A bad cough with phlegm

When a strong cough with phlegm occurs, the first thing to keep in mind is that both the cough itself and the significant, unforeseen volume of discharge are the body's response to the presence of a source of infection or irritation of the mucous membrane in the respiratory tract.

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Causes of severe cough with phlegm

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

Chronic bronchitis is characterized by a strong cough with sputum and blood, which appears due to damage to the blood vessels located in the mucous membrane, due to increased mucus formation in the bronchi, their inflammation and pathological changes in the tissues of the bronchi and lungs. During an exacerbation of the disease, sputum may contain purulent inclusions. However, doctors warn: the presence of blood in sputum may indicate pathologies such as bronchiectasis or pulmonary tuberculosis. And in the case of a purulent focus (abscess) in the lungs, when it breaks through and pus gets into the bronchi, the sputum that comes off when coughing will have a characteristic putrid odor and a greenish color.

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

Intense productive cough is also observed with pulmonary edema. Moreover, with pulmonary etiology of this condition, after coughing, the person feels better. But when the swelling of the lung tissue is caused by left-sided heart failure with blood stagnation in the pulmonary circulation, coughing 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 genetic disease that affects the mucus-producing organs. A sign of the respiratory form of this disease is an intense paroxysmal cough with mucopurulent sputum.

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Severe cough with sputum production

Sputum is a secretion that is formed in the trachea and bronchi. It is produced by special glands of the tracheobronchial walls together with goblet cell structures. Such secretions are also typical for healthy people, but in much smaller quantities. Healthy secretion has bactericidal properties and serves as a natural prevention of many respiratory diseases. Normally, mucus helps remove toxic products, exfoliated epithelial cells and dust particles that enter the respiratory organs during inhalation from the respiratory tract. Mucous secretion is removed progressively towards the larynx with the help of ciliated epithelium and exhaled air flow. The function of the cilia may depend on temperature indicators, on the acidity of the environment, and the output of mucus - on the density and properties of the secretion.

A severe cough with difficult to separate sputum is characteristic of bronchial asthma (without impurities, glassy), obstructive bronchitis or cystic fibrosis (sputum is purulent-mucous). The most difficult sputum removal is observed in pulmonary cystic fibrosis.

A strong cough with small amounts of blood in the sputum may mean that a small blood vessel in the respiratory tract has burst during an attack. However, such a symptom may be a sign of congestion in the lungs, an infectious inflammation such as pneumonia or tuberculosis, or the presence of a tumor in the lungs. If the patient does not present serious complaints, and blood in the sputum is not a constant symptom, then, as a rule, there is no reason to worry. However, the recurrence of bloody discharge, as well as the addition of other signs of disease, may indicate a serious pathology. What should alert you:

• increase in body temperature;
• persistent, long-term cough that does not respond to conventional treatment;
• regular appearance of impurities in mucous secretions;
• increased sweating;
• the appearance of various wheezing, whistling, and gurgling sounds in the lungs.

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

Diagnosis of severe cough with phlegm

The wording "symptoms of a severe cough with sputum" is not entirely correct from a medical point of view, since the cough itself - minor or severe, dry or with sputum - is a symptom. The symptoms of a severe cough with sputum in combination with other signs and taking into account the nature of the coughed up sputum allow doctors to establish a diagnosis.

Thus, with bronchitis and pneumonia, the sputum is first mucous, and then mucopurulent (with lobar pneumonia - rust-colored); with bronchial asthma, thick mucous sputum is coughed up, usually without a specific color. If the consistency of the coughed up secretion is liquid and foam is formed, then with a high degree of probability this is due to edema of the lung tissue. Sputum with blood has already been discussed above.

Diagnosis of a severe cough with sputum - determination of the cause of its occurrence - includes mandatory general and biochemical blood tests, as well as a study of blood serum for tuberculosis, antigens, eosinophils, mycoplasma. A study of sputum for microflora must be carried out without fail.

The diagnostic standard is the use of the X-ray method of examination of the chest organs in patients with complaints of a strong cough with sputum production, as well as taking an electrocardiogram. Spirometry is indispensable for determining the functional level of the respiratory system, and bronchography is used to examine the condition of the bronchi - X-ray examination of the bronchi with a contrast agent. If necessary, endoscopic examination of the bronchi (bronchoscopy), ultrasound and computed tomography of the bronchi and lungs are performed.

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Treatment of severe cough with phlegm

In practice, treatment of severe cough with sputum means symptomatic therapy aimed at reducing the viscosity of sputum and facilitating its removal from the respiratory tract. For this purpose, drugs with an expectorant effect are used.

Acetylcysteine (Acestin, ACC, Fluimucil, Tussicom, Mukobene, Mukonex, etc.) - for adults and children over 14 years old, 0.2 g 3 times a day. Effervescent tablets of ACC - 1-2 pieces twice a day. Tussicom (20% solution) is intended for inhalation - 2-5 ml per procedure, which is recommended to be carried out for a quarter of an hour up to four times a day.

Bromhexine chloride (Bromhexine, Bisolvon, Mugocil, Mukovin, Solvin, etc.) in tablets of 8 mg - adults and children over 14 years old 1-2 tablets three times a day; children 6-14 years old - one tablet three times a day, 3-6 years old - 4 mg three times a day. There is a solution for inhalation, which should be carried out twice a day: adults - 4 ml, children 10 years and older - 2 ml, 6-10 years - 1 ml, 2-6 years - 10 drops, under 2 years - 5 drops per procedure.

