according to a study published in the journal Chest. “Oftentimes, it’s the only symptom,” says Flores. Don’t be lulled into a false sense of security if you’ve never smoked: Research suggests up to 28 percent of lung cancer cases occur in people who’ve never touched a cigarette.

Be concerned if… 
Your cough lasts for more than two weeks, especially if it’s accompanied by bloody or rust-colored mucus, hoarseness, pain with swallowing, and chest pain. “There’s no need to panic—sometimes it’s due to something as treatable as adult-onset asthma,” says Flores. “But it always needs to be checked out, ideally with a low-dose cat scan, since an x-ray can miss tumors.” (Make sure you know these 8 surprising signs of lung cancer.)

We asked a hot doc how to treat a headache without drugs. Here’s what he said: 

​

​

Pneumonia

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The main symptom of so-called walking pneumonia—other than feeling beyond wiped—is a persistent dry cough that tends to worsen at night. “People often try to self-treat with over-the-counter cough suppressants, which can make you worse because they prevent your body from loosening and moving mucus and fluid from your lungs,” says Flores.

Be concerned if… 
You have a cough and other cold-related symptoms that don’t seem to improve after 10 days. See your doctor earlier if you’re having trouble breathing, have chest pain, are running a fever of over 102°F, and/or are coughing up green, yellow, or blood-tinged pus. Your physician will listen to your lungs with a stethoscope to check for any suspicious crackling sounds; if he hears them, you’ll likely need blood tests, a chest x-ray, and, in some cases, a CT scan. Treatment is a course of antibiotics; most people start to feel better within a few days.

RELATED: 7 Surprising Things Your First Period Says About You

COPD

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More than 7 million American women live with chronic obstructive pulmonary disease (COPD), a lung disease that causes you to have trouble breathing. (There are two kinds: chronic bronchitis, or inflammation of your bronchial tubes, and emphysema, a condition where the smallest air passages at the end of your lungs are destroyed.) Often a consequence of smoking, COPD incidence has increased four-fold over the past three decades. Since 2000, more American women than men have died from this condition, according to the American Lung Association.

Be concerned if… 
You’re a smoker or former smoker who also has a chronic hacking cough that produces a lot of mucus, particularly in the morning. You may also experience shortness of breath, wheezing, and chest tightness. Don’t delay if you see suspicious symptoms: Research shows that the earlier you get diagnosed and begin treatment (mainly prescription medications like bronchodilators), the better your prognosis. And stopping smoking is a must.

RELATED: Exactly What To Eat When You Have A Cold Or Flu

Tuberculosis

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Tuberculosis (TB), a disease caused by a bacteria known as mycobacterium tuberculosis, is relatively rare in the United States—less than 10,000 cases were reported in this country in 2015, according to the CDC, compared to over 10 million worldwide. Your risk goes up if you have a weakened immune system (say, from advanced diabetes, HIV, or cancer) and/or have spent time in high-risk areas such as Africa or parts of Eastern Europe. (Eat these power foods to boost your immunity.)

Be concerned if… 
Your cough lasts more than three weeks and is paired with chest pain, weight loss, fatigue, fever, and night sweats, and/or you’re coughing up blood. Without treatment, TB can be fatal; it can spread throughout your body, damaging your spine, joints, brain, and even heart. It’s diagnosed via skin or blood test; treatment is antibiotics. 

Hallie Levine
Hallie Levine is a freelance writer who has written about health and fitness for more than 20 national publications, including Glamour, Newsweek, and the New York Post.

This content is created and maintained by a third party, and imported onto this page to help users provide their email addresses. You may be able to find more information about this and similar content at piano.io

Cough

Is this your child’s symptom?

• The sound made when the cough reflex clears the airway of irritants
• Most coughs are part of a cold
• A coughing fit or spell is over 5 minutes of nonstop coughing
• Coughs can be dry (no mucus) or wet (with white, yellow or green mucus)

