In this article:
- When you inhale a pathogen or an irritant, your respiratory tract produces excessive amounts of mucus to stop the invader in its tracks, which ends up causing chest congestion.
- Diagnosing the cause of chest congestion must be insisted upon as it can be a result of certain allergy or asthma.
- There are several over-the-counter medications that can help in curbing or diluting the mucus secretions, fighting the underlying bacterial infection, and reducing the inflammation within the respiratory passages to relieve the congestion.
- Certain self-care measures and home remedies like maintaining proper hygiene, consuming hot beverages, coughing regularly and a honey tonic may help relieve chest congestion.
- The chest congestion usually clears within 3-5 days, but you must consult your doctor if the condition persists for longer without any sign of relief.
Chest congestion is a common symptom of influenza, bronchitis, and several other respiratory tract infections that trigger an overproduction of mucus.
When you inhale a microbial pathogen or any external irritant, the mucous membranes are stimulated to produce increased amounts of phlegm to trap the foreign invader.
The infection-causing agent is then coughed out from the respiratory tract along with the excess mucus.
It is when these slimy fluids accumulate in the lungs that you may experience a feeling of heaviness and tightness in the chest, which is referred to as chest congestion.
The buildup of mucus in your respiratory tract makes it harder for you to breathe by restricting airflow. It can adversely affect your paranasal sinuses, ears, throat, and voice as well.
This is why chest congestion is usually accompanied by other symptoms of respiratory distress such as sore throat, snoring, headaches, and impaired hearing and olfactory function.
So, even though chest congestion is a fairly common and nonthreatening condition, it can hamper your overall quality of life by causing sleep disturbances and interfering with your daytime activities. (1)
Causes of Chest Congestion
Chest congestion may be caused by any of the following:
- Influenza (flu)
- Asthma and reactive airway disease
- Bronchitis (inflammation of the bronchial tubes)
- Chronic obstructive pulmonary disease (COPD)
- Congestive heart failure
Signs and Symptoms of Chest Congestion
The signs and symptoms that may accompany chest congestion include:
- Persistent cough
- Production of phlegm
- Tightness in the chest
- Mild discomfort or pain in the chest
- Rapid breathing
- Labored breathing
- Fever and chills
- Night sweats
- Pain when swallowing or coughing when swallowing
- Gag reflex or vomiting
How Is Chest Congestion Diagnosed?
Chest congestion, along with a chronic cough, may indicate allergy or asthma. It is important to contact your physician to obtain a proper diagnosis.
The doctor usually considers your symptoms and medical history and performs a physical evaluation to determine the triggers of your allergic reactions.
Physical exam entails the visual inspection of your throat and ears and examining the lymph nodes in your neck. The doctor may gently tap your sinuses and listen to your heart and lungs using a stethoscope.
Also, the doctor may measure your pulse rate, body temperature, and/or blood pressure.
Some noninvasive diagnostic tests may also be recommended by the physician:
- Sputum and nasal discharge tests: Your doctor will examine a sample of your sputum or nasal discharge to identify the infection-causing agent responsible for your condition.
- Chest X-rays: To get an inside view of the chest cavity, your doctor may order a few X-rays, which will enable him/her to assess the extent of congestion and detect any structural abnormalities within the respiratory tract.
- Pulse oximetry: In this test, a small clip-like device that has a sensor is placed on your finger or toe to measure the oxygen saturation in your blood.
How Is Chest Congestion Treated Medically?
The following types of medications are generally used to relieve the symptoms of chest congestion.
1. Cough Expectorants
Chest congestion is caused by the accumulation of mucus in the respiratory tract, which is generally triggered by viral respiratory infections such as the common cold or flu.
Cough expectorants such as guaifenesin help to dilute the consistency of thick, coagulated mucus to make it easy to expel.
Guaifenesin is available in many cough syrup preparations and in combination with decongestants, antipyretics, and cough suppressants.
However, the doses of guaifenesin in cough syrups and combination medications are, usually, very low.
