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Asthma

Information About Mucus Plugs

10/17/2007

Question:

When I use my rescue inhaler I can breath better right away but it makes me cough for an hour afterwards. I cough so hard I gag, and sometime puke. My doctor said that is mucus plugs, I have to cough it up.

What causes mucus plugs and why do they make you puke? I have never read that about asthma in any of the fact sheets my dr gave me.

Answer:

The problem you are describing is really two problems. First, vomiting after you cough is a common problem for people with harsh or serious coughing. This is referred to as post-tussive emesis, literally, vomiting after you cough. Most likely this is due to gagging and upper airway responses to the cough. Unfortunately, cough is sometimes a problem with asthma. If you are having a lot of coughing, it is possible that this represents poor asthma control. Especially if the cough comes after using Albuterol, this may indicate that you asthma is not completely treated.

Mucus and mucus plugs are part of asthma. As the airway becomes inflamed, there is mucus produced. Part of the airway narrowing seen in asthma is mucus building up on the inside of the airway. This is a common complaint people with asthma have and is seen in all types of asthma. The question to ask you doctor or asthma specialist is whether something else could be causing the mucus plugs. There are a variety of lung diseases that can cause mucus plugging. Some more common diseases associated with mucus plugging are bronchiectasis, cystic fibrosis, allergic bronchopulmonary aspergillosis, chronic pneumonitis or pneumonia and immune deficiency that leads to one of these conditions (especially bronchiectasis). If the problem is still present, I recommend you talk to your doctors about any others causes she/he may suspect for the mucus plugs.

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Response by:

David  Hauswirth, MD David Hauswirth, MD
Clinical Assistant Professor
Pulmonary, Allergy, Crtitical Care & Sleep
Pediatrics
College of Medicine
The Ohio State University