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Severe cough with phlegm

, medical expert
Last reviewed: 17.10.2021
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When there is a strong cough with sputum, the first thing to keep in mind: the cough itself, and the significant, unintended by the norm, the volume of excretions in it are the body's response to the presence of a foci of infection or irritation of the mucosa in the airways.

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Causes of severe cough with phlegm

The most common causes of severe cough with sputum, that is, with pathologically increased formation and secretion of mucous secretions, are such diseases as acute respiratory disease, acute bronchitis, pneumonia, exudative pleurisy and pleural empyema, bronchiectatic disease, chronic obstructive pulmonary disease (collective name for chronic bronchitis and emphysema, usually caused by smoking).

For the chronic form of bronchitis due to increased mucus formation in the bronchi, their inflammation and pathological changes in the tissues of the bronchi and lungs is characterized by a strong cough with sputum and with blood, which appears due to damage to the blood vessels located in the mucosa. When the disease worsens, sputum may have purulent inclusions in its composition. However, doctors warn: the presence of blood in the sputum may indicate such pathologies as bronchiectasis or pulmonary tuberculosis. And in the case of a purulent foci (abscess) in the lungs during its breakthrough and the ingress of pus into the bronchi, the sputum, which goes away when coughing, will have a characteristic putrefactive smell and a greenish color.

In addition to shortness of breath, wheezing and attacks of weakening respiratory functions of the bronchi, a strong cough with sputum discharge (often at night) accompanies bronchial asthma associated with respiratory tract reaction to allergens.

With edema of the lungs, there is also an intense productive cough. And with a pulmonary etiology of this state after coughing, it becomes easier for a person. And when the swelling of the lung tissue is caused by left-sided heart failure with stagnation of blood in a small circle of blood circulation, the cough does not bring relief, and in severe cases, the sputum is colored pink.

Also, a strong cough with sputum is one of the symptoms of cystic fibrosis - an incurable genetically determined disease that affects mucus-releasing organs. An indication of the respiratory form of this disease is an intense paroxysmal cough with mucopurulent sputum.

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Strong cough with sputum

Sputum is a secretion that forms in the trachea and in the bronchi. They are produced by special glands of tracheobronchial walls together with goblet cellular structures. Such discharges are also characteristic of healthy people, but in a much smaller number. A healthy secret has bactericidal abilities and serves as a natural prophylaxis for many respiratory diseases. Normally, mucus helps to remove from the respiratory tract toxic products, exfoliated epithelial cells and dust particles trapped in the respiratory system during inspiration. The mucous secret is removed outwardly towards the larynx with the help of ciliated epithelium and exhaled airflow. The function of the cilia can depend on the temperature indexes, on the acidity of the medium, and on the mucus yield on the density and secretion properties.

A strong cough with hard-to-recover sputum is typical for bronchial asthma (with no phlegm, vitreous sputum), for obstructive bronchitis or cystic fibrosis (phlegm-mucous sputum). The most severe excretion of sputum is observed with pulmonary cystic fibrosis.

A strong cough of sputum with blood in small amounts can mean that a small blood vessel in the airway burst during an attack. However, such a symptom may be a sign of a stagnant phenomenon in the lungs, an infectious inflammation such as pneumonia or tuberculosis, the presence of a neoplasm in the lungs. If the patient does not make serious complaints, and blood in the sputum is not a constant symptom, then, as a rule, there is no cause for concern. However, the repetition of secretions with blood, as well as the addition of other signs of disease can speak of a serious pathology. What should alert:

  • increased body temperature;
  • persistent prolonged cough that does not respond to conventional treatment;
  • regular appearance of impurities in mucous secretions;
  • increased sweating;
  • appearance in the lungs of various wheezing, whistles, bubbling sounds.

If these symptoms appear, you should immediately contact the appropriate medical specialist - therapist or pulmonologist.

Who to contact?

Diagnosis of severe cough with phlegm

The wording "symptoms of a strong cough with phlegm" from a medical point of view is not entirely correct, since the cough itself - slight or strong, dry or with phlegm - is a symptom. Developing symptoms of a strong cough with phlegm combined with other symptoms and taking into account the nature of the cough phlegm enable doctors to establish a diagnosis.