Taking more of those medications to increase the amount of guaifenesin is not advisable, as this puts the patient at risk of overdosing on the other components.
Guaifenesin, in larger and more effective doses, comes in tablets ranging from 400 mg to 1200 mg per tablet. The total dose should not exceed 2400 mg daily, and it should be distributed throughout the 24 hours.
Tablets containing 600 mg or 1200 mg of guaifenesin are long-acting, while smaller doses are short-acting.
The main drawback of guaifenesin is the potential for stomach irritation, so it is preferable to take this drug after eating.
Expectorants are not intended to stop the cough. They loosen the mucus, which is then coughed out through your mouth in the form of phlegm.
Caution: Whether guaifenesin is safe for pregnant women or not is still subject to doubt, given the dearth of adequate research on the topic. So, it’s wise to err on the side of caution and refrain from using this drug unless advised by your OBGYN.
Even though guaifenesin has not been associated with any noticeable side effects that can undermine your pregnancy, the FDA has not entirely dismissed the potential risks.
Moreover, there is also the possibility that guaifenesin may be passed on to the baby through breast milk, which necessitates the need for caution even during the lactating phase.
2. Cough Suppressants
Cough suppressants are a class of medicines that are generally used to treat dry cough. It reduces the cough reflex, which decreases the urge to cough.
Dextromethorphan (DM) is an over-the-counter cough suppressant that alters the nervous system response to airway irritants and, consequently, reduces the cough reflex.
The main drawback of dextromethorphan is the potential for interaction with commonly prescribed medications, especially antidepressants.
Another drawback is that cough suppressants may prevent the airway contents (phlegm) from being expectorated.
So, cough suppressants, in general, should be used to reduce severe and disabling cough and only for short periods.
A cough that does not resolve within a couple of weeks should be investigated more thoroughly.
Mucolytics help in clearing the mucus from airways, lungs, bronchi, and trachea. Some examples of mucolytic drugs include:
- Nebulized sodium bicarbonate – It makes the phlegm less sticky and easier to cough up.
- Nebulized acetylcysteine – It helps with loosening the mucous secretions clogging up your bronchial passages, although it may cause constriction of the smooth muscles in the bronchi. In many places, acetylcysteine requires a prescription.
Dilated blood vessels may cause blockage of the nasal passages.
A decongestant called named pseudoephedrine shrinks the blood vessels within the nasal airways and relieves congestion.
If you are breastfeeding, it is recommended to consult your physician before using any decongestants as they may reduce lactation.
Antibiotics are specifically used to fight bacterial infections. As the chest congestion is, generally, caused by viruses, antibiotics are not used routinely to treat this condition.
Antibiotics must not be used without a proper prescription, as they may not be suitable for you and may cause adverse effects.
Taking antibiotics when they are not needed may result in the emergence of resistant microbes, which may need antibiotics that are not available in pill form and may require hospitalization.
Caution: Some medicines may have adverse interactions when used together. If you are using any over-the-counter drug or any complementary medicine (vitamins, herbal products), consult your doctor before using any over-the-counter medication to treat the chest congestion.
Secondly, unless recommended by your healthcare provider, avoid giving aspirin or any medicine containing aspirin to children younger than 19 years. It may predispose your child to Reye’s syndrome, which is a rare condition that mostly affects children in the wake of a viral infection and can cause serious liver or brain damage.
Self-Care and Home Treatment
You can try the following tips and therapies at home to relieve your chest congestion faster.
- Dry air can make chest congestion even more uncomfortable by coagulating or hardening the mucus, which can further block your breathing passages.
Hence, it is important to keep your living environment comfortably humid in order to moisten your dry, irritated airway.
The moisture from the air helps dilute the concentrated mucus. The thinner the mucus, the easier it is to cough out. If you live in an arid region or during the winter months, consider using a humidifier.
This may specifically be helpful at nighttime, when stuffy nose can cause sleep disturbances. Caution should be taken, however, not to increase the humidity too much as doing so may lead to the growth of mold.
