Moist Cough : Causes, Symptoms, Diagnosis & Treatment

• Causes Of Wet Cough
• Bronchitis
• Bronchiectasis
• Bronchial Asthma
• Pneumonia
• Other Pulmonary Pathology
• Inflammation Of The Larynx And Trachea
• Pulmonary Edema
• Oncological Diseases
• Survey
• Symptomatic Therapy

A wet cough is a cough that produces mucus or mucopurulent sputum. The symptom develops against the background of pain in the chest (thoracalgia), wheezing, signs of general intoxication of the body. This type of cough is observed in bronchitis and other bronchopulmonary pathologies, respiratory infections, heart failure. To determine the root cause of the disorder, x-rays, spirography, bronchoscopy, and laboratory tests are performed. In order to reduce discomfort, inhalations, the use of mucolytics, expectorants, and anti-inflammatory drugs are prescribed.

Causes of wet cough

Sputum secreted after a cough attack is usually represented by a mucous secretion, which is formed when the lower respiratory tract (trachea, bronchi, bronchioles) is affected. With the development of inflammation, the production and removal of mucus is enhanced to clear the respiratory system of pathogens or foreign particles. In turn, the mucus stimulates the nerve endings, causing coughing. After the discharge of a wet secret (mucus or pus), the state of health improves somewhat.

Bronchitis

In acute forms of bronchitis, the cough is initially dry. Sputum begins to depart on the 2nd-3rd day of the disease, while the condition improves markedly, pain in the chest area subsides. A specific productive cough is characteristic of such types of bronchial inflammation as:

• Obstructive bronchitis . It often occurs in children under 3 years of age against the background of a viral infection. Characterized by intense coughing attacks, after which a small amount of viscous secretion is separated. It is difficult for the child to breathe, bulging of the intercostal spaces and swelling of the wings of the nose during breathing are characteristic. On exhalation, a “whistling” sound and quiet wheezing are heard. Exacerbations more than 3 times a year indicate a relapsing course.
• Asthmatic bronchitis . A typical symptom is attacks of painful coughing lasting several minutes, after which viscous vitreous sputum is released and relief occurs. Before a coughing paroxysm, the throat slightly tickles, there is a slight malaise, nasal congestion. Exacerbation is provoked by pungent odors, inhalation of dust, contact with animal hair, plant pollen.
• Atrophic bronchitis . In the classical variant of the disease, a painful dry cough is first observed, associated with physical exertion, inhalation of pollutants or household dust. In the future, a small or moderate amount of sputum, resembling mucus in consistency, begins to be expectorated. With an exacerbation, the temperature rises to subfebrile figures, there are slight chills, chest pain, shortness of breath.
• Purulent bronchitis . During an attack, sputum of yellow or greenish color with an unpleasant odor is abundantly discharged. In acute inflammation and during the period of exacerbation of the chronic process, the volume of purulent secretion released per day is 150-25 ml. Cough is combined with fever over 38°C, sweating, weakness. Disturbed by intense chest pain, a feeling of lack of air during physical activity.

Bronchiectasis

With the outcome of chronic purulent bronchitis in bronchiectasis, coughing attacks become permanent, and purulent sputum becomes fetid and profuse (up to several hundred milliliters per day). It is especially abundant in the morning (expectoration with a "full mouth") or after being in the so-called drainage position (lying on the affected side with the head end of the bed lowered). With a high intensity of wet cough, the blood vessels of the thinned walls of the bronchi rupture, which leads to hemoptysis, and in severe cases, to pulmonary hemorrhages.

Bronchial asthma

The discharge of a small amount of moist, odorless, mucus-like secret indicates the completion of an asthma attack. The sputum is usually colorless. A possible yellowish or greenish tint of mucus is due to the breakdown of eosinophils, bronchial epithelium, and other cells, less often - the presence of pus during secondary infection of the bronchi. After coughing up sputum, the patient's condition gradually improves: the rhythm of breathing is restored, suffocation disappears. During an asthma attack, very viscous mucus can also be difficult to expectorate.