Causes of Cough

• Common Cold. Most coughs are part of a cold that includes the lower airway. The medical name is viral bronchitis. The bronchi are the lower part of the airway that go to the lungs. Bronchitis in children is always caused by a virus. This includes cold viruses, influenza and croup. Bacteria do not cause bronchitis in healthy children.
• Sinus Infection. The exact mechanism of the cough is unknown. It may be that post-nasal drip irritates the lower throat. Or pressure within the sinus may trigger the cough reflex.
• Allergic Cough. Some children get a cough from breathing in an allergic substance. Examples are pollens or cats. Allergic coughs can be controlled with allergy medicines, such as Benadryl.
• Asthma. Asthma with wheezing is the most common cause of chronic coughs in children. In adults, it’s smoking.
• Cough Variant Asthma. 25% of children with asthma only cough and never wheeze. The coughing spells have the same triggers as asthma attacks.
• Air Pollution Cough. Fumes of any kind can irritate the airway and cause a cough. Tobacco smoke is the most common example. Others are auto exhaust, smog and paint fumes.
• Exercise Induced Cough. Running will make most coughs worse. If the air is cold or polluted, coughing is even more likely.
• Serious Causes. Pneumonia, bronchiolitis, whooping cough and airway foreign object

Trouble Breathing: How to Tell

Trouble breathing is a reason to see a doctor right away. Respiratory distress is the medical name for trouble breathing. Here are symptoms to worry about:

• Struggling for each breath or shortness of breath
• Tight breathing so that your child can barely speak or cry
• Ribs are pulling in with each breath (called retractions)
• Breathing has become noisy (such as wheezes)
• Breathing is much faster than normal
• Lips or face turn a blue color

Phlegm or Sputum: What’s Normal?

• Yellow or green phlegm is a normal part of the healing of viral bronchitis.
• This means the lining of the trachea (windpipe) was damaged by the virus. It’s part of the phlegm your child coughs up.
• Bacteria do not cause bronchitis in healthy children. Antibiotics are not helpful for the yellow or green phlegm seen with colds.
• The main treatment of a cough with phlegm is to drink lots of fluids. Also, if the air is dry, using a humidifier will help. Sipping warm clear fluids will also help coughing fits.

Vaping Risks

• Talk with your child about the dangers of vaping.
• Vaping can cause severe lung injury. The lung damage can be permanent.
• Vaping can even cause death.
• Vaping tobacco also causes nicotine addiction.
• The legal age to purchase vaping products is 21 in the US.
• Encourage your teen to avoid vaping. If they have started, urge them to quit.
• Warning: never use home-made or street-purchased vaping solutions. Reason: they have caused most lung damage.

When to Call for Cough

Call 911 Now

• Severe trouble breathing (struggling for each breath, can barely speak or cry)
• Passed out or stopped breathing
• Lips or face are bluish when not coughing
• You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

• Trouble breathing, but not severe.
• Lips or face have turned bluish during coughing
• Harsh sound with breathing in (called stridor)
• Wheezing (high-pitched purring or whistling sound when breathing out)
• Breathing is much faster than normal
• Can’t take a deep breath because of chest pain
• Severe chest pain
• Coughed up blood
• Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
• High-risk child (such as cystic fibrosis or other chronic lung disease)
• Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
• Fever over 104° F (40° C)
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Nonstop coughing spells
• Age less than 6 months old
• Earache or ear drainage
• Sinus pain (not just congestion) around cheekbone or eyes
• Fever lasts more than 3 days
• Fever returns after being gone more than 24 hours
• Chest pain even when not coughing
• Concerns about vaping
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Coughing causes vomiting 3 or more times
• Coughing has kept home from school for 3 or more days
• Allergy symptoms (such as runny nose and itchy eyes) also present
• Runny nose lasts more than 14 days
• Cough lasts more than 3 weeks
• You have other questions or concerns