- Taking warm showers may help relieve chest congestion to a certain degree. The steam that you breathe while in the shower helps dissolve the consolidated mucus as it travels through the airway.
- Proper hand hygiene is one of the most fundamental steps in minimizing the risk of infection. You must frequently wash your hands or use a hand sanitizer to avoid picking up dirt and germs.
Hand sanitation is important in your everyday life, but more so during flu season or when a particular infection is doing the rounds.
- Annual flu vaccination is a must to steer clear of the flu, which is a highly contagious respiratory infection and may result in chest congestion.
You should consult your doctor about getting a pneumonia shot as well, especially if you are 60 or above.
- Rub some vapor rub. A vapor rub generally contains ingredients with decongestant and soothing effects, such as camphor, menthol, and eucalyptus oil.
The mild cooling effect of the vapor rub comforts the irritated nasal lining and allows relatively unhindered breathing.
- Some suspect that the heat generated in the body by spicy foods may help in diluting the thick and sticky mucus and, consequently, provide some degree of respiratory relief.
- Avoid dairy products, as they may cause thickening of the phlegm.
- Hot beverages, such as herbal tea, green tea, ginger tea without milk, or black coffee, can help thin out the consolidated mucus and may help alleviate the chest congestion.
Chicken soup is another dietary recommendation for people struggling with a respiratory infection. This warm, wholesome food can help strengthen your body from within to fight the infection and can also open up the jammed airway by diluting the trapped mucus.
- Place an extra pillow under your head to keep it elevated while you sleep. Positioning your head this way may prevent the accumulation of mucus, reduce coughing, and facilitate easy breathing.
- Drink adequate amounts of water to keep yourself hydrated. If possible, drink warm water as it may help soothe the throat and dissolve the mucus.
Maintaining an optimum fluid intake during chest congestion becomes all the more important if it is accompanied by fever or any condition that can trigger increased fluid loss from the body and can lead to dehydration.
- Include vitamin-rich fruits and veggies in your diet. Fibrous fruits, such as apples and pears, may help in reducing phlegm.
- Avoid carbonated beverages and oily/fatty foods because they can worsen your symptoms.
- Maintaining proper posture may help prevent the mucus buildup and keep the airways clear.
- You must cough regularly to relieve chest congestion. You may have to induce a cough if it does not come naturally to push out the excess mucus that is blocking your respiratory passages.
You can activate your cough reflex yourself or use the help of friends or family in performing a manually assisted cough.
- Apple cider vinegar may also help relieve chest congestion by thinning the mucus. You can add a teaspoon of apple cider vinegar to a glass of lukewarm water and consume it.
This is not recommended for people with diabetes. Also, regular consumption of apple cider vinegar may have some side effects on your tooth enamel as well.
2. Gargle with Warm Salt Water
Gargling frequently with warm salt water is a traditional remedy for chest congestion. It helps reduce the viscosity of mucus and soothes the irritation in the throat.
The American Journal of Preventive Medicine published a study that reported that gargling with plain water may be beneficial in preventing upper respiratory tract infections in generally healthy people. (2)
You can take a glass of warm water and add 1 teaspoon of salt and stir to dissolve. Gargle for a few seconds with 2-3 repetitions until the congestion clears.
3. Inhale Steam
Steam inhalation moistens the mucous membranes and makes the phlegm watery, consequently making it easy to expel via coughing.
General instructions for steam inhalation: (3)
- Pour hot water in a large bowl and add a few drops of essential oil, such as eucalyptus or peppermint oil. Eucalyptus oil contains cineole, which is a mucoactive agent. (4)
- Place a towel over your head and lean over the bowl.
- Maintain a comfortable distance between the hot water and your face to avoid any discomfort.
- Inhale the vapors deeply for as long as you feel comfortable.
The above process may be repeated two to three times a day until the congestion is relieved.
Steam inhalation is not suitable for:
- Women carrying child
- Young children
- People with hypertension
- People with cardiovascular diseases
- People who are allergic to eucalyptus and peppermint essential oils
4. Consume a Concoction of Honey
The medicinal use of honey goes back a long time, so it should not be a surprise that this sweet-tasting nectar may help relieve chest congestion as well.
