Chest Congestion Relief for People With Asthma

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Many people with asthma have problems with mucus. They often say that they would feel much better if they could get relief from their chest congestion. Unfortunately, chest congestion is one of the side effects of asthma that often bothers patients. However, if you achieve better asthma control, you are more likely to get relief from your chest congestion.

Chest Congestion Relief

Chest congestion is caused by a few things related to the pathophysiology of asthma. First, it may not be chest congestion at all, but post nasal drip symptoms that are causing you to have to clear your throat or cause you to cough.

On the other hand, asthmatics have inflamed airways that produce more mucus than usual, leading to symptoms of congestion. It is cytokines that lead to increased mucus production, which in turn increases congestion and symptoms such as:

Increased mucus production functionally leads to narrower airways, which makes it more likely for you to experience asthma symptoms. Additionally, the mucus production increases your risk of pneumonia as well as causes you to cough as your body attempts to force the mucus out.

Guaifenesin is an expectorant (from the Latin expectorare, meaning, to expel from the chest) that tries to increase hydration of your secretions and get the mucus (i.e., symptoms of congestion) out of your chest. The idea is that the more lubricated the respiratory tract, the easier it is for the lungs to expel the mucus. This may be used for the temporary relief of symptoms, but is not optimal for the long-term control of your asthma.

Controller medications such as the following are the best bet for chest congestion relief in the long term: AdvairSymbicort, and Flovent.

The other tactic is to try to destroy the mucus with drugs referred to as mucolytics. These drugs dissolve bonds in mucus. DNase and N-acetylcysteine are examples, but these drugs are generally not used for this purpose in the treatment of asthma.

The Nose Knows

One often-overlooked symptom is that of nasal congestion, which patients may experience as chest congestion. In fact, poorly controlled nasal allergies are a common exacerbator of asthma. Up to as many as 80 percent of asthmatics also have allergies or allergic rhinitis.

A runny nose, sneezing, and itchy, watery eyes you experience during some parts of the year are not only a risk factor for the development of asthma, but asthma and allergic rhinitis often exist together with the latter making the former worse.

Just as with your asthma, the best treatment is avoiding triggers. Medical treatment options may include nasal steroids and antihistamines. Leukotriene modifiers can be a tremendous help for asthmatics who have a lot of allergy symptoms. Ipratropium decreases nasal secretions and is most useful in treating symptoms of upper respiratory tract infections. Finally, if you do not get nasal or chest congestion relief from these medical treatments, allergy shots or immunotherapy are an option.

Many patients report improvements with the use of Neti pots.

All sorts of air filters and air purifiers make claims to improve symptoms of asthma and allergy patients. although there is very little evidence to support their value. These treatments will not hurt you but are expensive. Make sure you talk with your doctor to see if you might benefit.

Do You Need Antibiotics?

If you think you need antibiotics, then you need to see your doctor. It's not a great idea to call your doctor and ask for antibiotics.

In general, antibiotics are not going to clear up your chest congestion unless it is due to pneumonia or some other infection.

Doctors often get asked by patients if they could get antibiotics in case they are not feeling better in a few days. A conscientious doctor would always say "no" to such a request. This is because the overuse of antibiotics could be a serious problem.

First, antibiotics cost money and if there is no benefit, its use just increases the cost of healthcare. Second, there is the problem of antibiotic resistance. As we use more antibiotics, the bacteria develop resistance and become stronger and harder to kill. This can result in patients not responding to treatment when it is really needed. This may end up causing a complication, the patient may feel bad longer, or even end up in a hospital for an antibiotic that can only be given through an intravenous line.

On the individual level, antibiotics will not cure the infection, make you feel better, or prevent someone else from getting sick. In fact, antibiotics, like all other medications, have potential side effects that are harmful.

By asking you specific questions, your doctor can determine if antibiotics will be helpful to your care. Many times, your doctor will perform specific tests to help identify the particular bacterial strain that you carry (e.g. strep), which can then guide the decision of which antibiotic would be the best choice.

When Do You Need to See a Doctor?

If you are experiencing chest congestion that does not seem to be improving or any of the following symptoms, it is probably time to see a doctor:

  • more frequent coughing (e.g. more than twice per week at night)
  • coughing with physical activity
  • you hear yourself wheezing
  • chest tightness
  • shortness of breath
  • repeated infections or bouts of "bronchitis"
  • fever
  • rash associated with your congestion

In the end, chest congestion relief is best achieved through good control of your asthma.

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Article Sources

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  • Weber, RW. Allergic Rhinitis. Primary Care: Clinics In Office Practice. Volume 35, Issue 1 (2008): 1–10.

  • Wenzel, Sally E. Antileukotriene Therapy in Asthma in Middleton’s Allergy: Principles and Practice, 7th ed. Mosby 2008.