Self Care at Home

• Cough with no other problems

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Cough

1. What You Should Know About Coughs:
   • Most coughs are a normal part of a cold.
   • Coughing up mucus is very important. It helps protect the lungs from pneumonia.
   • A cough can be a good thing. We don’t want to fully turn off your child’s ability to cough.
   • Here is some care advice that should help.
2. Homemade Cough Medicine:
   • Goal: decrease the irritation or tickle in the throat that causes a dry cough.
   • Age 3 months to 1 year: give warm clear fluids to treat the cough. Examples are apple juice and lemonade. Amount: use a dose of 1-3 teaspoons (5-15 mL). Give 4 times per day when coughing. Caution: do not use honey until 1 year old.
   • Age 1 year and older: use honey ½ to 1 teaspoon (2-5 mL) as needed. It works as a homemade cough medicine. It can thin the secretions and loosen the cough. If you don’t have any honey, you can use corn syrup. You can also buy cough products that have honey in them at drug stores. They do not work better than plain honey and cost much more.
   • Age 6 years and older: use Cough Drops to decrease the tickle in the throat. If you don’t have any, you can use hard candy. Avoid cough drops before 6 years. Reason: risk of choking.
3. Non-Prescription Cough Medicine (DM):
   • Non-prescription cough medicines are not advised. Reason: no proven benefit for children and not approved under 6 years old (FDA).
   • Honey has been shown to work better for coughs. Caution: do not use honey until 1 year old.
   • If age 6 years or older, you might decide to use a cough medicine. Choose one with dextromethorphan (DM), such as Robitussin Cough syrup. DM is present in most non-prescription cough syrups. Follow the instructions on the package.
   • When to Use: give only for severe coughs that interfere with sleep or school.
   • DM Dose: give every 6 to 8 hours as needed.
4. Coughing Fits or Spells – Warm Mist and Fluids:
   • Breathe warm mist, such as with shower running in a closed bathroom.
   • Give warm clear fluids to drink. Examples are apple juice and lemonade.
   • Age under 3 months. Don’t use warm fluids.
   • Age 3 – 12 months of age. Give 1 ounce (30 mL) each time. Limit to 4 times per day.
   • Age over 1 year of age. Give as much as needed.
   • Reason: both relax the airway and loosen up any phlegm.
5. Vomiting from Hard Coughing:
   • For vomiting that occurs with hard coughing, give smaller amounts per feeding.
   • Also, feed more often.
   • Reason: vomiting from coughing is more common with a full stomach.
6. Encourage Fluids:
   • Try to get your child to drink lots of fluids.
   • Goal: keep your child well hydrated.
   • It also loosens up any phlegm in the lungs. Then it’s easier to cough up.
   • It also will thin out the mucus discharge from the nose.
7. Humidifier:
   • If the air in your home is dry, use a humidifier. Reason: dry air makes coughs worse.
8. Fever Medicine:
   • For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
   • Another choice is an ibuprofen product (such as Advil).
   • Note: fevers less than 102° F (39° C) are important for fighting infections.
   • For all fevers: keep your child well hydrated. Give lots of cold fluids.
9. Avoid Tobacco Smoke:
   • Tobacco smoke makes coughs much worse.
10. Return to School:
    • Your child can go back to school after the fever is gone.
    • Your child should also feel well enough to join in normal activities.
    • For practical purposes, the spread of coughs and colds cannot be prevented.
11. Extra Advice- Allergy Medicine for Allergic Cough:
    • Allergy medicine can bring an allergic cough under control within 1 hour. The same is true for nasal allergy symptoms.
    • A short-acting allergy medicine (such as Benadryl) is helpful. No prescription is needed.
    • Give every 6 to 8 hours until the cough is gone.
12. What to Expect:
    • Viral coughs most often last for 2 to 3 weeks.
    • Sometimes, your child will cough up lots of phlegm (mucus). The mucus can normally be gray, yellow or green.
    • Antibiotics are not helpful.
13. Call Your Doctor If:
    • Trouble breathing occurs
    • Wheezing occurs
    • Cough lasts more than 3 weeks
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 12/02/2021

Last Revised: 10/21/2021

Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.

Blood in sputum | FBUZ Treatment and Rehabilitation Center of the Ministry of Economic Development of Russia. Official site

Hemoptysis is the appearance of blood in sputum when coughing. It can be associated with a disease of both the respiratory system and the cardiovascular, digestive systems, nasopharynx, and oral cavity. Coughing up blood may be accompanied by other complaints: fever, shortness of breath, chest pains, palpitations, and a sharp drop in blood pressure. The appearance of these symptoms often helps the doctor diagnose and determine the cause of hemoptysis.

Causes of hemoptysis.
Most often, the presence of streaks of blood in the sputum with a strong paroxysmal cough during a cold in young people is not a formidable symptom. It’s just that with a strong cough, the vascular wall can be damaged and a small amount of blood gets into the lumen of the bronchi. Such hemoptysis disappears immediately after the inflammatory process in the bronchi subsides. However, even in this case, an ENT doctor’s examination and an x-ray of the chest organs is necessary in order to exclude another cause of hemoptysis, which we will now talk about.

