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Coughing up a lot of mucus or phlegm in the morning is a common complaint many doctors get from their patients. Sometimes it gets so bad it can feel like vomiting, or it may really cause one to vomit after coughing up phlegm. It is common to experience these symptoms in the morning after getting up because mucus tends to pool in the throat while we are in a recumbent position.

It is normal for everyone to produce a certain amount of mucus daily. In fact, the mucus glands in the lining of the nose, airways, throat, stomach, and intestines produce up to two quarts of mucus daily.

Mucus is important to keep these areas moist. It also helps to trap and neutralize viruses and bacteria to prevent infection.

However, we do not normally feel the mucus coming up because it mixes with other secretions like saliva and drips down at the back of the throat and is continuously swallowed throughout the day.

We experience uncomfortable symptoms when the body produces more than the normal amount of mucus or if the mucus is thicker than usual. It may come out of the nose, a condition we call runny nose, or it may run down at the back of the throat as postnasal drip.

Postnasal drip is the most common cause of chronic cough and copious mucus secretion. Postnasal drip may caused by various conditions such as colds, flu, sinusitis, and allergic conditions. Other possible causes include the presence of foreign body in the nose, pregnancy, deviated septum, certain medications, changes in weather and humidity, certain foods, chemicals, and irritants.

Other conditions that can cause excess mucus production that leads to chronic cough and vomiting of phlegm include laryngopharyngeal reflux and bronchiectasis.

Laryngopharyngeal reflux (LPR) occurs when the stomach contents come up (reflux) into the throat and the voice box. It is distinct from gastroesophageal reflux disease (GERD) and is sometimes called extraesophageal reflux disease because patients do not experience heartburn. Thus it is also called silent reflux and what feels like mucus stuck in the throat is actually a combination of mucus and acid from the stomach.

The acid irritates the throat and increases one's sensitivity to mucus buildup in the area.

Symptoms include frequent cough, choking, hoarseness, difficulty swallowing, and bad taste in the mouth. People who develop LPR have one or more risk factors that include stress, tobacco use, excess alcohol consumption, overweight, eating large meals, eating before sleeping or lying down, and eating or drinking certain foods and beverages.

Bronchiectasis is a chronic lung condition where the airways are abnormally widened due to injury, mucus buildup, airway blockage and bacterial infection. The damage in the airways makes it difficult to get rid of mucus, so it builds up and causes the airways to stretch and swell, leading to repeated infections.

This leads to a daily production of large amounts of mucus, chronic cough, shortness of breath, chest pain and clubbing of the fingers.

If you have any of these symptoms, consult a doctor for proper evaluation and diagnosis. There may be other reasons for your symptoms, and it is best to have a complete physical examination and evaluation.

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