Thus, with bronchitis and pneumonia, phlegm first mucous, and then mucopurulent (with croupous pneumonia - rust color); With bronchial asthma, thick mucous sputum, as a rule, does not have a definite color. If the consistency of the cough secretion is liquid and foam is formed, then it is most likely due to the swelling of the lung tissue. About a sputum with a blood already it was spoken above.

Diagnosis of a strong cough with phlegm - the determination of the cause of its occurrence - includes mandatory general and biochemical blood analysis, as well as the study of serum for tuberculosis, antigens, eosinophils, mycoplasma. Sputum examination on the microflora should be carried out without fail.

Diagnostic standard - the use of fluoroscopic examination of the chest in patients with complaints of severe cough with sputum, and the removal of an electrocardiogram. To determine the functional level of the respiratory system, spirometry is indispensable, and for the purpose of examining the bronchial state, the method of bronchography is used - radiography of bronchi with contrast material. If necessary, endoscopic examination of the bronchi (bronchoscopy), ultrasound and computed tomography of the bronchi and lungs.

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Treatment of severe cough with phlegm

In practice, the treatment of a strong spit with sputum means symptomatic therapy aimed at reducing the viscosity of sputum and removing it from the respiratory tract. For this, medicines with an expectorant effect are used.

Acetylcysteine (Acestin, ACTS, Fluimutsil, Tussikom, Mukobene, Mukoneks, etc.) - adults and children after 14 years, 0.2 g 3 times a day. Effervescent tablets ATSTS - 1-2 pieces twice a day. Tussikom (20% solution) is designed for inhalation - 2-5 ml per procedure, which is recommended for a quarter of an hour up to four times a day.

Bromhexin chloride (Bromgexin, Bisolvon, Mugotsil, Mukovin, Solvin, etc.) in tablets of 8 mg - adults and children over 14 years of 1-2 tablets three times a day; children 6-14 years - one tablet three times a day, 3-6 years - 4 mg three times a day. There is a solution for inhalations, which should be done twice a day: adults - 4 ml, children 10 years and older - 2 ml, 6-10 years - 1 ml, 2-6 years - 10 drops, less than 2 years - 5 drops per procedure.

Mucolytic drug Ambroxol hydrochloride (Ambroxol, Ambrohexal, Lazolvan, Bronchoprot, Mukozan, Mukovent, etc.) - adults and children over 12 years, one tablet 2-3 times a day after eating; in the form of syrup - 10 ml 3 times a day. Children 6-12 years of age, the dose is reduced by half, 2-5 years - the fourth part of the adult dose twice a day. Pregnant drugs based on ambroxol hydrochloride should not be used in the first trimester. This remedy can cause dry mouth, heartburn, pain in the stomach, nausea. It should also be taken into account that all preparations containing this active substance increase the absorption of antibacterial agents of bronchial mucosa.

Muciltin tablets are prescribed at 0,05-0,1 g 2-3 times per day (before meals); Tablets Terpinhydrate - 0.25-0.5 g three times a day. Potassium iodide (1-3% solution of potassium iodide) for the expectoration of sputum, doctors recommend taking two tablespoons 3-4 times a day. This drug is contraindicated for pulmonary tuberculosis.

In chronic obstructive pulmonary disease and bronchial asthma, a strong cough with sputum is treated with inhalations with drugs of the group of m-holinoretseptor blockers that dilate the bronchi and reduce the production of mucus. For example, Atrovent (an aerosol with an active ingredient ipratropium bromide) is prescribed 3-4 inhalations per day.

In cystic fibrosis, drainage of bronchial tubes, inhalation with corticosteroids, administration of drugs, for example, Pulmozyme in the form of daily inhalations (using a nebulizer), 2.5 mg once a day.

A strong cough with sputum discharge can also be treated with traditional breast pills with such medicinal plants as licorice root, althea root, oregano and coltsfoot, plantain large (leaves), blackberry (flowers): a tablespoon of dry collecting a glass of boiling water. Insist for 1-1.5 hours and take 3-4 tablespoons after meals several times a day. Coughing up sputum is also promoted by steam inhalations with a decoction of leaves of eucalyptus, sage, peppermint (50 grams per cup of boiling water) or with eucalyptus oil (4-5 drops per 200 ml of water).