• Quite often, hemoptysis is caused by diseases of the pharynx and paranasal sinuses. If blood appears in sputum, an ENT doctor’s examination is necessary to exclude a tumor of the larynx, pharynx or inflammation of the sinuses (sinusitis, frontal sinusitis)
• In 20% of cases, hemoptysis is caused by tumors of the bronchopulmonary system.
• Pulmonary embolism (damage to the lung tissue due to a blockage of a blood clot supplying this section of the pulmonary artery) can also cause hemoptysis.
• Severe heart disease: myocardial infarction, heart defects, cardiomyopathies can cause streaks of blood in the sputum. This is because the high pressure in the pulmonary vessels, which develops in heart disease due to the weakness of the heart muscle, leads to the expansion of the pulmonary vessels and their damage.
• Sometimes the appearance of blood in the mouth with diseases of the esophagus or stomach can be mistaken for hemoptysis.

Examinations that must be passed to establish the source of blood in the sputum
If blood in the sputum appears for the first time with a strong cough against the background of a cold, the patient should be examined by an ENT doctor and a chest x-ray should be performed.If, after the end of treatment, blood appears in the sputum again or its amount increases during treatment, then it is necessary to continue the examination.
One of the main methods of examining the organs of the chest, which allows you to correctly diagnose, is computed tomography of the chest organs, if necessary, it is carried out with contrast.
To determine the source of hemoptysis allows broncho-fibroscopy – a study in which a bronchoscope is inserted into the trachea and bronchi and the trachea, large and medium bronchi are examined.
If during these examinations the cause of the appearance of blood in sputum is not established, then an ultrasound examination of the heart, esophagogastroscopy is performed, the patient is examined by a dentist.
Despite the use of different methods, the cause of hemoptysis cannot be detected in 30-40% of cases.

90,000 Cough? Note the color of the sputum

Sputum is the mucus that is produced in the lungs and bronchial tree. Sputum is known to play an important role in preventing the entry of germs that can cause an infection in the respiratory tract.

Changes in the color of sputum can provide a large amount of information about what happens to the respiratory system during colds and other diseases. Below are the possible sputum color options:

• sputum is normally transparent, liquid and excreted in small quantities. It consists of water, salts, and a small number of cells of the immune system. Sputum production is not normally felt by a person;
• White sputum signals the occurrence of an inflammatory process in the respiratory tract.Initially, the mucous membrane swells, which slows down the passage of mucus through the airways. When this happens, the mucus becomes more viscous and turns white;
• Yellow mucus means that an active immune response to an infection in the respiratory tract begins. Leukocytes, cells of the immune system that are responsible for fighting bacterial infection, arrive at the site of inflammation;
• green sputum indicates a widespread and strong immune response.A mixture of a large number of white blood cells, bacteria and other cell components, gives mucus a green color;
• red and brown sputum can signal the presence of blood in it. Bleeding can be caused by rupture of small blood vessels in the respiratory system during coughing. But often the presence of blood in the mucus, especially with heavy or prolonged bleeding, may indicate a disease with a severe course. A bright red or pink tint in the sputum means that the bleeding is more recent, while the brown color of the mucus suggests more recent bleeding;
• A black tint of mucus may indicate a fungal infection in the airways and a weakened immune system.In this case, you should immediately seek the advice of a doctor.

Infection is not the only reason for changes in the consistency and color of sputum. The phlegm may be thicker if you are dehydrated, after sleep, or after severe stress. Allergic reactions can also change the color and texture of mucus.

The foamy structure of mucus indicates the presence of air bubbles in the sputum. Whitish-gray, frothy mucus can be a sign of chronic obstructive pulmonary disease and should be seen by a doctor.

If frothy sputum is pink in color, and is also accompanied by impaired breathing, increased sweating and chest pain, this may be a symptom of pulmonary edema and acute left-sided heart failure. This condition is life-threatening and in this case, an ambulance should be called immediately.

It is important to remember that self-diagnosis of the disease cannot be carried out based only on the color of the sputum. You should consult a specialist for advice and conduct a comprehensive study of the bronchi and lungs.

Based on materials from www.medicalnewstoday.com

90,000 Cough me here. How to recognize a disease by a cough? | Healthy life | Health

Cough is a protective reflex, the purpose of which is to cleanse the respiratory tract from microbes, mucus and foreign objects, – says the therapist of the highest category Irina Mechnikova . However, when the cleansing process is delayed, it is a legitimate concern.

Experts believe that the main criterion for a cough is its productivity (sputum discharge) or unproductiveness (lack of such).

