Chesty cough

Characterised by expelling mucus or phlegm from the chest


Dr. Jen Tan
@AVogelUK


17 August 2018

What is a chesty cough?

Chesty coughs are characterised by an excessive amount of mucus in the chest. For this reason, they are sometimes referred to as mucus coughs.

Doctors classify chesty coughs as ‘productive coughs’ as the act of coughing brings up mucus from the chest. This is distinct from dry coughs and tickly coughs which are both ‘non-productive’ coughs resulting from irritation at the back of your throat or pharynx.

Why do we produce mucus?

Oxygen is brought into our bloodstream via the lungs. The air we breathe moves firstly through the large and medium sized tubes known as the bronchi and bronchioles. These tubes are lined by mucous membranes, so-called because they produce a layer of mucus which covers the surfaces of the tubes.

This mucus lining has a purpose – it traps unwanted particles such as dust, bacteria and viruses entering the respiratory tract and in this way, helps protect the body.

When the common cold or flu viruses enter the respiratory system, more mucus is produced in an attempt to wash away the bugs and help fight off the infection. This increased mucus can gather in the respiratory system and a cough reflex is triggered to help remove the extra phlegm.

Causes of chesty coughs

There are a number of health conditions and lifestyle habits which can give rise to excessive mucus production is seen in the respiratory system. These include:

  • Cold and flu – A bout of cold or flu is most often caused by a virus and a lingering viral infection can damage the mucous membranes lining your respiratory tract giving rise to excess mucous.  
  • Secondary infections – if we don’t manage the symptoms of viral infections effectively, they can easily translate into secondary infections. More often than not, secondary infections are caused by bacteria. Bacterial infections can affect the upper or lower respiratory tract and can give rise to conditions such as bronchitis, pneumonia or chest infections. If you cough up yellow or green phlegm then this signals that at infection may be at the root of the cause and you should visit your doctor.
  • Other medical conditions – conditions affecting the lungs may have been apparent from a young age such as cystic fibrosis or asthma or they may have developed over time as with chronic obstructive pulmonary disease (COPD). Infectious lung conditions such as tuberculosis (TB) or conditions affecting the heart may also give rise to a chesty cough.
  • Smoking – although smoking may initially give rise to a dry cough, longer-term you could develop a ‘smoker’s cough’ which is typically a hacking, chesty cough. Smoking bungs up our airways with chemicals, irritates the lining of our lungs and also prevents alveoli, the unique structure of our lungs, from moving freely. Normally these would easily remove any excess mucous or debris from our lungs but, as they become clogged, more debris remains in the lung. Additionally, we know the act of smoking adds more debris and chemical waste to our lungs anyway so this will only add to the problem. A smoker’s cough is often persistent as your reflexes work hard to try and clear the lungs but to no avail. This can often develop into more chronic conditions such as COPD.

Symptoms of a chesty cough

Your chesty cough will most probably be the result of infection by cold and flu viruses and if this is the case, it is likely you will experience other symptoms of the cold or flu such as a blocked nose or fever.

However, you may experience other symptoms associated with a chesty cough including:

  • Bringing up phlegm from your chest. This occurs as you cough
  • A rattling sound as you breath in. This can also often be felt further down in the chest as a result of mucous and phlegm that has become dislodged
  • Sore throat. Mucus produced when you cough can irritate the lining of your throat causing it to become painful
  • Feeling more breathless than normal. This can occur as a result of your airways being blocked with excess phlegm
  • Pain in the chest. This arises as the muscles become strained or ‘bruised’ because of coughing. In rare circumstances, it has also been known for ribs to be fractured during prolonged and vigorous coughing 
  • Muscular pain in the abdomen. Coughing can also strain your abdominal muscles.