Mucolytic drug Ambroxol hydrochloride (Ambroxol, Ambrogeksal, Lazolvan, Bronchopront, Mukosan, Mucovent, etc.) - adults and children over 12 years old, one tablet 2-3 times a day, after meals; in the form of syrup - 10 ml 3 times a day. For children 6-12 years old, the dose is reduced by half, 2-5 years - a quarter of the adult dose twice a day. Pregnant women should not use drugs based on ambroxol hydrochloride in the first trimester. This drug can cause dry mouth, heartburn, pain in the stomach, nausea. It should also be taken into account that all drugs containing this active substance increase the absorption of antibacterial agents by the bronchial mucosa.

Mucaltin tablets are prescribed at 0.05-0.1 g 2-3 times a day (before meals); Terpinhydrate tablets - 0.25-0.5 g three times a day. Doctors recommend taking potassium iodide (1-3% potassium iodide solution) to thin sputum, two tablespoons 3-4 times a day. This drug is contraindicated in pulmonary tuberculosis.

In chronic obstructive pulmonary disease and bronchial asthma, severe cough with sputum is treated with inhalations of drugs from the group of m-cholinergic receptor blockers, which dilate the bronchi and reduce mucus production. For example, Atrovent (aerosol with the active substance ipratropium bromide) is prescribed 3-4 inhalations per day.

In case of cystic fibrosis, bronchial drainage, inhalations with corticosteroids, and taking medications such as Pulmozyme in the form of daily inhalations (using a nebulizer) - 2.5 mg once a day are prescribed.

A severe cough with sputum production can also be treated with traditional chest infusions with medicinal plants such as licorice root, marshmallow root, oregano and coltsfoot, plantain (leaves), black elder (flowers): one tablespoon of dry infusion per glass of boiling water. Infuse for 1-1.5 hours and take 3-4 tablespoons after meals several times a day. Coughing up sputum is also facilitated by steam inhalations with a decoction of eucalyptus leaves, sage, peppermint (50 g per glass 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 setting using aero- and barotherapy, breathing exercises, postural drainage of the respiratory organs, chest massage, etc.

Herbs for severe cough with phlegm

Expectorant medications with a reflex action can be herbal mixtures and extracts from them. Such medications increase and activate the release of mucus from the trachea and bronchi. The medicinal group of herbal preparations is quite extensive, because many medicinal herbs have expectorant properties. Medicines based on licorice, thyme, wild savory, marshmallow, pine buds, coltsfoot, elecampane, thermopsis, oregano, anise, sundew, plantain, wild rosemary, violet, etc. are known.

Plants and extracts from them are used in various breast infusions and mixtures, as well as potions, tablets, and syrups.

1. Doctor Mom can be presented as tablets, lozenges or syrup based on elecampane, aloe, basil, pepper, ginger root, turmeric, licorice, nightshade. This is a combined anti-inflammatory and expectorant drug, bronchodilator, secretolytic. Lozenges and tablets are used from the age of 14, and syrup - for children from three years. Small children drink this syrup with pleasure, as it is produced with various attractive fruit and berry flavors.
2. Mucaltin is nothing more than an extract from the marshmallow plant. This drug has long been known for its anti-inflammatory and expectorant effects, in addition, mucaltin enhances the peristaltic movements of the bronchioles and stimulates the secretory activity of the bronchi. In addition to marshmallow, the tablets contain baking soda, which thins mucus and increases the amount of secretions.
3. Thermopsis is a part of the long-known "Cough Tablets". These tablets are free of any additional harmful substances, as they contain only thermopsis and baking soda - the leading expectorant of folk medicine.
4. Other herbal expectorants - these include more expensive foreign drugs. These are such drugs as bronchicum, eucabal, gedelix. Such medications are prepared on the basis of the herbs listed above and have a similar composition to similar domestic drugs.

Herbs for coughs not only help improve the patient's condition, but also support his immunity. This will make it easier for the body to cope with the disease. The main thing to remember is that a strong cough with phlegm should be treated as quickly as possible, without waiting for self-healing. If everything is done correctly, that is, if competent and timely treatment is carried out, then recovery will come quickly and without negative consequences.

Prevention and prognosis of severe cough with phlegm

Prevention of a severe cough with phlegm is the prevention of any diseases of the upper respiratory tract, and if they occur, adequate treatment so that a common, at first glance, cold does not develop into bronchitis or pneumonia.

It is impossible to do without observing the rules of personal hygiene and proper care of residential and industrial premises, since infection and air contaminated with harmful substances enter the body through the process of inhalation.

In order to prevent the development of chronic bronchitis or chronic obstructive pulmonary disease, you should, first of all, give up smoking. It is also necessary to observe all precautions provided for when working in hazardous production conditions: with increased dustiness of the air from coal, cement, asbestos, flour dust, as well as gas pollution 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.

As trivial as it may seem, a healthy lifestyle - a sufficient amount of vitamins in food (in winter - the use of vitamin complexes), physical exercise, outdoor recreation, giving up bad habits - are the most accessible measures for everyone to prevent diseases accompanied by a strong cough with sputum.

The prognosis for a severe cough with phlegm - with timely and correct treatment of acute bronchitis or pneumonia - is absolutely positive. Which cannot be said about protracted infectious lesions of the respiratory organs, which result in a chronic condition.

According to medical statistics, almost 5% of adults in Ukraine suffer from chronic obstructive pulmonary disease (COPD) and contribute to the population's disability. And according to WHO, from 1979 to 2009, the mortality rate due to this disease increased by more than 160% worldwide.

If you or your loved ones have a severe cough with phlegm that does not go away for a month or more, please contact a pulmonologist or therapist.