Credited with potent antibacterial and antiviral properties, honey may help fight the underlying infection that is causing the buildup of mucus.
Moreover, the humectant effect of honey can help water down the mucus trapped in your respiratory passages and can facilitate its expulsion.
Pharmacy (Basel) published a study in 2017 that revealed that cough syrups containing glycerol along with honey and lemon may help safely manage acute cough in both children and adults. (5)
Another 2012 study concluded that the oral administration of honey to relieve congestion may be better than taking an antihistamine (diphenhydramine) or no treatment at all. Honey was also found to be as effective as a cough suppressant (dextromethorphan) in alleviating the symptoms of congestion. (6)
Without undermining the therapeutic potential of honey, we must take into account the side effects associated with honey before using it for respiratory relief.
According to a study published in the Canadian Family Physician, the use of honey for clearing chest congestion in children resulted in mild side effects such as nervousness, insomnia, and hyperactivity in about 10% of the subjects. (7)(8)
You can consume the recommended dose of raw honey directly or dissolve it in warm water and drink it as a tonic.
Note: Giving honey to children below the age of 1 year must be avoided. Honey may be contaminated with botulism spores, which can cause poisoning in infants.
There is substantial scientific evidence that favors the use of honey for relieving the symptoms of chest congestion. In fact, honey is one of the most widely used ingredients in commercial cough syrups which further validates these claims. All things considered, honey is a relatively mild and safe therapeutic agent which is unlikely to cause any adverse side effect if taken in the recommended amounts.
5. Apply a Warm Compress with Onion (Onion Poultice)
External application of a warm onion poultice may help alleviate chest congestion. When placed on the chest, the heat from the poultice seeps into the skin to break up the coagulated mucus.
Also, onions are credited with expectorant properties that may further help in thinning out the mucus secretions, making them easier to expel.
Although there isn’t much scientific merit to this adjunct therapy, it enjoys considerable popularity among the lay community as a complementary home treatment for chest congestion.
You can safely use this remedy to potentially ease spasmodic coughs and get some symptomatic relief from chest congestion, provided you are not allergic to onions.
Here’s how you can make an onion poultice:
- Peel and thinly slice 2 onions and then steam the slices until they become tender.
- Use a clean kitchen towel to pat dry the excess moisture from the steamed onions.
- Wrap the steamed onions in a soft cotton cloth, gather its ends, and tie them to make a compress.
- Allow the onion poultice to cool down to a comfortably warm temperature and then place it on the patient’s chest.
- Let the warm poultice sit on the chest until it cools down completely.
- You can also apply this gentle heat therapy to the back to relieve coughs.
After the poultice has cooled down, onion slices can be reused by steaming them again for a few minutes.
Wrap the re-steamed onions in a fresh cotton cloth. Instead of steaming the onion slices, you may microwave them until they become soft.
You may also add ginger or garlic to this mix for additional therapeutic effects.
Caution: To avoid the risk of getting burns from the poultice, do not use scalding-hot onions. Let them cool down for some time and then wrap them up.
Also, onion juice seeping from the cotton cloth directly on the skin may cause mild irritation in some people. Immediately remove the onion poultice from your skin if you notice any signs of allergic reaction.
The Importance of Coughing
Coughing is a reflex action that helps in clearing the excess mucus from your respiratory tract. If not relieved for an extended period, the chest congestion may cause breathing problems.
The following techniques may facilitate easier coughing:
- Postural drainage: This is a positioning technique that uses gravity to move the mucus from the lungs up to the throat.
There are a number of different positions you can choose from. One of the easiest ones is performed by placing the feet of the patient higher than his/her head for 15-20 minutes.
Once the mucus starts flowing upwards through the respiratory channel and reaches high enough, the patient may expel it by coughing.
- Glossopharyngeal breathing: This method entails rapidly taking big gulps of air through your mouth until your chest becomes full of air.
