Cough: productive or 'wet' cough

A productive (‘wet’ or chesty) cough is when you have a cough that produces mucus or phlegm (sputum). You may feel congested and have a ‘rattly’ or ‘tight’ chest.

Symptoms are often worse when waking up from sleep and when talking. The wet cough may be the last symptom left after a common cold infection.

Depending on the cause of your productive cough, other symptoms may include:

  • breathlessness;
  • fever;
  • cold and flu symptoms;
  • wheeze; and
  • chest pain.

Causes of chesty coughs

Causes of chesty (productive) coughs include:

  • viral infections, including the common cold and influenza (the flu);
  • bronchitis;
  • pneumonia;
  • smoking; and
  • chronic obstructive pulmonary disease (COPD).

Other, less common causes of a wet cough include:

  • bronchiectasis (a condition where the airways are damaged and abnormally wide causing a persistent, wet cough); and
  • cystic fibrosis (an inherited condition that causes excessively thick mucus secretions in the airways).

Diagnosis and tests

Your doctor will ask about your symptoms and perform a physical examination. Tests that may be useful in diagnosing the cause of a chesty cough include:

  • chest X-ray;
  • sputum analysis (a sample of the mucus or phlegm that you have coughed up can be tested – usually to find out the organism causing a chest infection);
  • blood tests; and
  • lung function tests.

When should you seek medical advice about a productive cough?

You should seek medical advice if:

  • you cough up blood (fresh blood or dried blood like coffee granules);
  • you have a high temperature;
  • you are short of breath or wheezy;
  • the cough is mainly at night;
  • you have chest pain when coughing;
  • the cough has changed;
  • you are a cigarette smoker;
  • you have other symptoms such as an ongoing headache, sore ears or a rash;
  • you have recently lost weight;
  • the productive, wet cough has lasted longer than 5 days;
  • the cough affects an infant or child under 5 years old; or
  • you have high blood pressure, a heart complaint, respiratory illness (such as asthma), gastric problems, glaucoma, or are taking medicines for other conditions.

 
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