Productive cough – moist, with discharge of sputum, cleansing the respiratory tract from pathogenic microorganisms.

Despite this, a wet productive cough is considered “good” and is a symptom of the most severe diseases.

Bronchitis – inflammation of the mucous membrane lining the inner surface of the bronchi.

With bronchitis, the mucous membrane not only becomes inflamed, but also swells, which is accompanied by the release of a large amount of mucus.Therefore, the cough with bronchitis is long and exhausting, often ends with vomiting. The most painful attacks are in the morning, after waking up, when the phlegm accumulated during the night leaves.

Pneumonia – damage to the lung tissue.

Cough appears on the 3-5th day of illness and is accompanied by pain in the chest (from the lesion of the lung tissue) during coughing and breathing and high fever. There is so much purulent sputum (sometimes streaked with blood) that a person can “choke” on it.Later, shortness of breath occurs – a consequence of respiratory failure and fatigue.

Bronchial asthma – chronic inflammatory airway disease

Asthma cough – paroxysmal, in which sharp and intermittent breaths alternate with long heavy exhalation, accompanied by whistling noises. Attacks occur at night or in the morning. During the day, seizures can occur when crying, laughing, or inhaling cold air. Another characteristic symptom of bronchial asthma is shortness of breath and profuse transparent vitreous sputum.

Pulmonary tuberculosis is a severe infectious disease that affects lung tissue.

Tuberculosis cough is chronic. He is usually deaf, persistent, with a metallic tinge. The nature of the cough in tuberculosis depends on the processes occurring in the lungs. At the onset of the disease, it is dry; as the disease progresses, it becomes wet. The most alarming sign is hemoptysis (the release of fresh blood with sputum), which indicates the progression of the infectious process in the lungs.

Indirect signs of tuberculosis are weight loss and increased sweating (especially at night).

Bronchiectasis – a chronic lung disease in which areas of deformation of the small bronchi are formed.

With this dangerous disease in the dilated sections of the bronchi, there is a chronic inflammatory process, accompanied by the formation of copious sputum. When a bacterial infection is attached, it suppurates. Most of all purulent, with an unpleasant odor of phlegm is released in the morning.With exacerbations, the temperature may rise.

Dry cough

Dry, irritating cough without phlegm usually occurs with sore throat and nasopharynx. A dry cough is characteristic of the onset of the disease and, with its normal course, after 2-3 days it is replaced by a wet one.

Pharyngitis – inflammation of the pharyngeal mucosa – the main provocateur of dry cough. Typical symptoms are sore throat, pain and a lump in the throat. The cough is persistent and painful, in children it often leads to vomiting.With proper therapy, it disappears in 3-5 days.

Laryngitis – inflammation of the larynx mucosa.

A barking, harsh, dry, debilitating cough is the hallmark of the disease. At the initial stage, it is accompanied by wheezing and noisy breathing. If the cough is not treated, it will be accompanied by a feeling of “tearing” of the throat, with proper therapy, dry cough becomes wet and after 7-10 days disappears.

False croup – a pathology in which the larynx becomes inflamed and narrowed.

This causes barking, paroxysmal coughing and shortness of breath. With croup, it is difficult to inhale (sometimes you can notice how the jugular fossa, the depression between the collarbones, is pulled inward when inhaling), exhalation remains normal.

Sinusitis – inflammation of the sinuses, in which mucus flows down the wall of the pharynx and irritates the cough receptors.

At the beginning of the treatment of sinusitis, the cough may worsen, as the edema subsides and the contents enter the nasal cavity, and as it recovers, it subsides.

… and other reasons

Sometimes a cough has nothing to do with viruses or infections of the nasopharynx and upper respiratory tract, but occurs for completely different reasons.

Heart disease

In case of heart failure, the blood circulation is disturbed. Blood stagnates in the lungs, thereby provoking a dry cough. Causes a cough and the use of certain drugs prescribed for arrhythmias and high blood pressure.

Diseases of the gastrointestinal tract

Chronic dry cough can be a symptom of reflux esophagitis – a disease caused by dysfunction of the stomach and esophagus, in which gastric juice is thrown into the esophagus.At night (when lying down) it reaches the pharynx and irritates the cough receptors. If the cough is accompanied by heartburn, belching with a sour taste (many take it for heartburn), pain in the larynx, the diagnosis is beyond doubt.