The air is forced into the lungs, which comes out strongly with the cough. Glossopharyngeal breathing may help in clearing out the phlegm and restoring normal, unobstructed breathing.
- Chest physiotherapy (CPT): This technique can be performed with the help of a doctor or caregiver. It aims to clear the congestion in the five lobes of the lungs through gravitational force.
This airway clearance therapy involves placing the patient’s body in different postural drainage positions while a respiratory therapist claps and/or vibrates the patient’s chest.
This technique helps loosen the mucus that flows to the larger airways, from where it can be coughed out of the body.
CPT is generally recommended to be done early morning and at bedtime. To reduce the risk of vomiting, CPT should be performed either on an empty stomach or two hours after eating.
The duration and frequency of CPT may vary, depending on the severity of congestion and the patient’s response to the therapy.
Risk Factors for Developing Chronic Cough
The risk factors for developing chronic cough are as follows:
- Cigarette smoking increases your likelihood to develop a chronic cough, even after you have quit the habit. Direct smoking or secondhand inhalation of tobacco smoke causes chronic inflammation in the airways and the lungs.
- Exposure to someone with a contagious respiratory infection increases your risk of picking up the infection as well.
The infection-causing pathogen is easily transmitted from the infected individual to a healthy individual through direct or indirect contact.
- People with preexisting allergies have a tendency to break into uncontrollable coughing spells when exposed to specific allergens.
- Environmental irritants – whether occupational (allergens, organic dust, or toxins) or household (smoke caused by cooking on a coal fire, pet dander, etc.) – may trigger a cough.
- Chronic lung diseases such as COPD, bronchiectasis (enlarged airways), and asthma and previous lung infections that left scars can make you more susceptible to developing a chronic cough.
- Women are more likely to develop chronic cough than men as they are born with a relatively sensitive cough reflex.
Why Do You Feel More Congested in the Morning?
A lot of people report that their productive cough tends to worsen in the morning.
During the daytime, your coughing reflex is active, allowing you to regularly expectorate the phlegm accumulating in your airways.
However, your cough reflex gets stifled during sleep. This causes the phlegm to build up inside your nasal passages, aggravating the symptoms of chest congestion in the morning.
Is It Okay to Exercise When You Have Chest Congestion?
As the mucus builds up inside your respiratory passages, the space for airflow becomes increasingly constricted. The sticky, condensed mucus makes it difficult for the air to move through the airways and reach the lungs.
This is why chest congestion is always associated with heavy or labored breathing, and you have to make an extra effort to pull air into your lungs.
The restricted airflow will inadvertently decrease the amount of oxygen in your blood. You may find it harder to breathe while exercising, further diminishing your blood oxygen level.
Hence, exercising when you have chest congestion may further increase your respiratory distress and cause complications.
Also, if the infection responsible for your chest congestion gives rise to fever, you are more likely to get dehydrated while exercising.
Thus, it is best not to engage in any draining activities while your body is recovering from the illness.
Is Phlegm a Sign That Your Asthma Is Getting Worse?
If you suffer from asthma, you may have a productive cough when you contract an infection.
Your nasal airways may become inflamed, leading to the development of other symptoms such as tightness or heaviness in the chest, coughing, labored breathing, and wheezing.
Your daily preventer inhaler may help manage your symptoms and diminish the inflammation in your nasal passages, although your reliever inhaler may provide faster relief.
However, if the need for a reliever inhaler becomes frequent, such as more than three times a week, it is absolutely necessary to consult your physician.
Chest Congestion with No Coughing or Fever
Coughing is your body’s way to force out the extra mucus that may be blocking your airway. It is one of the most characteristic symptoms of respiratory illnesses that usually cause chest congestion.
But if you develop chest congestion that causes you to wheeze but does not trigger a cough or fever, visit your doctor for a thorough evaluation.
Your doctor may conduct a few tests such as X-rays and CBC to ascertain the cause of your condition and treat it accordingly.
Acute Bronchitis Versus Chest Congestion
Chest congestion is characterized by a persistent cough, recurrent urge to clear your throat, and tightness in the chest. It is a commonly occurring ailment that affects everyone at least once in their lives.
