Emphysema causes a chronic, hacking cough that’s often accompanied by shortness of breath and a tightness in the chest.

Emphysema is a type of chronic obstructive pulmonary disease (COPD) that causes breathing difficulties and airflow blockage due to long lasting (chronic) inflammation in the lungs.

Emphysema is characterized by the destruction of the tiny air sacs in the lungs, called alveoli. This results in the loss of their elasticity and leads to severe symptoms, such as shortness of breath and rapid breathing.

One of the most disruptive symptoms of emphysema is a chronic cough. Having a persistent cough can be physically and emotionally exhausting, leading to interrupted sleep and difficulty with everyday activities.

An emphysema cough can feel tight and uncomfortable, as if there’s a lot of pressure or congestion in the chest. It’s often accompanied by shortness of breath or wheezing.

The cough can be persistent and disruptive, and it may interfere with your daily activities and sleep. In some cases, a strong and persistent cough can lead to incontinence or a fractured rib.

People with emphysema often have a highly sensitive cough reflex, meaning they cough easily in response to irritants in the airways.

One study from 2020 found that cough reflex sensitivity increases during COPD exacerbations (sudden worsening of symptoms). This sensitivity tends to decrease once the exacerbation is over. But if it persists after recovery, you may be more likely to have future exacerbations.

What does an emphysema cough sound like?

An emphysema cough can vary from person to person, but it’s often described as a chronic cough with a dry, hacking, or wheezing sound. It may be more forceful or deeper-sounding than a typical cough. It may also be accompanied by a crackling or rattling sound, due to the buildup of mucus and air in the lungs.

Many people with severe emphysema also have chronic bronchitis, which causes a productive cough with phlegm. Research from 2022 suggests that a frequent productive cough is linked to greater severity of the condition in people with COPD.

The first symptom of emphysema is often shortness of breath. The cough usually develops as the disease progresses.

In general, the early symptoms of pulmonary emphysema may include:

  • shortness of breath, which worsens with physical exertion
  • rapid breathing
  • phlegm production
  • coughing
  • wheezing

Do you cough up phlegm when you have emphysema?

Many people with emphysema cough up phlegm, particularly those with a more severe condition.

Phlegm production is caused by inflammation and damage to the airways and alveoli in the lungs. This damage can make it difficult for the lungs to clear mucus, leading to increased phlegm production and coughing.

In addition, people with emphysema are at greater risk for developing chronic bronchitis, which can add to mucus production and coughing.

A 2020 study of people with COPD shows that phlegm production is more common among people with chronic cough. People with a chronic cough also have the following symptoms:

  • wheezing
  • shortness of breath
  • chest pain and tightness
  • nighttime shortness of breath
  • episodes of acute bronchitis or pneumonia in the last 10 years
  • more than three general practitioner visits in the past year

Still, not everyone with emphysema will have phlegm production, and the severity of this symptom can vary between individuals.

There are several ways to calm an emphysema cough:

  • Medications: Your doctor may prescribe bronchodilators or corticosteroids to help open your airways and reduce inflammation in your lungs.
  • Breathing techniques: Controlled breathing techniques, such as pursed-lip breathing or diaphragm breathing, can help slow your breathing rate and reduce coughing.
  • Hydration: Drinking plenty of fluids can help thin mucus in your lungs and make it easier to cough up.
  • Avoidance of triggers: Try to avoid exposure to irritants like cigarette smoke and air pollution, as well as other respiratory irritants that can aggravate your cough.

Can you get rid of emphysema cough?

Emphysema is a chronic condition, so it’s not really possible to get rid of an emphysema cough. But there are ways to manage your symptoms and reduce cough frequency and severity.

If you’re a smoker, quitting is one of the most effective ways to manage your cough. Medications, such as bronchodilators and inhaled steroids, can also help reduce inflammation in the airways and improve breathing. This, in turn, may reduce the frequency of coughing.

Engaging in a program of exercise and education to increase your knowledge about lungs and illness can also help improve lung function and reduce coughing. This type of program is called pulmonary rehabilitation.

Can lungs recover from emphysema?

Emphysema is a chronic and progressive lung disease, which means it is long lasting and gets worse over time. It causes irreversible damage to the lungs’ air sacs.

But quitting smoking and avoiding other lung irritants can help slow down lung deterioration.

Over-the-counter (OTC) cough medications aren’t typically recommended for emphysema.

While excessive phlegm is common in emphysema, expectorant cough medications, such as guaifenesin (Mucinex), can make things worse.

Expectorants help thin and loosen phlegm, making it easier to cough it up, but these medications can also increase the production of mucus in the airways, which can worsen breathing difficulties.

Similarly, cough suppressant medications, such as dextromethorphan (Delsym 12 hour), aren’t recommended for people with chronic cough or excessive phlegm.

Rather, treatments such as bronchodilators and corticosteroids are typically used to manage the symptoms of emphysema.

One of the hallmark symptoms of emphysema is a chronic cough. This is caused by irritation of the airways due to inflammation or blockage caused by mucus buildup.

Over time, the cough may become more severe and frequent as the lungs become more damaged, making it harder to breathe.

While there is no cure for emphysema, treatments such as corticosteroids and breathing techniques can help manage your symptoms and slow the progression of the disease.