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Mucus.

COPD and Mucus

The coughing associated with COPD produces large amounts of a slimy substance called mucus. The increase in the production of mucus and secretions are due to an excessive amount of mucus-producing cells (called goblet cells), and oversized mucus glands in the airways compared with those found in the lungs of healthy people. This can result in a chronic cough. As we know, a cough is the body’s defense mechanism in an effort to clear the airways of this mucus. Mucus may also be referred to as sputum and/or phlegm and it can become prevalent in the airway and lungs during illnesses. Unfortunately, people with COPD can have difficulty clearing the excess mucus because of ineffective cough as well as other aspects of the condition.

Although other terms for conditions with excess mucus include chronic mucus hypersecretion or chronic sputum production, in COPD the condition is typically called “chronic bronchitis.” A diagnosis of chronic bronchitis usually requires the presence of a chronic, productive cough with sputum production for at least three consecutive months in two consecutive years.

Some of the factors that contribute to the excessive production of mucus in this type of COPD include:

  • smoking
  • acute and chronic viral infections
  • bacterial infections.

Smoking, by far, is the biggest factor in COPD and specifically, chronic bronchitis. Studies show that cigarette smokers with both chronic bronchitis and a limited airflow have an increased number of goblet cells and inflammatory cells in their airway. Infections, whether viral or bacterial, are characterized by the production and presence of mucus in the airway and lungs, and even excessive secretions in the nose.

How Does Excessive Mucus Affect One’s Health?

COPD, with excessive mucus production, can impact a person’s health. This manifests itself in a variety of ways.

  • Lung Health: Chronic mucus production over time and through the years is related to a decline in lung function. This can be quantified with pulmonary function testing ordered by a physician.
  • Quality of Life: COPD patients with chronic bronchitis often have more physical activity limitations and a worse quality of life than those who don’t have excess mucus and cough. People find coughing and mucus production to be the more disruptive and embarrassing of COPD symptoms to deal with on a day-to-day basis.
  • Flare-ups: COPD and chronic bronchitis may increase the number of exacerbations and consequently, hospitalizations. People with COPD dread the exacerbations as they fear the acute flare-ups may result in a lengthy hospital admission.

Techniques to Bring up Mucus

As has been mentioned, people with COPD often produce a large amount of mucus or sputum. If the mucus is allowed to collect in the airways, breathing may become more difficult and there is a greater risk of developing an infection.

Techniques to remove mucus are often done after using an inhaled bronchodilator. The medication helps to both loosen the mucus and also to open the airways. This makes the techniques to expel the secretions more effective. The patient with COPD should bear this in mind as being compliant with medication regimens combined with coughing techniques can insure a more successful maneuver.

Deep Coughing:

Start by taking a deep breath. Hold the breath for 2-3 seconds. Use your stomach muscles to forcefully expel the air. Avoid a hacking cough or just simply trying to clear the throat. A deep cough is less tiring and more effective in clearing mucus out of the lungs.

Huff Coughing:

Huff coughing or ‘huffing’ is an alternative to deep coughing when you have trouble clearing the mucus from your lungs and throat.

  • Take a breath that is slightly deeper than normal.
  • Use your stomach muscles to make a series of three rapid exhalations with the airway open, making a “ha, ha, ha” sound.
  • Follow this by controlled diaphragmatic breathing and a deep cough when you feel the mucus moving.

Other Techniques to Bring up Mucus

If, in your condition, a large amount of mucus is produced, your health care provider may recommend other techniques to help clear the mucus.

