A cough that produces mucus, or phlegm, is known as a wet — or productive — cough. Producing mucus while coughing is typically a response to allergens and irritants, airway infections, or an underlying condition.

This article will outline some conditions that can cause a productive cough, along with their associated symptoms and treatment options.

It will also list some home remedies that people can incorporate into their treatment plan to help alleviate a productive cough.

A woman has a cough with mucus and coughs into a tissue.Share on Pinterest
A person with a productive cough may find mucus in their tissue.

Coughing is either productive or nonproductive. A productive cough is a cough that brings up phlegm or mucus. A nonproductive cough is a cough that does not bring up any phlegm or mucus.

In most cases, coughing is an automatic reflex that helps clear the airways of mucus or irritants.

Most coughs clear up within 3 weeks and do not require medical attention. However, certain conditions will require medical treatment and management.

Below are some health conditions that can cause a productive cough.

Upper respiratory tract infections are often the result of the common cold or the flu. Both develop due to viruses.

The common cold and the flu share a number of common symptoms, including:

The flu may cause some additional symptoms, such as:

Diagnosis

A doctor can diagnose the common cold by assessing a person’s symptoms.

In order to diagnose the flu, they may take a swab from the person’s nose.

Treatment

Symptoms of the common cold typically clear up within 7–14 days. In the meantime, the following over-the-counter (OTC) medications can help reduce the symptoms:

Doctors may prescribe antiviral therapy for the flu. Antiviral therapy is more effective if people begin taking it within 48 hours of developing flu symptoms.

Lower respiratory tract infections are those that affect the lungs or airways. There are two main types: bronchitis and pneumonia.

Bronchitis is the medical term for inflammation of the bronchi in the lungs. The bronchi are the airways that enable airflow into the lungs. Bronchial inflammation can occur as a result of a viral infection or irritation from allergens or pollutants.

The symptoms of bronchitis include:

Pneumonia is the medical term for infection and inflammation of one or both lungs. Pneumonia can occur as a result of infection with any of the following pathogens:

The symptoms of pneumonia may include:

  • a nonproductive cough or a productive cough that brings up blood tinged mucus
  • chest pain
  • shortness of breath
  • headaches
  • muscle and joint aches and pains
  • fever with chills
  • fatigue

Diagnosis

When diagnosing bronchitis or pneumonia, a doctor will ask about the person’s symptoms and examine their chest using a stethoscope.

They may also order one or more of the following diagnostic tests:

  • pulse oximetry, to evaluate blood oxygen levels
  • blood tests, to check for signs of infection
  • a sputum test, to help identify the pathogen responsible for the infection
  • a chest X-ray, to check for signs of inflammation in the lungs

Treatment

If a person has bronchitis, a doctor may prescribe codeine to help suppress coughing. They may also prescribe beta-agonist medications to prevent wheezing and steroids to reduce inflammation.

The treatment for pneumonia depends on the type a person has, as well as its severity. For example, a doctor may prescribe antibiotics to treat bacterial pneumonia and antiviral medications to treat viral pneumonia.

Chronic obstructive pulmonary disease (COPD) refers to a group of conditions that affect the lungs. It is chronic and causes long-term breathing difficulties.

The main cause of COPD is smoke. Some other factors that may contribute to COPD include:

  • exposure to air pollutants
  • previous respiratory infections
  • genetic factors

Symptoms of COPD include:

  • an ongoing cough that produces a lot of mucus
  • shortness of breath after physical activities
  • wheezing, whistling, or squeaking when breathing
  • tightness in the chest

Diagnosis

When diagnosing COPD, a doctor will ask about the person’s symptoms and take a full medical history. They will also administer a pulmonary function test to measure:

  • how fast a person is breathing
  • how much air they can breathe in and out
  • how effectively the lungs are delivering oxygen to the blood

The doctor may also order the following diagnostic tests:

  • Chest X-ray: This is a medical imaging test that can help a doctor identify the location and severity of lung damage.
  • Chest CT scan: This test can also help doctors learn more about lung damage.
  • Arterial blood gas test: This is a test that measures blood oxygen levels and allows a doctor to assess the severity of COPD damage.

Treatment

There is currently no cure for COPD. However, a doctor may prescribe one or more of the following treatments to help a person manage the condition:

  • Bronchodilators: These are medications that assist breathing by relaxing the muscles around the airways.
  • Inhaled steroids: These are medications that assist breathing by reducing inflammation in the airways.
  • Pulmonary rehabilitation: This is a therapeutic program that aims to reduce symptoms and improve quality of life in people living with chronic respiratory conditions.
  • Oxygen therapy: This refers to the use of an oxygen mask or nasal prongs to deliver more oxygen into the body. This can reduce COPD symptom severity and help protect other organs from damage.
  • Surgery: In severe cases, a doctor may recommend surgery to remove all or part of the damaged lung. Removal of an entire lung will require replacement with a healthy lung from a donor.

Bronchiectasis is a chronic lung disease in which the airways become abnormally widened and fill with excess mucus. This can make the lungs vulnerable to infection.

The following factors may cause bronchiectasis:

  • bacterial, viral, or fungal infections
  • airway obstructions, such as a tumor or foreign body
  • genetic lung conditions, such as cystic fibrosis

Symptoms of bronchiectasis include:

Diagnosis

Doctors will usually order a chest X-ray or CT scan to diagnose bronchiectasis.

