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What are the Most Common Causes of Coughing with Phlegm?

By Rebecca Harkin
Updated May 17, 2024
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Coughing with phlegm is an annoying problem that can be short-lived or long-lasting, depending on the cause. Infections such as the common cold, the flu, acute bronchitis, and pneumonia are the most common causes of short-term coughing and phlegm. Allergic reactions and chronic obstructive pulmonary disease (COPD) are often to blame for a long-lasting or recurring phlegmy cough.

Coughing with phlegm is one of the most uncomfortable and annoying symptoms of the common cold, the flu, acute bronchitis and pneumonia. Coughing up phlegm occurs during these types of infections because the body produces an immune response in an effort to try to destroy the invading bacteria or viruses. The immune response inflames the airways and produces excess phlegm.

The cough, which often accompanies these infections, is produced when the surplus phlegm tickles the sensory nerves in the respiratory system. The reflexive response to the tickle is a cough. This cough is often referred to as a productive cough because it will help to bring the phlegm out of the lungs. A productive cough relieves the heavy feeling in the chest that is often a part of being sick.

Another common cause of coughing with phlegm is COPD. The term refers to two diseases: chronic bronchitis and emphysema. Smoking is the primary cause of both, and the most common symptom for both is coughing up phlegm.

Phlegm is normally removed from the lungs by cilia or tiny, waving hairs. Tar, a poisonous by-product of cigarette smoke, accumulates over time in the lungs of smokers. The tar coats the cilia, making them brittle and preventing them from being able to remove the phlegm. Instead, the phlegm accumulates in the lungs. Repetitive and frequent coughing, the main symptom of COPD, is needed to try to clear the phlegm from the lungs.

Allergic reactions are yet another common cause of coughing with phlegm. When foreign bodies such as pollen and dust enter the nasal passages, they can irritate the mucous membranes that line the respiratory system and produce phlegm. Excess phlegm, often referred to as post-nasal drip in this case, carries the foreign invaders away. During a bad allergic reaction, the extra phlegm may travel down into the lungs, where it irritates the sensory nerves and results in a cough.

Decongestants will somewhat relieve coughing with phlegm associated with infections and allergies. This group of medications works by constricting the blood vessels in the nose and sinuses. The result is reduced inflammation and a decrease in the amount of phlegm generated during the immune response.

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Discussion Comments

By healthy4life — On Oct 03, 2012

@feasting – Smoking is so addictive that people are willing to die for it. My uncle found out last year that he has emphysema, but he has decided that he wants to enjoy his last few years, and for him, this means continuing to smoke.

He said that quitting now would put too much strain on his mind and body, and since he is already in a weakened state, he couldn't handle it. He has a persistent cough with phlegm, and he is finding it harder to breathe.

His lungs are slowly losing their elasticity. He will likely keep that phlegm and the cough until the end.

By DylanB — On Oct 02, 2012

I would much rather have a dry cough than a cough with phlegm. I suffer from constant post-nasal drip because of my allergies, so I have phlegm in my throat all the time.

In the mornings, it is worse. I wake up and cough up phlegm for about the first hour of the day. Though it isn't as intense as having bronchitis, some of the phlegm is in my chest, and getting it out is important. Once I've coughed up a significant amount, I can go about my day breathing normally.

By lighth0se33 — On Oct 02, 2012

I have had bronchitis three times in my life, and each time, I would feel as if I were drowning in phlegm. I could hear my lungs rattling when I breathed, and when I would lie down at night, I felt like I was suffocating.

I lived with the cough for a week the first time before deciding that it was not going away on its own. In fact, it seemed to be getting worse.

My doctor gave me some cough syrup with codeine in it. It helped me sleep by suppressing my cough at night and knocking me out. During the day, I took an expectorant, which made me cough even more, but it helped me get rid of more phlegm.

By feasting — On Oct 01, 2012

My aunt has been a smoker for nearly fifty years, and she has a chronic cough with phlegm. Every time that she coughs, she sounds like she is dying!

These coughing fits last about a minute. She knows that smoking causes them, but she doesn't want to quit. I can't understand how she can put up with feeling so miserable in order to keep her habit.

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