  • Adjunct airway clearance devices have proven to be successful for some patients in assisting to cough out residual secretions and mucus. Examples of these include the Acapella, Aerobika and Flutter devices, among others on the market. In general, they are small individual devices through which you exhale. The theory is that exhalation through the device results in oscillations of expiratory pressure and airflow, which vibrate the airway walls loosening the mucus. It’s also thought they decrease the collapsibility of the airways through the back pressure that is generated which can help to accelerate airflow. This can facilitate movement of mucus up through the airway.
  • Chest Physical Therapy (CPT) and postural drainage are techniques that use physical intervention and gravity to promote drainage of mucus from the lungs. CPT with bronchial drainage is the standard treatment for mobilization and removal of airway secretions in many types of respiratory dysfunction, especially in chronic lung disease, such as COPD and bronchitis. CPT has been shown to be effective in maintaining pulmonary function and prevention or reduction of respiratory complications in patients with chronic respiratory diseases.
  • High Frequency Chest Wall Oscillation (HFCWO) provides positive pressure air pulses which are then applied to the chest wall. This can be done utilizing an inflatable vest and an air pulse generator. The generator produces therapeutic pressures at prescribed frequencies which are delivered via a pneumatic vest which surrounds the thorax. These air pulses oscillate the chest and the vibrations reportedly cause flow increases in the airways, loosening mucus and producing cough-like sheer forces.
    We have used these in a hospital setting for some COPD patients who are then discharged to their home environment. The device can then be prescribed as medical equipment for use in the home environment. Some patients find these devices to be extremely helpful.
  • Simple exercise alone or combined with a scheduled pulmonary rehabilitation program is also a good way to help bring up mucus in the lungs.

Each technique can be ordered and demonstrated by your health care provider. You may consider discussing these available techniques with your health care team to determine if they are suitable for you.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The COPD.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. What is COPD? https://www.copdfoundation.org/What-is-COPD/Understanding-COPD/What-is-COPD.aspx (Accessed June 2017)
  2. National Heart, Lung, and Blood Institute. “What Are the Signs and Symptoms of COPD?” https://www.nhlbi.nih.gov/health/health-topics/topics/copd/signs [Accessed June 2017]
  3. COPD Conditions: Chronic Bronchitis & Emphysema https://copd.net/basics/damaged-lungs/ (Accessed June 2017)
  4. Not “Just” a Cough? https://copd.net/living/not-just-cough/ (Accessed June 2017)
  5. Increase in Mucus and Change in Color https://copd.net/symptoms/mucus/ (Accessed June 2017)
  6. COPD and Mucus Production https://www.verywell.com/why-does-copd-cause-increased-mucus-production-914878(Accessed June 2017)
  7. The Presence of Chronic Mucus Hypersecretion across Adult Life in Relation to Chronic Obstructive Pulmonary Disease Development. https://www.ncbi.nlm.nih.gov/pubmed/26695373 (Accessed June 2017)
  8. Chronic cough and sputum production: a clinical COPD phenotype? http://erj.ersjournals.com/content/40/1/4 (Accessed June 2017)
  9. Clinical issues of mucus accumulation in COPD https://www.researchgate.net/publication/260091781_Clinical_issues_of_mucus_accumulation_in_COPD (Accessed June 2017)
  10. Techniques to Bring Up Mucus https://www.nationaljewish.org/conditions/copd-chronic-obstructive-pulmonary-disease/overview/lifestyle-management/bring-up-mucus (Accessed June 2017)
  11. Current devices of respiratory physiotherapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2580042/ (Accessed June 2017)

Comments

  • horndust 2
    4 months ago

    Hi Leon. Just read a post discussing how to get rid of phlegm. Every morning, at the back of my throat I can feel it there. I take carbocisteine 3 times a day 375mg but I have no cough at all so cant get rid of it. As soon as I have my first cup of tea i sip it hot 2 or 3 times and (i assume) its gone into my stomach. I also have high levels of large red blood cells so my GP is testing me for thyroid problems as my haemaglobin is high too. I also have diabetes, type 2 so take metformin daily. I sleep well as I never have a cough, sometimes wish i did so i could clear my lungs and be less breathless but wey hey, Im still here. What worries me is my dizziness which my GP is trying to sort out so with a bit of luck, I shall be dizzy free soon and stop bumping into things. Never thought the day would come when I wished for a really good cough. Dont know why I cant cough. Even when I have exacerbations, its very rare I cough. Why do you think this is?. Brilliant site, learnt loads, thanks a lot.

  • Leon Lebowitz, BA, RRT moderator author
    4 months ago

    Hi horndust2 and thanks for your post in response to this article. I apologize for the delay in getting back to you here.

