What are the causes and treatments of excessive mucus production?

From the Guidelines

Excessive mucus production is most effectively managed by addressing the underlying cause, with treatments including medications to thin mucus, reduce inflammation, and clear nasal passages, as well as lifestyle modifications to stay hydrated, avoid irritants, and use humidifiers. The causes of excessive mucus production are multifactorial, including respiratory infections, allergies, asthma, chronic sinusitis, gastroesophageal reflux disease (GERD), smoking, environmental irritants, and certain foods 1. Key treatments include:

• Over-the-counter medications like guaifenesin (Mucinex) at 400-600mg every 12 hours to thin mucus
• Antihistamines such as loratadine (10mg daily) or cetirizine (10mg daily) for allergy-related mucus
• Nasal saline irrigation using a neti pot or saline spray to clear nasal passages
• Antibiotics for bacterial infections
• Corticosteroid nasal sprays like fluticasine (1-2 sprays per nostril daily) to reduce inflammation Lifestyle modifications are equally important:
• Staying hydrated with 8-10 glasses of water daily to thin mucus
• Using a humidifier to add moisture to dry air
• Avoiding smoking and irritants to prevent further irritation
• Eliminating dairy or wheat if they trigger symptoms
• Hot liquids like tea with honey can provide immediate relief by loosening mucus, as suggested by the most recent guidelines 1. These treatments work by either reducing inflammation that causes mucus overproduction, thinning existing mucus for easier clearance, or addressing the underlying condition triggering the excess mucus response. It's crucial to note that the most recent and highest quality study, published in 2017 1, emphasizes the importance of managing chronic airways infection, improving mucociliary clearance, and reducing the impact of structural lung disease to improve quality of life and stop disease progression in patients with bronchiectasis. Therefore, the most effective approach to managing excessive mucus production involves a comprehensive strategy that includes medical treatment, lifestyle modifications, and, when necessary, addressing underlying conditions such as bronchiectasis, as outlined in the latest guidelines 1.

From the FDA Drug Label

The viscosity of pulmonary mucous secretions depends on the concentrations of mucoprotein and to a lesser extent deoxyribonucleic acid (DNA). The latter increases with increasing purulence owing to the presence of cellular debris.

The causes of excessive mucus production are not directly stated in the provided drug labels. However, it can be inferred that pulmonary mucous secretions viscosity is affected by:

• Mucoprotein concentrations
• Deoxyribonucleic acid (DNA) concentrations, which increase with purulence due to cellular debris The provided drug labels do not explicitly address the question of causes of excessive mucus production, but rather describe the mucolytic action of acetylcysteine and its effects on mucous viscosity 2, 2.

From the Research

Causes of Excessive Mucus Production

• Excessive mucus production is a common symptom of chronic obstructive pulmonary disease (COPD) and other obstructive airway diseases such as asthma and cystic fibrosis 3
• Inhaled particulates, such as viruses, bacteria, and cigarette smoke, can stimulate the production of mucins, leading to mucous hypersecretion 3
• The deposition of these particulates on the airway surface can induce a cascade of signals, including the Epidermal Growth Factor Cascade, leading to the production of mucins 3
• Bacterial infections, such as those caused by Pseudomonas aeruginosa, can also induce mucus hypersecretion by activating Toll-like receptor 5 (TLR5) and stimulating the release of TGF-α and the activation of epidermal growth factor receptor (EGFR) 4

Treatments for Excessive Mucus Production

• Non-pharmacological measures, such as smoking cessation and chest physiotherapy, can help decrease mucus hypersecretion and improve mucus clearance 5
• Pharmacological interventions, including expectorants and mucolytics, can help loosen and clear mucus from the airways 5, 6
• Guaifenesin, an expectorant, can increase hydration and decrease viscosity of mucus, leading to improved clearance of accumulated secretions from the upper and lower airway 5, 6
• Beta2-adrenoceptor agonists, such as salbutamol, can enhance mucociliary clearance and reduce sputum production 7
• Dual D2 dopamine receptor and beta2-adrenoceptor agonists, such as sibenadet, may also have a dual benefit in lessening sputum production and enhancing mucociliary clearance 7