Cough with Excessive Mucus: Normal or Should It Be Watched?

By: dr. Anggie Indari, Sp.P

1. Why Does the Body Produce Phlegm?

Coughing serves as the body’s natural mechanism to clear the respiratory tract of dust, germs, irritants, or foreign substances. Under normal conditions, phlegm — also called mucus — is produced by epithelial cells in the airways. It coats the mucosal surface to maintain moisture, trap harmful particles, and support the mucociliary defense mechanism. However, in pathological conditions such as chronic bronchitis, Chronic Obstructive Pulmonary Disease (COPD), or viral infections like COVID-19, the quantity and characteristics of mucus may change significantly.

2. When Is Phlegm Considered Abnormal and Needs Attention?

Phlegm is considered abnormal when it becomes excessive, changes color (yellow, green, brownish, or blood-streaked), has an unpleasant odor, or becomes thick and sticky, making it difficult to expel. This condition is often accompanied by other symptoms such as a persistent cough, shortness of breath, chest pain, or decreased stamina. Continuous mucus production may signal infection, chronic inflammation, or structural abnormalities in the airways — such as bronchiectasis, COPD, or even lung tumors. If phlegm does not improve after standard treatments, further examination may be needed to identify the exact cause. One of the most useful diagnostic procedures is bronchoscopy, which allows doctors to directly visualize the airways and determine the source of the problem.

3. Bronchoscopy: Evaluating the Cause of Persistent Cough and Excessive Phlegm

Bronchoscopy is a medical procedure that uses a thin, flexible tube equipped with a camera at its tip to view the inside of the airways. Through this examination, doctors can assess the bronchial walls, identify abnormalities, detect signs of infection, inflammation, or tissue growths such as tumors. In addition, bronchoscopy allows for the collection of mucus or tissue samples, and even removal of mucus buildup if needed. By performing bronchoscopy, doctors can obtain a clearer diagnosis of the cause of chronic cough and excessive phlegm, leading to more accurate and effective treatment.

4. What Can Be Done at Home as Initial Management?

Most mild cases of cough can be managed at home with simple steps. Drinking plenty of water helps thin the mucus, making it easier to expel. Inhaling warm steam or using a humidifier keeps the airways moist and relieves irritation. Getting enough rest, avoiding cigarette smoke and dust, and eating a balanced diet will speed up recovery. If necessary, over-the-counter cough remedies or expectorants may be used according to the instructions. However, if the cough lasts for more than two weeks, or if phlegm becomes colored, bloody, foul-smelling, or is accompanied by shortness of breath — it’s best to consult a doctor. You can start by visiting a Pulmonologist (Lung Specialist), and if required, the evaluation may also involve an Internal Medicine or ENT Specialist.

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FAQ

1. Is every phlegmy cough dangerous? No. However, a long-lasting cough with excessive mucus may indicate a more serious lung condition and should be evaluated further.

2. Is bronchoscopy painful? No, the procedure is performed under anesthesia or mild sedation, ensuring that patients remain comfortable throughout.

3. When should I see a doctor? If your phlegm changes color, contains blood, or if a cough persists for more than two weeks.