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Tips to help reduce inflammation, mucus, and coughing

Coughing is a fact of life with SGS. Your airway has scar tissue instead of healthy mucosa. In your airway, the mucus gets stuck in the region of the scar tissue, meaning it becomes thick and can potentially harbour bacterial infections and build up into a mucus plug (see next section). Inflammation is also often an issue for airway stenosis patients which can exacerbate the issue. Fortunately, there are some things you can immediately do to help with this.

Diet

What you eat has a massive impact on your breathing – both the inflammation and mucus elements. You can search on the internet for the most current advice, but generally:

  • Eat a diet rich in fruits and vegetables, especially:

    • Green leafy vegetables – such as kale, spinach, cabbage, water cress, romaine lettuce, Swiss chard, arugula, and endive

    • Dark yellow vegetables – such as pumpkin, yellow peppers, beans, and carrots

    • Whole nuts

    • Fruits – especially blueberries, pomegranate, orange, cherries, strawberries, apples, and pears

  • Drink– tea, coffee, and red wine (in moderation), and water (as much as you like)

  • Cook with and dress salads with extra virgin olive oil.

  • Fatty fish – e.g. rich in omega 3 fats in sardines, mackerel, salmon

  • Nuts – especially walnuts.

  • Apple cider vinegar – one tablespoon in soda water daily 

Presentation of inflammatory foods

​Minimise

  • Red meat, processed meat, organ meat (kidney, heart, lungs etc) and refined carbohydrates (white flour and white rice)

  • Sweetened beverages (anything with sugar in particular)

  • Dairy products and soy – many members notice an immediate difference when cutting out cow’s milk and its associated products (i.e. cream, yoghurt, butter, cheese, and products containing milk derivatives such as milk protein, lactose, whey). Soy milk is often portrayed as an alternative to cow’s milk but can often result in similar mucus effects. 

​​Other solutions

  • Nebuliser - with 0.9% normal saline or cool boiled water - 5ml at a time as often as you need it. Research has found that 7 in 10 SGS patients experience improved mucus symptoms, and 6 in 10 experience improvement in cough (K Tanner, 2019 ).

  • Humidifier in heated or air-conditioned environments Over the counter medicines

  • Mucinex or Robitussin Chesty Cough Capsule or liquid. Vicks cough syrup

  • Bisolvon Chesty tablets (Australian brand) - contains bromhexine hydrochloride 8mg (breaks down mucus to make it easier to clear)

  • Difflam (may have other names in different countries - this is the Australian brand name) AntiInflammatory, Anti-Bacterial Lozenges - helps to reduce inflammation and coughing and mucus without the need for steroids.

  • Nasacort (brand name in Australia, USA & UK) or Telnase nasal allergy spray - contains a steroid to reduce swelling in nasal passages. Can aid airway as well. Alternatively look for any nasal spray including triamcinolone (the active ingredient) - do not use long term (due to negative steroid side effects) or when you have a throat infection.

  • Antihistamine can help dry existing mucus and prevent additional formation due to allergy.

 

Prescription medication

Prednisolone / oral steroids

 

Techniques to help clear mucus

Deep Coughing: Start by taking a deep breath. Hold the breath for 2-3 seconds. Use your stomach muscles to forcefully expel the air. Avoid a hacking cough or merely clearing the throat. A deep cough is less tiring and more effective in clearing mucus.

 

Huff Coughing: Huff coughing, or huffing, is an alternative to deep coughing if you have trouble clearing your mucus. Take a slow deep breath that is slightly deeper than normal. Use your stomach muscles to make a series of three rapid exhalations with the airway open, making a "ha, ha, ha" sound. Follow this by controlled diaphragmatic breathing and a deep cough if you feel mucus moving.

Nebulizer Use in Adults with Subglottic Stenosis: A Survey Study, Ann Otol Rhinol Laryngol 2019 Apr;
128 (4):345-351. Doi:10.1177/0003489418823797. Epub 2019 Jan 14. K Tanner, C Anderson, M Smith

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