Pneumonia

With inflammation of the lungs of any etiology, the cough becomes wet only on the 3rd-4th day of the disease. The nature of the secret depends on the type of pathology: with viral pneumonia and mycoplasmal respiratory infection, patients note the release of a small amount of transparent viscous mucus without pus or blood, bacterial focal pneumonia is characterized by purulent discharge. With croupous inflammation of the lungs during a wet cough, “rusty” sputum containing blood inclusions leaves.

Pneumonia begins acutely with severe thoracic pain, tremendous chills, shortness of breath, which is accompanied by a cough. In an uncomplicated course, the temperature reaches 38-38.5 ° C, in case of damage to an entire lobe of the lung, the patient is worried about high fever, chills. The duration of a wet cough for more than 3 months indicates the chronic nature of the inflammation, which is typical for people with immunodeficiencies. In children, chronic recurrent pneumonia may be a sign of congenital lung hypoplasia.

Other pulmonary pathology

Complaints about a productive cough occur in diseases of the lower respiratory system, both inflammatory and non-inflammatory. Increased production of wet mucous secretion provokes the influence of parasites, the deposition of pigment compounds in the lungs with congenital or acquired metabolic disorders of trace elements. The intensity and frequency of attacks depend on the severity and duration of the disease. Coughing up a secret is typical for the following types of pulmonary pathology:

• Hemosiderosis . In the acute phase, frequent coughing is accompanied by red-brown sputum discharge, which is due to the presence of blood and the specific pigment hemosiderin. Patients feel constant weakness, frequent headaches and dizziness, which are caused by concomitant deficiency anemia. Exacerbation of hemosiderosis, in addition to wet coughing, is characterized by intense pain in the chest, fever, enlarged liver.
• Echinococcosis . A dry persistent cough, followed by a wet cough with the release of mucus streaked with blood, appears at 3-5 years of parasitic invasion as a result of pressure on the bronchi and destruction of the lung tissue. When an echinococcal abscess breaks into the bronchus cavity, a cough attack develops abruptly. Abundant watery sputum contains inclusions of blood, pus, scraps of cyst membranes, small daughter capsules. Severe allergic reactions, cyanosis, asphyxia are possible.

Inflammation of the larynx and trachea

In most cases, these diseases are characterized by the absence of sputum. However, the appearance of a wet cough is possible at the stage of recovery or with certain clinical variants of laryngotracheitis occurring with damage to the glandular cells of the mucous membrane. When the process is localized in the larynx and trachea, patients notice a change in voice - it becomes low and hoarse, it constantly tickles or “scratches” in the throat, and pain is disturbing when swallowing. With the separation of the secret after a cough paroxysm proceed:

• Chronic hyperplastic laryngitis . For this form of inflammation of the larynx, coughing with mucopurulent sputum in the morning for 3 weeks or more without a tendency to recovery is pathognomonic. Before the start of a wet cough, changes in the timbre of the voice and hoarseness that occur after a long conversation are noticeable. Complaints of pain and sensation of a foreign object in the throat are typical.
• Tracheitis . Initially, inflammation of the tracheal mucosa is manifested by paroxysmal debilitating cough, which ends with the separation of a small amount of viscous mucus. Patients note that cough paroxysms are associated with deep inspiration, crying or laughter. After a few days, the volume of the secret increases, it acquires a mucopurulent character.

Pulmonary edema

The disease often develops as a complication of acute heart failure, cardiac asthma, but can complicate the course of severe diseases of the respiratory, urinary systems, and other internal organs. A few hours before the manifestation, tightness or pain in the chest is felt, shortness of breath increases. Then there is a painful cough and suffocation, which makes the patient rise in bed to facilitate breathing. A cough attack is accompanied by the release of foamy pink sputum, wheezing, blue nasolabial triangle.

