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Symptoms, Their Causes & Cures: Congestion

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Congestion

WHEN TO SEE YOUR DOCTOR

* You're also coughing or wheezing, your sputum is discolored and you have chills and a fever.

* You also have chest pain, irregular heartbeat, swelling in your ankles or a history of heart disease.

* You're short of breath or find it difficult to breathe.

What Your Symptom Is Telling You

It's rush hour in your lungs. Your bronchial highways are packed tightly with bumper-to-bumper congestion, and you're honking and hacking. Every inhalation is a fight for an exit ramp off that breathing bottleneck.

Congestion means different things to different people. Some use the term to describe a tightness in their lungs, as if a wide strap were affixed firmly across the chest, says Richard L. Sheldon, M.D., a pulmonologist and internist at Beaver Medical Clinic in Banning, California. They also may find it difficult to breathe or feel short of breath.

If by congestion you mean a tightness in the chest, it's likely that you have asthma. If this is the case, you may notice a dry cough or wheezing as your constricted and swollen bronchial passages try to move air in and out.

Tightness and congestion also could indicate heart trouble. The lungs fill with fluid because the heart isn't pumping properly. Clues to look out for include swollen ankles, shortness of breath, awakening at night with difficulty breathing, chest pain and palpitations (or irregular heartbeat) as well as a history of heart problems.

When other people complain of congestion, "they describe a lot of soupy stuff down there in their lungs," says Dr. Sheldon. "They're usually coughing up a lot of that soupy stuff, too."

If you feel as if there's burning in your windpipe or like you're trying to breathe through the froth of a tall glass of root beer, chances are you have some sort of respiratory irritation or infection. Something is harassing your bronchial tubes enough to force them to counterattack by increasing the production of mucus, according to Anne L. Davis, M.D., associate professor of clinical medicine in the Division of Pulmonary and Critical Care Medicine at New York University Medical Center and assistant to the director of chest service at Bellevue Hospital Center in New York City.

An irritant in the air—such as pollution, dust, pollen, smoke or chemicals—may be responsible, says Dr. Davis. If it is, the congestion may be fleeting, leaving soon after you've escaped the irritant. But sometimes there can be a lag time of six to eight hours.

If your congestion is caused by an infection, you'll probably know it, says Charles P. Felton, M.D., chief of pulmonary medicine at Harlem Hospital Center and a clinical professor of medicine at Columbia University College of Physicians and Surgeons in New York City. The phlegm that you cough up will be yellow, green or brown. You'll also have a fever or the chills, and you won't feel very well. The infection could be anything from a mild cold to severe bronchitis or pneumonia, says Dr. Felton. Latent chronic bronchitis or emphysema also could be stirred from its slumber by a milder bug, he says.

Symptom Relief

As with traffic on the way home from work, you may have to tolerate the congestion until it clears. But here are a few shortcuts to try and some snarls to avoid.

Love those liquids. Drink more water and juices to loosen up and liquefy the increased mucus that's stuck down in your lungs, Dr. Felton says.

Go full steam. Holing up in the bathroom and turning on the hot water may provide some relief if you have an infection, Dr. Davis says. The hot, moist air may make you feel better. "But some people feel worse after exposing themselves to steam," she notes. "It's a matter of trial and error."

Try some tea. Have something warm to help loosen lung secretions, Dr. Davis recommends. Enjoy some tea with a little honey and lemon, for example. "It's also soothing on your irritated throat," she says. In addition, caffeine in tea or coffee may help open up your air passages.

Take something for your cough. Over-the-counter cough syrups containing guaifenesin help thin out the mucus lodged in your lungs, making it easier to cough up, says Dr. Felton.

Suppress the suppressants. If your lungs feel clogged with mucus and you're already hacking, leave cough suppressants on the shelf, Dr. Sheldon advises. You're supposed to cough and get rid of that gunk.

Widen the bronchial highway. If your physician diagnoses your congestion as asthma, Dr. Sheldon says you'll be given bronchodilating inhalers or pills to help you breathe easier.

Don't play doctor. One of the most counterproductive self-treatment steps is to rummage through the medicine cabinet and take a few old antibiotics from infections gone by. "Those antibiotics have made whatever bug you have down there stronger," Dr. Sheldon says. "The last time you took that drug, the bugs were warned that it was in the environment and they built up their defenses against it. You have to go after those bugs with something the little devils don't expect." And Dr. Sheldon also urges you to take the antibiotics your doctor prescribes for the full course of treatment: seven to ten days. Stopping earlier—even if you feel better—means you won't kill all the bugs.

See also Coughing; Wheezing

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