Nervous disorders

Excessive mental and physical exertion increases the tone of the neck muscles, and this provokes the onset of sore throat and cough – dry, prolonged, obsessive. A distinctive feature of psychogenic cough is that it rarely occurs in the morning, appears during the day, intensifies in the evening and never bothers at night.

90,000 Yellow sputum – causes, diagnosis and treatment

Yellow sputum is formed in the pathology of the bronchopulmonary system: acute and chronic purulent bronchitis, chronic obstructive pulmonary disease, lung abscess and bronchiectasis. Rare causes of the symptom include pulmonary eosinophilia, foreign bodies entering the respiratory tract, cancer and congenital diseases. The diagnostic plan includes X-ray and CT scan, bronchoscopy, spirometry, peak flowmetry.From laboratory methods, sputum examination, clinical and biochemical blood tests are used. Treatment is mainly medication – antibiotics, expectorants, bronchodilators and hormones. Operations are carried out if necessary.

Causes of yellow sputum

Purulent bronchitis

The acute process is characterized by a frequent moist cough accompanied by expectoration of dirty yellow phlegm. The discharge of the bronchi is liquid, with an unpleasant odor, occasionally there are separate yellow-green lumps in it.Coughing up in the morning after inhalation. Patients experience pain in the chest area, shortness of breath, fever.

In chronic bronchitis outside the period of exacerbation, a person occasionally coughs up yellow sputum, but mainly the cough ends in the discharge of cloudy mucus. An increase in coughing attacks and an increase in the amount of purulent discharge of a yellow color is noted with an exacerbation of inflammation. The symptom is combined with signs of intoxication, decreased performance.With a long history of bronchitis, broncho-obstructive syndrome develops.

Lung abscess

Discharge of yellow fetid sputum is characteristic of the second period of the disease – the breakthrough of an abscess into the draining bronchus. This happens suddenly: a dry cough is replaced by a wet one, then a large volume of liquid purulent discharge is coughed up with a “full mouth”. Taking into account the size of the infected cavity, up to 0.5-1 liters of yellow sputum can be released per day after opening the abscess.

There is a clear relationship between the onset of coughing up yellow pus and the general condition of the patient.In the first period, the person suffers from hectic fever, chills, severe chest pains and an excruciating unproductive cough. After sputum discharge, the state of health quickly improves, body temperature normalizes, signs of intoxication disappear.

Bronchiectasis

The appearance of thick yellow sputum is typical for mild to moderate forms of pathology, while in severe cases, green discharge with a putrid odor is observed. Coughing up of yellow pus occurs during an exacerbation of bronchiectasis (1-4 times a year).During the day, a person secretes up to 200 ml of yellow sputum, the bulk of which falls in the morning – after waking up, pus is coughing up “with a full mouth”.

During the day, coughing fits occur with the accumulation of secretions in the bronchi. During paroxysms, a small amount of yellow sputum mixed with mucus is released. When bronchial capillaries are injured due to a strong cough attack, blood streaks are noticeable in the purulent discharge. The patient is worried about shortness of breath and symptoms of respiratory failure, intoxication, exhaustion of the body.

Yellow sputum

Chronic obstructive pulmonary disease

Coughing up yellowish sputum indicates an exacerbation of the disease and the addition of a bacterial infection. Patients complain of increased cough paroxysms during the day, after which thick sputum is coughing up. Specific changes in the bronchopulmonary system and ventilation disorders contribute to the multiplication of microorganisms, therefore, purulent processes in COPD are observed several times a year.

Pulmonary eosinophilia

The pathognomonic symptom of this group of pathologies is the appearance of bright yellow (canary) sputum, which is caused by an increased content of eosinophils in the mucus. The symptom occurs in diseases of various etiology: parasitic pulmonary invasions (ascariasis, ankylostomosis, strongyloidosis), aspergillosis, acute and chronic eosinophilic pneumonia. Occasionally, yellow sputum leaves with an attack of atopic bronchial asthma.

Kartagener’s syndrome

Congenital anomaly in the structure of the epithelium of the respiratory tract manifests itself in children from the first months of life.Ciliary dyskinesia results in recurrent bacterial infections with purulent yellow discharge. At first, sputum is cleared up only during periods of exacerbation. After 2-3 years of age, the process becomes chronic, so scanty yellow discharge when coughing becomes a common symptom.