Oncological diseases

Tumors of the lung are usually asymptomatic or asymptomatic. Severe clinical symptoms are observed only in 10-15% of cases, mainly with the central localization of a malignant neoplasm. With all types of oncological pathology, the first manifestations are non-specific symptoms of intoxication - causeless weakness, weight loss, loss of appetite, and only then cough. With expectoration of sputum can occur:

• Bronchioalveolar cancer . At first, the disease is characterized by a dry, painful cough that exhausts the patient, disrupts sleep and performance. A large amount of mucus during a cough attack is usually released in the case of a mucinous cancer histotype. At the same time, patients complain of intense shortness of breath both during physical exertion and at rest, periodic fever, intense pain in the affected part of the chest, less often behind the sternum.
• Bronchial carcinoid . A strong dry cough, which after a while becomes productive, is one of the early symptoms of a tumor, which manifests itself many years before its discovery. Such patients are treated for a long time for alleged chronic bronchitis. In the later stages of the process, hemoptysis, difficult expiration with tension of the intercostal and cervical muscles join the productive cough, which makes it possible to suspect carcinoid.
• Squamous cell carcinoma . The classic triad of early signs of a tumor is excruciating coughing paroxysms, moderate thoracology, and shortness of breath on exertion. Cough with the separation of a large amount of viscous mucopurulent secretion often develops as a result of a complication of cancer with obstructive pneumonia when the tumor is localized in a large bronchus. Half of patients with a central form of cancer have hemoptysis, which can provoke pulmonary hemorrhage.

Survey

A prolonged productive cough is a reason to contact a pulmonologist who will select the optimal diagnostic plan depending on the general condition and the presence of other complaints. To identify the cause of the symptom, a comprehensive assessment of the morphological and functional features of the respiratory system is carried out. The most diagnostic value are:

• X-ray methods . Plain radiography in two projections is prescribed to visualize the structures of the chest, to study the state of the lower respiratory tract. With the help of X-ray examination, lesions of the bronchi and directly lung tissue are differentiated. Fluoroscopy is necessary to assess the mobility of the diaphragm.
• Spirography . The functional examination method is used to study the capabilities of the respiratory system and determine the type of respiratory disorder. Spirography is more often prescribed for chronic cough with sputum, occupational diseases. During the study, the maximum lung volume, forced expiratory volume and other indicators are evaluated.
• Endoscopic examination . Inspection of the walls of large bronchi during bronchoscopy is the most informative method used to determine the morphological variant of bronchitis, detect indirect signs of inflammation of the lung tissue or the presence of bulk neoplasms. According to the indications for bronchoscopy, a forceps biopsy is performed for histological examination.
• Bacteriological analysis . Sputum culture is prescribed to detect infectious agents, and an additional study of the antibiotic sensitivity of the isolated microflora is carried out. According to the indications, a microscopic analysis of the discharge from the respiratory tract is performed in order to detect specific cells, crystals, spiral accumulations of mucin.

For differential diagnosis between inflammatory and other pathologies of the respiratory system, a general blood test is performed, and the concentration of acute phase proteins is determined. If the infectious nature of a wet cough is suspected, serological tests are prescribed to determine antibodies to pathogenic microorganisms. To clarify the structure of volumetric formations of the chest cavity, tomography (CT, MRI) is performed. Informative examination of the ENT organs: pharyngoscopy, laryngoscopy.

Expectorants and mucolytics are effective for wet coughs

Symptomatic therapy

To reduce the frequency of wet cough attacks, sudden changes in temperature should be avoided, if possible, contact with household chemicals and other irritants should be limited. Regular inhalations with antiseptics and anti-inflammatory drugs help reduce pain, stimulate mucus discharge. With viscous and thick sputum, expectorants and mucolytics are effective, which help to clear the bronchial tree from mucus.

It is forbidden to use specific antitussive drugs, as they cause a delay in the mucous secretion and pathogens in the respiratory tract, which prolongs the recovery period. An increase in the volume or a change in the nature of the secret, frequent coughing attacks leading to insomnia are indications for a visit to the doctor, who will find out the cause of the wet cough and prescribe etiotropic treatment. With the development of hemoptysis, the appearance of pink foamy sputum, emergency medical care is required.