Airway Mucus and Symptom Support

People with bronchiectasis and NTM lung disease often find it hard to clear mucus from their lungs. To manage mucus buildup and prevent infections, it is important to have a routine for keeping the airways clear.

In addition to mucus build up, people with bronchiectasis and NTM lung disease may experience other symptoms including nausea, cough, weight loss, and fatigue. Understanding common symptoms can help identify management strategies.

Dive Deeper

Airway Mucus and Symptom Support

Airway Mucus

Individuals with bronchiectasis and nontuberculous mycobacterial (NTM) lung disease struggle to keep their airways clear of mucus. Bronchiectasis causes too much mucus, which collects in the lungs. It also creates expanded airways, which makes it harder to cough up the mucus. The cilia in the airways also struggle to clear mucus from the lungs. Cilia are tiny, hair-like structures that help to “sweep” the mucus out of the smaller airways into larger airways. In bronchiectasis and NTM, the cilia are often damaged because of a thickening of the airway wall. All three of these problems cause mucus to collect in the lungs. When mucus collects in the lungs, it creates an ideal home for bacteria to live, grow and cause infections. This can lead to further inflammation and worsening of your condition. For these reasons, it is important for patients to create a bronchial hygiene routine to help clear mucus from the lungs. This will break the cycle of inflammation and infection.

Bronchial hygiene measures are those done on a routine basis to help clear the mucus from the lungs. If you have a chronic lung condition, it is very important that you find a bronchial hygiene routine that works best for you. Your pulmonologist can guide you in choosing the right routine for your diagnosis. Not every person with a chronic lung condition responds the same way to each routine. You may need to change your routine during different seasons, when you have a flare-up or exacerbation, or for other personal health reasons.

A typical bronchial hygiene routine uses therapy from one or more of the following categories¹:

Manual techniques for airway clearance – There are several different coughing and breathing methods that will help you move and cough up the mucus in your lungs. These methods should make your coughing more effective. These methods should also make coughing less irritating to your throat and less tiring. Click here to learn more about the different types of manual airway clearance techniques.
Devices for airway clearance – Mucus can be sticky, which makes it even more difficult to move. Airway clearance devices can help loosen the mucus. This will allow it to move from the smaller airways into the larger airways, where it can be coughed out. You may need or want to use a device in your bronchial hygiene routine. Click here to learn more about different airway clearance devices.
Medications for airway clearance – Your doctor may give you the names of over-the-counter medicines, prescription medicines, and inhaled therapies that can help make the mucus thinner. Thinner mucus is easier to cough up. Remember to follow their instructions carefully. Report any side effects that occur. Click here to learn more about different medicines that can help with airway clearance.

Regardless of the type of bronchial hygiene measure(s) you use, the most important thing to consider is—is it working effectively? Is it helping you cough out the mucus and clear your lungs? Doing so will help you lower your risk of infection and eliminate any airway blockage.²

Nausea

Large amounts of mucus and repeated use of certain medicines called antibiotics (an tee by ah tics) can cause nausea and an upset stomach for many people with bronchiectasis and nontuberculous mycobacterial (NTM) lung disease. Nausea causes a loss of appetite and weight loss. Extreme or quick weight loss can lead to poor health, an inability to fight infections, and poor health for patients with chronic lung disease. This includes those with bronchiectasis and NTM lung disease.³

Here are some ways to cope with nausea and an upset stomach from antibiotic use and too much mucus:

Prescription Medicines

Ondansetron (on DAN se tron), also known as Zofran (zo fran) – This is a medicine used to treat nausea and vomiting. It is available in different forms including tablet that you swallow, oral dissolving tablet, and by an injection or “shot.”⁴ This medicine must be prescribed by a doctor. Not all patients will be able to use it because of their health history and the other drugs they may also be taking.

Prochlorperazine (pro chlor per azine), also known as Compazine (com pa zeen) – This medicine is used to prevent and treat nausea and vomiting. It can be taken by mouth as a quick acting tablet or a slow-release capsule. It can also be given by injection or as a rectal suppository.⁵

Metoclopramide (met o clo pra mide), also known as Reglan (reg lan) – This medicine increases muscle movement in the upper digestive tract. This can help to speed up the rate in which the stomach empties. This action helps to relieve nausea. Metoclopramide is typically taken by mouth before meals.⁶

Therapy to Pair with Your Medicines

Probiotics – Probiotics are good, live bacteria or yeasts that naturally occur in your body. These “good bacteria” help your immune system to work correctly. They can also reduce inflammation.⁷ Antibiotics tend to kill the good bacteria, along with the bad bacteria, in the stomach. It is important to replace the good bacteria by taking a probiotic supplement. Taking probiotics can also lessen the diarrhea that antibiotics can cause.⁸ You can get probiotics by eating foods like yogurt or cottage cheese, but they are also available as supplements you can buy.

There may be other foods and herbs that could help reduce nausea or improve gut health. Talk with your doctor to find out if there are specific foods that may help you.

Other Words of Advice

Some antibiotics are better absorbed on an empty stomach. However, if the antibiotic instructions are “take with food,” be sure to take as instructed. In some cases, food can help coat the stomach. This can help reduce side effects such as upset stomach, nausea, and diarrhea.

A diet that is bland in flavor may also help to sooth the stomach. Bland foods that are low in dietary fiber can be used for a short-term treatment of nausea and diarrhea.⁹ This type of diet, however, does not provide you with all the daily nutrients that your body needs. If you are eating like this for a long period, talk with your doctor about other food choices to make sure you are giving your body the fuel it needs.

References

Lester M, Fume P. Airway-clearance therapy guidelines and implementation. Respir Care. 2009;54(6):733-753. doi: https://doi.org/10.4187/002013209790983205
Lesan A, Lamle AE. Short review on the diagnosis and treatment of bronchiectasis. Med Pharm Rep. 2019;92(2):111-116. doi: https://doi.org/10.15386/cjmed-1060
Itoh M, Tsuji T, Nemoto K, Nakamura H, Aoshiba K. Undernutrition in patients with COPD and its treatment. Nutrients. 2013;5(4):1316-1335. doi: https://doi.org/10.3390/nu5041316.
Prescribers’ Digital Reference (PDR). Ondansetron. PDR website. Updated 2021. Accessed February 5, 2021. https://www.pdr.net/drug-summary/Ondansetron-ondansetron-hydrochloride-3428.2904.
Prescribers’ Digital Reference (PDR). Prochlorperazine - drug summary. PDR website. Updated 2021. Accessed March 16, 2021. https://www.pdr.net/drug-summary/Compro-prochlorperazine-2001.1792.
Prescribers’ Digital Reference (PDR). Metoclopramide - drug summary. PDR website. Updated 2021. Accessed March 16, 2021. https://www.pdr.net/drug-summary/Reglan-Tablets-metoclopramide-956.5843.
Cleveland Clinic. Probiotics. Cleveland Clinic website. Updated March 9, 2020. Accessed February 2, 2021 https://my.clevelandclinic.org/health/articles/14598-probiotics.
Guo Q, Goldenberg JZ, Humphrey C, El Dib R, Johnston BC. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev. 2019;4(4):CD004827. doi: https://doi.org/10.1002/14651858.CD004827
Duro D, Duggan C. The BRAT diet for acute diarrhea in children: should it be used? Pract Gastroenterol. 2007;31(6):60-68.

This page was reviewed on April 16, 2026 by the Bronchiectasis and NTM Association Content Review and Evaluation Committee.