Treatment

Treatment for bronchiectasis depends on the underlying cause. Some possible treatment options include:

  • antifungals, to help clear an underlying fungal infection
  • antibiotics, to help clear an underlying bacterial infection
  • bronchodilators, to assist breathing
  • corticosteroids, to reduce airway inflammation and improve airflow into the lungs

Gastroesophageal reflux disease (GERD) is a condition in which stomach acid and other stomach contents frequently leak out of the stomach and back up into the esophagus. The esophagus is the tube that connects the mouth to the stomach.

The primary symptoms of GERD are heartburn and acid reflux. Other common GERD symptoms include:

Diagnosis

A doctor may be able to diagnose GERD based on a person’s symptoms. If the symptoms do not improve despite the person taking medication and making appropriate lifestyle changes, the doctor may refer them to a specialist.

A specialist may perform one or more of the following diagnostic tests:

  • Upper gastrointestinal (GI) endoscopy and biopsy: A surgeon will pass a long, thin, flexible instrument called an endoscope down the esophagus and into the stomach. The endoscope allows the surgeon to see inside the esophagus and stomach. Tiny instruments inside the endoscope enable the surgeon to remove small tissue samples.
  • Upper GI series: A person will receive an X-ray while drinking a mixture containing barium. As the barium moves through the person’s GI tract, it highlights potential problems that could be the cause of GERD.
  • Esophageal pH and impedance monitoring: This is a test that measures the amount of acid in the esophagus while a person is eating and sleeping.
  • Esophageal manometry: This is a test that can help identify a weak sphincter muscle in the esophagus. This muscle usually closes after swallowing to prevent stomach contents from backing up into the esophagus.

Treatment

A person may be able to manage GERD by making the following lifestyle changes:

  • quitting smoking
  • avoiding or limiting alcohol
  • not eating large meals
  • not eating within 2–3 hours of going to bed
  • not eating foods that may trigger GERD, such as fatty, greasy, or spicy foods
  • losing weight (if the person has overweight or obesity)

OTC and prescription medications may also be effective in controlling GERD or reducing the symptoms. Some examples include:

  • Antacids: These are medications that can help alleviate heartburn and other mild symptoms of GERD.
  • H2 blockers: These are medications that decrease acid production.
  • Proton pump inhibitors: These are medications that reduce the amount of acid the stomach makes. They can also help heal damage to the lining of the esophagus.
  • Prokinetics: These are medications that speed up stomach emptying.

If a person experiences severe, persistent GERD despite trying the above treatments, their doctor may recommend surgery to tighten the esophageal sphincter muscle.

Tuberculosis (TB) is an infectious disease that primarily affects the lungs. However, it can also affect the nervous system, glands, and bones.

TB develops due to bacteria called Mycobacterium tuberculosis. People can catch M. tuberculosis by inhaling infected droplets from the coughs or sneezes of a person carrying these bacteria.

The symptoms of TB may differ depending on which part of the body it affects. Some general symptoms include:

  • night sweats
  • lack of appetite
  • weight loss
  • extreme tiredness or fatigue

TB that affects the lungs may cause the following additional symptoms:

  • a persistent cough that lasts for longer than 3 weeks and typically produces mucus
  • blood tinged mucus
  • breathlessness that gradually worsens over time

Diagnosis

In order to diagnose TB of the lungs, a doctor may order a chest X-ray (to detect changes in the lungs) and a sputum test (to check for the presence of M. tuberculosis in the mucus).

Treatment

Medical treatment depends on whether the TB is latent or active. Latent TB means that a person is carrying M. tuberculosis but is not showing any symptoms. Active TB means that the person is showing symptoms.

Doctors will usually prescribe the antibiotic isoniazid for latent TB. People should take this medication for 6 or 9 months.

For people with active TB of the lungs, a doctor will typically prescribe a 6-month course of the antibiotics isoniazid and rifampicin. They will also prescribe the antibiotics pyrazinamide and ethambutol for the first 2 months of the 6-month treatment period.

People who complete their antibiotic treatment should make a full recovery.

Some conditions that cause a cough with mucus require medical treatment and specialist management.

However, a person can incorporate certain home remedies into their treatment plan. The following remedies could help alleviate a cough that produces mucus:

  • quitting smoking, and avoiding secondhand smoke
  • avoiding known allergens or irritants, such as:
    • chemical fumes
    • air pollution
    • dust
    • pollen
    • pet dander
  • performing regular, gentle exercise to help clear mucus from the airways

A person with a chronic lung condition should also ensure that they receive regular vaccinations against the flu and pneumonia.

It is important to see a doctor if a cough does not clear up within 3 weeks or is accompanied by other worrying symptoms. A doctor will work to diagnose the cause of the cough, and they will be able to provide appropriate treatments.

People should seek immediate medical attention if they are struggling to breathe or if their symptoms suddenly worsen.

A cough that produces mucus can sometimes occur in response to irritation from an allergen or irritant. Common culprits include smoke, air pollution, and pollen.

Sometimes, however, a cough that produces mucus can signal an acute health condition, such as an upper or lower respiratory infection. Other times, it may be a symptom of a chronic lung condition, such as COPD. Certain health conditions share similar symptoms, so it is important to see a doctor to get an accurate diagnosis.

A person should see a doctor if they have a cough that persists for longer than 3 weeks, or if they experience other worrying symptoms. A doctor will work to diagnose the cause and provide appropriate treatments.