Wet cough is a cough in which mucous or mucopurulent sputum is secreted. The symptom develops against the background of chest pain (thoracalgia), wheezing, signs of general intoxication of the body. This type of cough is observed in bronchitis and other bronchopulmonary pathology, respiratory infections, heart failure. To find out the root cause of the disorder, radiography, spirography, bronchoscopy, laboratory tests are performed. In order to reduce unpleasant sensations, inhalations, mucolytics, expectorants, anti-inflammatory drugs are prescribed.
Causes of wet cough
Sputum secreted after a cough attack is usually represented by a mucous secret that forms when the lower respiratory tract (trachea, bronchi, bronchioles) is affected. With the development of inflammation, the production and removal of mucus are intensified in order to clear the respiratory system of pathogenic microorganisms or foreign particles. In turn, the mucus stimulates the nerve endings, causing a cough. After the discharge of wet secretions (mucus or pus), the state of health improves somewhat.
In acute forms of bronchitis, the cough is dry at first. Sputum begins to recede on the 2-3 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 occurs more often in children under 3 years of age on the background of a viral infection. Intense coughing attacks are characteristic, after which a small amount of viscous secretion is separated. It is difficult for the child to breathe, the swelling of the intercostal spaces and the swelling of the wings of the nose when breathing are characteristic. On exhalation, a “whistling” sound and quiet wheezing are heard. Exacerbations more than 3 times a year indicate a recurrent course.
- Asthmatic bronchitis. A typical sign is attacks of painful cough lasting for several minutes, after which viscous vitreous sputum is released and relief comes. Before the cough paroxysm, the throat is slightly scratchy, there is a slight malaise, nasal congestion. Exacerbation is provoked by sharp odors, inhalation of dust, contact with animal hair, pollen of plants.
- Atrophic bronchitis. In the classic version of the disease, a painful dry cough is initially observed, associated with physical exertion, inhalation of pollutants or household dust. In the future, a small or moderate amount of sputum begins to expectorate, resembling mucus in consistency. With exacerbation, the temperature rises to subfebrile figures, slight chills, chest pain, shortness of breath appear.
- Purulent bronchitis. During an attack, sputum of a yellow or greenish color with an unpleasant odor abundantly departs. In acute inflammation and during the exacerbation of the chronic process, the volume of purulent secretion released per day is 150-250 ml. Cough is combined with an increase in temperature of more than 38 ° C, sweating, weakness. They are worried about intense chest pain, a feeling of lack of air during physical activity.
With the outcome of chronic purulent bronchitis in bronchiectatic disease, cough attacks become permanent, and purulent sputum is fetid and abundant (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 burst, which leads to hemoptysis, and in severe cases — to pulmonary bleeding.
The discharge of a small amount of moist, odorless mucus-like secretion indicates the end of an attack of bronchial asthma. Sputum is usually colorless. A possible yellowish or greenish tinge of mucus is caused by the decay of eosinophils, bronchial epithelium, and other cells, less often by 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 passes. During an asthmatic attack, very viscous mucus can also be difficult to expectorate.
With pneumonia of any etiology, the cough becomes moist only on the 3-4 day of the disease. The nature of the secret depends on the type of pathology: with viral pneumonia and mycoplasma 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 croup inflammation of the lungs during a wet cough, “rusty” sputum containing blood inclusions departs.
Pneumonia begins acutely with severe thoracic pain, tremendous chills, shortness of breath, which is joined by a cough. With an uncomplicated course, the temperature reaches 38-38.5 ° C, in the case of a lesion of the whole 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 inflammation, which is typical for people with immunodeficiency. In children, chronic recurrent pneumonia may be a sign of congenital hypoplasia of the lung.
Other pulmonary pathology
Complaints of productive cough occur in diseases of the lower respiratory system of both inflammatory and non-inflammatory nature. The increased production of moist mucous secretions is provoked by 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 seizures depend on the severity and duration of the disease. Coughing up secretions is characteristic of the following types of pulmonary pathology:
- Hemosiderosis. In the acute phase, frequent cough is accompanied by the discharge of red-brown sputum, which is due to the presence of blood and a specific pigment hemosiderin. Patients feel constant weakness, frequent headaches and dizziness, which are caused by concomitant deficiency anemia. Exacerbation of hemosiderosis, except for wet coughing, is characterized by intense chest pain, fever, and liver enlargement.
