What’s Causing This Productive Cough?

A Wet Cough That Brings Up Phlegm or Sputum

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A productive cough, also known as a wet cough, is one that brings up mucus (phlegm). These coughs are common with colds and other respiratory tract infections. Chronic lung diseases like COPD and cystic fibrosis can also cause a productive cough.

In contrast, a nonproductive (dry) cough does not bring up phlegm and is more common with asthma, allergies, flu, COVID-19, and medication side effects.

This article describes the common causes of a productive cough, as well as how the symptoms are treated and when it is time to see a healthcare provider. 

Causes of Dry and Wet Coughs

Ellen Lindner / Verywell

What Does Having a Productive Cough Mean?

A productive cough is one that brings up phlegm or saliva mixed with phlegm (sputum). It is often called a “chesty” or “wet” cough because you can hear a gurgling or rattling sound while you are coughing.

A productive cough usually happens when something irritates the lungs or airways, causing inflammation. With inflammation, tissues of the respiratory tract will swell and produce excess mucus. Coughing is a way for the body to expel the accumulated mucus.

Respiratory infections, chronic lung diseases, and inhaled irritants can trigger inflammation. Depending on the cause, the symptom may be acute (sudden, severe, and generally short-lived) or chronic (long-lasting or recurrent).

As you recover from a respiratory infection, the wet cough may turn into a dry cough that can linger for weeks. The dry cough is caused by ongoing irritation of the airways that makes them more sensitive.

Wet Cough vs. Dry Cough

Dry coughs are more commonly associated with allergies, flu, COVID-19, and medications such as ACE inhibitors. More serious causes include heart failure, pneumothorax (a collapsed lung). and lung cancer.

What Causes a Productive Cough?

A productive cough is a symptom of many diseases, infections, and medical conditions. Some are relatively mild and others can be potentially serious.

Possible causes of a wet cough include:

  • Bronchiectasis: The permanent enlargement of the airways by many causes
  • Bronchitis: Inflammation of the large airways of the lungs (bronchi)
  • Bronchiolitis: Inflammation of the smaller airways of the lungs (bronchioles)
  • Common cold: An upper respiratory infection caused by a variety of viruses
  • Chronic obstructive pulmonary disease (COPD): A progressive lung disease strongly associated with cigarette smoking
  • Croup: A group of conditions in children that cause breathing problems and a barking cough
  • Cystic fibrosis: A genetic disease that causes the excesses production of mucus in the lungs and other parts of the body
  • Influenza: Better known for causing a dry cough (this is one way to distinguish a cold from the flu), but sometimes may also produce a wet cough
  • Pneumonia: A lower respiratory infection that causes the air sacs of the lungs (alveoli) to fill with mucus and fluid
  • Postnasal drip: The drainage of mucus from the nasal passages to the airways caused by allergies and upper respiratory infections
  • Toxic exposure: Caused by the inhalation of smoke, industrial fumes, and other aerosolized toxins
  • Whooping cough: A childhood bacterial respiratory infection, also known as pertussis

How do you tell if a productive cough is from COVID?


Coughing is one of the most common symptoms of COVID-19. Most often, a COVID-19 cough is dry or unproductive. Some patients with COVID-19 do experience a wet cough, but the only way to know if this symptom is related to COVID-19 is to take a COVID test.

People with COVID-19 may also develop a wet cough if the infection moves into the lungs and causes pneumonia.

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How Pneumonia Occurs

How to Get Rid of a Rattly, Productive Cough

The treatment of a productive cough varies according to the cause.

Even so, many cases can benefit from an over-the-counter (OTC) expectorant that helps loosen and thin mucus so that it is easier to cough up. Guaifenesin is the most common expectorant used in OTC medications like Mucinex and Robitussin.

Wet coughs can often be treated at home with remedies like:

If these don't help (or your symptoms are chronic or severe), your healthcare provider may recommend prescription drugs, including:

Chronic coughs associated with COPD and cystic fibrosis may require ongoing treatment with bronchodilators, inhaled steroids, oxygen therapy, and pulmonary rehabilitation.

Don't Use Cough Suppressants

A cough suppressant can make a productive cough worse because it reduces the excretion of mucus from the lungs. In some cases, using a cough suppressant for a wet cough can turn a minor illness like a cold into a more serious one, like pneumonia.

If a Productive Cough Is Not Getting Better

A productive cough from a cold or minor respiratory infection typically lasts a week or two and can often be treated at home. However, it is important to see a healthcare provider if:

To diagnose the cause of your cough, the healthcare will review your medical history and perform a physical exam, paying close attention to lung sounds on their stethoscope.

Other tests may be ordered, including:

When to Call 911

Call 911 or go to your nearest emergency room if:

  • You are coughing up blood
  • You have a high fever accompanied by shortness of breath and wheezing
  • You are unable to swallow
  • You have severe chest pains

Summary

A productive (wet) cough is one that produces phlegm. Common causes include colds, COPD, and pneumonia. Mild cases can usually be treated at home with over-the-counter expectorants and steam inhalation. Severe or chronic coughs may require prescription drugs and other therapies.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Kristina Herndon, RN
Kristina Herndon, BSN, RN, CPN, has been working in healthcare since 2002. She specializes in pediatrics and disease and infection prevention.