    You may be aware we cannot provide medical advice or diagnostics over the internet (for your own safety).
    It sounds like you and your doctor are doing everything you can to diagnose and treat the various symptoms and conditions you’ve shared with the community.
    There are a variety of causes that result in the types of coughing you describe. It can be extremely frustrating to have mucus/phlegm that you just can’t seem to cough out. What does your physician think and recommend about that?
    In view of that concern of yours, I thought you might gain some additional insight from this article on COPD and coughing: https://copd.net/living/not-just-cough/.
    Please do check back and let us know how you’re doing.
    All the best, Leon (site moderator)

  • MAYJO116
    10 months ago

    For 2 weeks I was running a low grade temperature of 100.4 to 100.8. Felt very tired
    and had trouble breathing. Saw my primary
    doctor and said I had an infection in my lungs.
    On prednisone and antibiotic starting to feel
    a little better. For the mucus, I use Mucinex and nebulizer. Also ginger tea with honey helps

  • Barbara Moore moderator
    10 months ago

    Hi MayJo116,
    I am sorry to hear that you have been feeling poorly the last few days. All of what you are doing sounds good and I hope you are better in no time. Barbara (Site moderator)

  • Leon Lebowitz, BA, RRT moderator author
    10 months ago

    Hi MAYJO116 and thanks for your post. Thanks for commenting on this article and advising us of your recent situation. We appreciate your input.
    Leon (site moderator)

  • srhule68
    1 year ago

    Hi I read you article and I was just wondering when you have an inflamed mucus gland due to bronchitis why does it make more mucus than usually? Whats telling it to make more?

  • buckybuck
    2 years ago

    It appears that my situation is different. I do not have chronic bronchitis nor do I have a persistent cough. What I do have is excess nasal mucus when I exert. It just flows and thus interferes with whatever I am trying to do including exercise. Is there something I can safely take to lessen this condition? I have been on oxygen 24/7 for almost 8 years and I am still quite active. I’d like to keep it that way!

  • Barbara Moore moderator
    10 months ago

    Hi buckybuck, As long as you are able to be active and keep up even with 02, that is great. As Leon mentioned, check with your doctor as to a solution. Barbara (Site Moderator)

  • Leon Lebowitz, BA, RRT moderator author
    2 years ago

    Hi buckybuck and thanks for sharing your experiences of eight years. Although we cannot provide medical advice over the internet (for your own safety), your inquiry does warrant a comment. Since you have maintained your level of activity while on long term supplemental oxygen, there doesn’t seem to be any reason for you to change that. Since, from what you’ve said, this appears to be a persistent issue, you may want to check in with your physician or specialist. They may be able to shed some light on your concerns and provide a remedy for your specific situation. I thought you might find it helpful to look over this material from John Bottrell, one of our moderator/contributors: https://copd.net/living/stuffy-noses/. Please check back with us and let us know how you’re doing.
    All the best,
    Leon (site moderator)

  • Laurie2ll
    2 years ago

    Thank you so much for this very informative article. I’ve recently been put on home oxygen therapy (3 months now). My COPD Diagnosis doesn’t include chronic bronchitis, however I’m experiencing increasing excessive mucus build up in my throat since being on oxygen. Not only when I awake but for morning until night. Could you please let me know if this is a common experience with oxygen therapy. Thank you!

  • luvmylife1948
    1 year ago

    Laurie, I have learned through diet that when I have milk/dairy products in my diet it increases phlegm. This includes ice-cream.
    Drinking a lot of water is supposed to loosen phlegm and help expel this.
    I drink 2 glasses of water each morning after waking and this does loosen phlegm. But I do still struggle with the skill of expelling phlegm. I feel it in my chest and it is stuck. I am going to practice the steps learned here which is to use the stomach muscles when trying to expel the mucus. Best wishes.

  • Leon Lebowitz, BA, RRT moderator author
    2 years ago

    Hi Laurie2II and thanks for your inquiry. While we cannot provide medical advice over the internet (for your own safety), your concern does warrant a comment. It sounds coincidental to have the buildup of mucus since you’ve been placed on supplemental oxygen therapy. Oxygen therapy is usually not associated with an increase in mucus production. I would suggest if these symptoms (excessive mucus) continue, to reach out for your doctor for an assessment. Something else may be occurring with your condition that might benefit from further examination. Please check back with us and let us know how you’re doing, Laurie.
    All the best,
    Leon (site moderator)

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