Patients with chronic bronchitis, bronchial asthma, chronic obstructive pulmonary disease require functional treatment in a sanatorium using aerotherapy and barotherapy, respiratory gymnastics, postural drainage of respiratory organs, chest massage, etc.

Herbs from strong cough with phlegm

Expectorant medications for reflex action can be a collection of medicinal herbs and extracts from them. Such medicines increase and activate the release of mucous secretions from the trachea and bronchi. The medicinal group of preparations based on herbs is quite extensive, because expectorant abilities are possessed by many herbs. Medicines based on licorice, thyme, thyme, althea, pine kidney, mother-and-stepmother, elecampane, thermopsis, oregano, anise, sundew, plantain, ledum, violet, etc. Are known.

Plants and extracts from them are used in the composition of various chest charges and mixtures, as well as potions, tablets, syrups.

  1. Dr. Mom can be presented with tablets, lozenges or syrup based on elecampane, aloe, basil, pepper, ginger root, turmeric, licorice, nightshade. It is a combined anti-inflammatory and expectorant drug, bronchodilator, secretolytics. Pastilles and tablets are used from 14 years, and syrup is used for children from three years of age. Small children drink this syrup with pleasure, since it comes with various attractive fruit and berry flavors.
  2. Mukaltin is nothing more than an extract from an althea plant. This drug has long been known for its anti-inflammatory and expectorant action, in addition, mukaltin enhances the peristaltic movements of bronchioles and stimulates the secretory activity of the bronchi. In addition to the althaea, tablets contain baking soda, which liquefies mucus and increases the amount of secretions.
  3. Thermopsis - is part of the long-known "Tablets from a cough". These tablets are devoid of any additional harmful substances, since they contain only thermopsis and baking soda - the leading expectorant of alternative medicine.
  4. Other expectorants on a plant basis - they can include more expensive foreign drugs. These are such medicines as bronchicum, eucabal, gedelix. Such medicines are prepared on the basis of the above mentioned herbs and have a similar composition with similar domestic preparations.

Herbs when coughing help not only improve the condition of the patient, but also support its immunity. So the body will be easier to cope with the disease. The main thing is to remember that a strong cough with sputum should be treated as quickly as possible, without waiting for self-healing. If everything is done correctly, that is, to conduct competent and timely treatment, then recovery will come soon and without negative consequences.

Prophylaxis and prognosis of severe cough with phlegm

Prevention of severe cough with phlegm is the prevention of any diseases of the upper respiratory tract, and in case of their occurrence - adequate treatment, so that the usual, at first glance, cold does not pass into bronchitis or pneumonia.

Without observing the rules of personal hygiene, without proper care for residential and industrial premises is indispensable, because the infection and contaminated with harmful substances air enter the body during its inhalation.

In order not to develop chronic bronchitis or chronic obstructive pulmonary disease, it is first of all necessary to give up smoking. It is also necessary to comply with all the precautions provided for work in harmful production conditions: with increased dust content of the air with coal, cement, asbestos, flour dust, and gas contamination with ammonia, chlorine, etc. It is necessary to undergo fluorography once a year - for the timely detection of changes in the lungs , associated with tuberculosis.

No matter how corny it may seem, but a healthy lifestyle - a sufficient amount of vitamins in food (in winter - the use of vitamin complexes), physical education, recreation in the open air, the rejection of bad habits - the most accessible preventive measures for diseases accompanied by a strong cough with sputum discharge.

The prognosis of a strong cough with phlegm - with the timely and correct treatment of acute bronchitis or pneumonia - is absolutely positive. What can not be said about the protracted infectious diseases of the respiratory system, which pour out into the chronicle.

According to medical statistics, in Ukraine, chronic obstructive pulmonary disease (COPD) is present in almost 5% of adults and contributes to the disability of the population. And according to WHO, from 1979 to 2009 the lethality due to this disease on a global scale has increased by more than 160%.

If you or your relatives have a strong cough with phlegm within a month or more, please consult a pulmonologist or a therapist.

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