Treating a chesty cough

Home remedies

 If a chesty cough has troubled you for less than 3 weeks, some simple home remedies may help to get your symptoms under control:

  • Plain and simple – enough water! It’s important to stay hydrated if you’re fighting an infection anyway, but staying properly hydrated can also help keep excess mucous looser so you can cough it up more easily
  • Hot water & honey – good quality honey, such as manuka honey is soothing to the area but also has unique anti-bacterial properties. Add a slice of lemon for some added vitamin C and extra immune support. Vitamin C is important for helping to maintain the health of mucous membranes and the normal functions of our immune cells1
  • Gargling with salt water – this may help to stop infections in their tracks
  • Inhaling steam from hot water – this again helps to loosen excess mucous and helps you expel it more easily, it also very relaxing which is helpful during a tough time of recovery
  • Sleep with your head slightly raised – this makes breathing easier during the night and helps you expel mucous more naturally as opposed to lying flat
  • Ensure you don’t push yourself too hard! Now is the time you need rest more than ever. Rest, keep warm and get sufficient sleep to help your immune system to operate at its best.2

Herbal remedies 

 When it comes to chesty coughs, sometimes, mucus can feel ‘stuck’ in your chest and although you might feel like you a ‘chesty cough’, nothing comes up when you cough. In these situations, you need something to help break up or shift the mucus.  

The herbs such as ivy and thyme act as expectorants and so are especially useful here - these have been used to treat chesty coughs for this reason for many years. 

Bronchoforce combines fresh extracts of ivy and thyme and can be taken by adults and children over 12, up to 5 times daily to help treat the symptoms of a chesty cough. 

If a viral or bacterial infection is at the root of the cause an extract of Echinacea, such as in Echinaforce, may work well in combination with Bronchoforce to help manage your symptoms and support recovery.

Conventional remedies

 If your cough has persisted for more than 3 weeks, some conventional medicine may be required to help get your symptoms under control:

  • Decongestant or expectorant medications - these may help to break up or loosen some of the phlegm clogging up your chest so that it is then easier to cough up.
  • Antibiotics - these may be required if your cough has developed into a secondary, bacterial infection. If the root of the cause is viral though, the conventional medicine options may be more limited and antibiotics won’t help.
  • Other cough medicines – some medicines may help to suppress coughs but when it comes to chesty coughs it is important to expel any stubborn mucous. Please note it’s also important to identify the underlying cause of your cough rather than simply mask the symptoms. Please note that certain cough medicines may not be helpful as this is dependent on your symptoms, for example, cough syrups or anti-histamines may not be the best option for a chesty cough. 
  • Painkillers – these may help with the irritation caused by persistent coughing but often won’t help tackle the underlying cause. We must also be careful not to take painkillers unnecessarily.

Please note, if you find medicine prescribed by the doctor isn’t helping it, you should return for further investigation. It’s important to help identify the underlying cause when it comes to chesty coughs.

What should I look out for?

Chesty coughs can also be caused by conditions other than cold or flu infections. It would be time to visit your doctor if you experience any of the following symptoms:

  • If a child under 2 years is coughing – self medication isn’t suitable here
  • You’re producing green or yellow phlegm or foul smelling mucous and aren’t yet being treated for a bacterial infection
  • You are pregnant and have developed a persistent cough (many remedies and medicines may not be suitable for you so best to double check)
  • Suffer from a persistent, unexplained cough (longer than 3 weeks)
  • Severe cough that’s getting worse rather than better
  • Coughing up blood
  • Shortness of breath
  • Pain in your chest with your cough
  • Changes in your voice
  • Swelling or lumps forming in your neck
  • Unexplained weight loss accompanying your cough
  • Notice a fever with increase temperature or headaches

 

1. https://www.ncbi.nlm.nih.gov/pubmed/16373990

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/

Initial publication date: 18/07/2013 Update on: 17/08/18

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Did you know?

A tickly cough is technically termed as ‘non-productive.’ This is because, unlike a chesty cough, tickly or dry coughs typically bring up little to no phlegm.

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