Foreign body of bronchi

Coughing up yellow sputum is possible with prolonged presence of a foreign object in the respiratory tract, which contributes to the development of purulent inflammation around it.The process is sluggish, therefore, when coughing, a meager amount of pus is released. The disease proceeds according to the type of chronic pneumonia with alternating periods of exacerbation and remission, when sputum stops coughing up.

Lung cancer

The appearance of yellow purulent discharge is typical of cancerous pneumonia, a serious complication of malignant neoplasia, which is caused by hypoventilation or atelectasis of a portion of the lung tissue. In addition to chest pains and intoxication syndrome, a person’s temperature rises to febrile numbers, and there is a frequent wet cough with yellow sputum.A similar clinical picture is observed with pulmonary metastases.

Diagnostics

In the presence of yellow sputum, the patient needs the help of a general practitioner or pulmonologist. During a physical examination of the patient, attention is paid to the participation of the chest in breathing, retraction of the intercostal spaces, local zones of pain on palpation. Auscultation of the lungs provides valuable information – a preliminary diagnosis is made by the presence of wheezing, hard or amphoric breathing. The following methods are included in the diagnostic scheme:

• X-ray examinations. On plain radiography of the OGK in two projections, you can see areas of infiltration in the lungs, a rounded shadow with a horizontal fluid level, and local compaction. Chest CT is done to diagnose tumors. Bronchography is done to confirm chronic bronchitis.
• Endoscopy of the bronchial tree. Bronchoscopy with visual examination of large and medium-sized bronchi is an informative method for diagnosing chronic inflammatory and fibrotic processes, detecting malignant tumors.During the examination, biopsies of suspicious areas of tissue are taken for examination under a microscope.
• Functional Techniques. In chronic diseases of the bronchopulmonary system, external respiration is impaired. To detect pathology, spirometry is prescribed, with the help of which the forced expiratory volume, vital capacity of the lungs, and other indicators are assessed. For express research, peak flowmetry is shown.
• Sputum tests. The cytological method is aimed at identifying eosinophils and neutrophils, specific crystals and mucin spirals in the tracheobronchial secretion. Bacterial culture with an antibioticogram is used to determine the type of bacterial pathogen that caused the disease.

Additional diagnostic methods include a hemogram, which determines leukocytosis with increased ESR, eosinophilia, lymphopenia, as well as a biochemical blood test, which determines acute phase parameters, the ratio of plasma proteins.In chronic bronchopulmonary processes, the work of the heart is often disrupted, therefore, ECG and EchoCG are included in the examination plan.

Sputum analysis

Treatment

Help before diagnosis

Coughing up yellow phlegm indicates a serious respiratory injury, so a visit to the doctor should not be postponed. To relieve symptoms, pus should be allowed to drain freely. For this, it is recommended to take special drainage positions, to massage the chest.It is forbidden to use antitussive drugs that contribute to the stagnation of pathological secretions in the bronchial tree.

Conservative therapy

In most cases, yellow sputum is purulent, therefore, patients need etiotropic antibiotic therapy. Medicines are selected empirically immediately after the diagnosis of the disease, and after receiving the results of the antibioticogram, the therapy plan is adjusted. Against the background of the destruction of pathogenic bacteria, purulent sputum ceases to stand out.For pathogenetic and symptomatic treatment use:

• Expectorants . They enhance the discharge of thick sputum and dilute it, accelerate the sanitation of the bronchial tree. Thanks to the intake of mucolytics and secretomotor drugs, recovery is faster.
• Corticosteroids . Hormone therapy is justified in case of eosinophilic lung damage. The drugs quickly stop the inflammatory reaction and reduce the symptoms of allergies.Glucocorticosteroids are administered as aerosols or parenterally.
• Bronchodilators . The release of yellow sputum in bronchiectasis or COPD requires the appointment of beta-adrenergic agonists, anticholinergics. They are injected using nebulizers or spacers to ensure targeted delivery of the drug to the bronchi.

Surgical treatment

In bronchiectasis and other chronic pathologies, when conservative measures are ineffective, resort to medical bronchoscopy and sanitation of the bronchial tree.After washing and removing the pus, the patient’s condition improves. When lung diseases are complicated by pleurisy, a puncture is performed to remove exudate, targeted administration of drugs.

Large abscesses, localized bronchiectasis, and areas of suppuration with a complicated course of Kartagener’s syndrome are subject to prompt removal.