Acute bronchitis is a viral infection that causes inflammation of the respiratory airways (bronchial tubes), which are responsible for carrying air to and from your lungs. This contagious infection causes swelling in the lining of your bronchial tubes.
In response to the infection, mucus production in the respiratory tract increases. As a result, the airways are narrowed.
The typical symptoms of acute bronchitis include chest congestion, cough with yellow or green mucus, difficulty breathing, fever, and body ache.
Acute bronchitis generally resolves in a few days. However, if it keeps lingering for an extended duration, chest congestion may occur.
Chest congestion is a symptom of acute bronchitis; however, it may not always be caused by the latter.
Chest Congestion Versus Wheezing
Chest congestion is one of the most typical symptoms of upper respiratory tract infections, such as influenza, common cold, and bronchitis.
These infections trigger an overproduction of mucus in the respiratory passages, which eventually settles down in the chest and causes chest congestion.
The accumulation of mucus in the respiratory tract can impede or block the passage of air through the bronchi into the lungs and vice versa.
Due to the congestion, you may have to strain to inhale and exhale. In such cases, the act of breathing may produce a squeaky, whistling sound that is known as wheezing.
You tend to wheeze more clearly while expelling air. However, if the congestion or inflammation in your airways is particularly severe, you may hear the sound while breathing in.
Hence, wheezing is the sound that is usually produced due to forceful exhalation on account of respiratory congestion or inflammation, whereas chest congestion is simply the buildup of excess mucus in the respiratory tract that often causes wheezing.
Unlike chest congestion, which is symptomatic of pulmonary infections, wheezing can also occur during an allergic reaction, acid reflux and GERD, or asthma, which causes your airways to become inflamed.
Chest Congestion Versus Nasal Congestion
The type of congestion may vary depending on the region it affects – the chest, sinus, or nasal passages.
Nasal congestion is characterized by a stuffy nose caused by the inflammation of nasal mucous membranes, which leads to the production of thick, sticky mucus.
Other symptoms include sinus pain, swelling of the nasal tissues, and difficulty breathing through your nose.
Nasal congestion is often an indication of other health conditions such as sinusitis, common cold, and allergies.
On the other hand, chest congestion is characterized by heaviness in the chest, sore throat, and production of phlegm. It occurs when there is overproduction of mucus in your respiratory airways, which ends up restricting your airflow.
When to See a Doctor
Chest congestion may exhaust you and disrupt your daily routine. The signs and symptoms of chest congestion usually subside in 3-5 days. However, if they continue for more than 7-14 days, seek prompt medical consult.
If you experience any of the following symptoms, immediately contact your doctor:
- Coughing up blood
- High fever
- Difficulty in breathing
- Shortness of breath
- Recent exposure to a person with tuberculosis or whooping cough
- Swollen leg and shortness of breath especially when lying flat
- Wheezing while breathing
- Mucus discharge which may be green or yellow in color
- Heaviness in the chest that causes difficulty sleeping
What you may ask your doctor:
- What over-the-counter medicines or prescriptions may help alleviate my symptoms?
- Am I contagious?
- What is the risk of getting pneumonia or other lung infections?
- What is the course of action if my cough worsens during the treatment or does not respond to the treatment?
What your doctor may ask you:
- Have you taken any medications?
- How long have you been suffering from a cough?
- What changes have you observed in the cough?
- Do you have a dry cough, or is phlegm present?
- What is the color and consistency of the phlegm?
- What other symptoms do you have (such as fever or light-headedness)?
- What is your medical history?
Chest congestion may signify an underlying condition such as allergy, cold, or flu. It may cause discomfort and difficulty breathing.
Mild chest congestion may be treated with over-the-counter medications. Along with medication, some home remedies may help provide fast relief by loosening the mucus and clearing the airways.
To prevent respiratory infections, it is important to maintain a healthy diet and stay hydrated. However, if the chest congestion becomes recurrent, medical advice is required to determine the cause.