- Echinococcosis. A dry persistent cough, followed by a wet one with the release of mucus with streaks of blood, appears at 3-5 years of parasitic invasion as a result of pressure on the bronchi and destruction of lung tissue. When an echinococcal abscess breaks into the bronchial cavity, a cough attack develops sharply. Copious watery sputum contains inclusions of blood, pus, fragments 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 the defeat of glandular cells of the mucous membrane. When the process is localized in the larynx and trachea, patients notice a change in the voice — it becomes low and hoarse, there is a constant tickling or “scratching” in the throat, pain worries when swallowing. With the separation of the secret after a cough paroxysm:
- Chronic hyperplastic laryngitis. For this form of laryngeal inflammation, coughing with mucopurulent sputum is pathognomonic in the morning for 3 weeks or more without a tendency to recovery. Before the onset of a wet cough, there are noticeable changes in the timbre of the voice and hoarseness that occurs after a long conversation. Typical complaints of pain and the sensation of a foreign object in the throat.
- Tracheitis. Initially, inflammation of the tracheal mucosa is manifested by a paroxysmal debilitating cough, which ends with the separation of a small amount of viscous mucus. Patients note that coughing paroxysms are associated with deep breathing, crying or laughing. After a few days, the volume of the secret increases, it acquires a mucopurulent character.
The disease often develops as a complication of acute heart failure Source: https://www.krasotaimedicina.ru/symptom/cough/moist, 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, there is tightness or pain in the chest, shortness of breath increases. Then there is a painful cough and suffocation, which forces the patient to sit up on the bed to facilitate breathing. Cough attack is accompanied by the release of foamy pink sputum, wheezing, blue nasolabial triangle.
Lung tumors are characterized by a low-symptomatic or asymptomatic course. Pronounced clinical symptoms are observed only in 10-15% of cases, mainly in the central localization of malignant neoplasm. With all types of oncological pathology, the first manifestations are nonspecific symptoms of intoxication — causeless weakness, weight loss, decreased appetite, and only then cough. With coughing up sputum , it can leak:
- Bronchioloalveolar cancer. At first, the disease is characterized by a dry, painful cough, which exhausts the patient, disrupts sleep and performance. A large amount of mucus during a cough attack is usually released in the case of mucinous histotype of cancer. At the same time, patients complain of intense shortness of breath both during physical exertion and at rest, periodic increase in body temperature, intense pain in the affected part of the chest, less often – behind the sternum.
- Bronchial carcinoid. A strong dry cough, which becomes productive after a while, is one of the early symptoms of a tumor that manifests itself many years before its detection. Such patients are treated for a long time for suspected chronic bronchitis. In the later stages of the process, hemoptysis, difficult exhalation with tension of the intercostal and cervical muscles join the productive cough, which makes it possible to suspect a carcinoid.
- Squamous cell carcinoma. The classic triad of early signs of a tumor are painful cough paroxysms, moderate thoracalgia, shortness of breath during exercise. Cough with the separation of a large amount of viscous mucopurulent secretions often develops as a result of complications of cancer with obstructive pneumonia when the tumor is localized in a large bronchus. In half of patients with the central form of cancer, hemoptysis is detected, which can provoke pulmonary bleeding.
A prolonged productive cough is a reason to consult 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 greatest diagnostic value are:
- Radiological methods. Overview radiography in two projections is assigned to visualize the structures of the chest, study the condition of the lower respiratory tract. With the help of X-ray examination, lesions of the bronchi and directly of the lung tissue are differentiated. X-ray examination 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 disorders. Spirography is more often prescribed for chronic cough with sputum, occupational diseases. During the study, the maximum lung volume, forced exhalation volume and other indicators are estimated.
- Endoscopic examination. Examination 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 volumetric neoplasms. According to the indications during bronchoscopy, a forceps biopsy is performed for histological examination.
- Bacteriological analysis. Sputum culture is prescribed for the detection of infectious agents, an additional study of the antibiotic sensitivity of the isolated microflora is carried out. According to the indications, microscopic analysis of the airway discharge is performed in order to detect specific cells, crystals, spiral clusters of mucin.
For differential diagnosis between inflammatory and other pathologies of the respiratory system, a general blood test is performed, the concentration of acute phase proteins is determined. If the infectious nature of a wet cough is suspected, serological reactions are prescribed to determine antibodies to pathogenic microorganisms. To clarify the structure of the volume formations of the thoracic cavity, tomography (CT, MRI) is performed. The examination of ENT organs is informative: pharyngoscopy, laryngoscopy.
To reduce the frequency of attacks of wet cough, it is necessary to avoid sudden temperature changes, if possible, limit contact with household chemicals and other irritating substances. Regular inhalations with antiseptics and anti-inflammatory drugs help to reduce pain, stimulate the discharge of mucus. With viscous and thick sputum, expectorant drugs and mucolytics are effective, which help to clear the bronchial tree of mucus.
It is forbidden to use specific antitussive drugs, because they cause a delay of mucous secretions and pathogenic microorganisms 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 a doctor who will find out the cause of a wet cough and prescribe etiotropic treatment. With the development of hemoptysis, the appearance of pink foamy sputum requires urgent medical attention.