How to speak to your doctor
COPD
NICE9 (the UK’s health watchdog) says: Many people with COPD cough up mucus (sputum). Mucolytics are medicines which are believed to make it easier to cough up mucus – by making it less sticky. In some European countries, mucolytics are used more than in the UK, because it is thought that they reduce the frequency of flare-ups (exacerbations) or reduce symptoms in people with chronic bronchitis. The latest update on the management of COPD recommends the use of mucolytics in the UK, because there is evidence from clinical studies that they significantly reduce the frequency of exacerbations, increase the number of people who remain exacerbation-free and improve lung capacity (forced expiratory volume in 1 second [FEV1], measured by spirometry).
Reducing the frequency of exacerbations is important because they often mean having to take time off work, or having to go into hospital for treatment.
CYSTIC FIBROSISThe Cystic Fibrosis Trust14 points out that dehydration, severe infection and diabetes – to which people with CF are prone – can all contribute to excessively sticky mucus, that is hard to clear. Mucus ‘plugging’ can result in serious complications. Treatment of excess mucus or plugging includes physiotherapy, effective airway clearance techniques and additional mucolytic therapy. It is vital to ensure adequate hydration, and moistening the air we breathe – or the oxygen supply for people on oxygen therapy – is also important.
LUNG CANCERClinical Knowledge Summaries,13 a resource provided by the NHS for doctors, says that the goal of treatment of cough in people with cancer – whether cancer of the lungs or lung complications of cancer in another part of the body – is to relieve the cough in the way that most enhances the person’s quality of life. Where the cough is caused by excess mucus secretion, the treatment of choice is a mucolytic to reduce the viscosity, or stickiness, of the secretions, and treatment should be continued for as long as it is helpful.13
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