I feel like I'm experiencing a lot more mucus in this weather. Why does this happen?
When you breathe through your stoma, the air goes directly into your lungs without passing through your nose and throat first. This means the natural warming, moistening, and filtering that your upper airway used to do no longer happens in the same way. Your HME (Heat and Moisture Exchanger) does a wonderful job of adding moisture and warmth back into the air you breathe, and of filtering out particles. But in certain environments, you may notice changes in your secretions that can feel unexpected or inconvenient. There are three main reasons this can happen.
Reason 1: Extra humidity is helping your airway clear itself
In warm, humid environments (like a steam room, a hot shower, or humid weather), the air you breathe in already contains a lot of moisture. This can actually be a good thing for your airway. The extra humidity:
- Helps keep the lining of your airway moist and healthy
- Makes any existing mucus thinner and easier to move
- Helps the tiny hair-like structures (cilia) in your airway work more efficiently, sweeping mucus upward and out
The result can be a sudden surge of secretions, which can feel like a flood and often happens at an inconvenient moment.
What to look for:
- Secretions that are clear or slightly cloudy
- The episode lasts around 10 minutes to an hour
- Once the mucus has cleared, your airway feels comfortable and settled
- No ongoing cough or irritation after clearance
This is generally a positive sign that your airway is clearing itself well.
Reason 2: Airway sensitivity or hyperactivity
Some people find that their airway becomes over-responsive to certain things in the environment. Because your stoma bypasses the filtering function of your nose and throat, the lining of your airway is more directly exposed to what is in the air around you.
Common triggers include:
- Humid air, cold air, or sudden temperature changes
- Pollen, dust, mould spores
- Air pollution, smoke, or strong perfumes
- Exercise
When your airway reacts to one of these triggers, it can produce increased secretions and cause you to cough more.
What to look for:
- Secretions that are thin and watery
- Coughing and secretions that continue for as long as you stay in that environment
- Secretions come back quickly after you clear them, if you are still in that environment
- You may have noticed similar reactions to other triggers in the past (e.g. perfume, smoke, pollen)
Reason 3: Hot weather and thick, sticky secretions
Hot weather creates another challenge. When it is very hot, you lose more fluid through sweating and breathing, and if your fluid intake has not kept up, or if you have a low humidification HME, your airway can become less well humidified than usual. This can cause secretions to become thick, sticky and difficult to cough up or clear.
This is important to recognise early because thick secretions are harder to manage and can become a more serious problem if left unaddressed.
What to look for:
- Secretions that feel thick, sticky, or stringy rather than thin or watery
- Difficulty coughing secretions up or out
- A feeling that your airway is not fully clear even after attempting to clear it
- Feeling more breathless than normal when trying to clear your airway
- Secretions may appear slightly darker than usual
Why does this happen:
When the airway is not getting enough moisture, the mucus lining becomes dehydrated, more concentrated, and more viscous. The cilia (tiny hair-like structures that sweep mucus upward) struggle to move thick mucus effectively. The combination of heat, increased fluid loss through sweating, and any gaps in wearing your HME can compound this problem quickly.
Managing thick secretions in hot weather:
- Increase fluid intake. The single most important thing you can do is drink more water. When it is hot, your body loses more fluid, and your secretions will reflect this. Aim to drink regularly throughout the day, even if you do not feel thirsty. Staying well hydrated helps keep the mucus thinner and easier to clear.
- Check HME wear. Make sure you are wearing your HME consistently, including during rest periods and overnight. Any time you spend without your HME means dry air is reaching your lungs directly. Gaps in your HME use will make thick secretions worse.
- Saline nebuliser - if approved by your clinical team. If secretions are thick and difficult to clear, saline nebulisers can help loosen and soften them, making them easier to cough out. Your clinical team can advise on the most appropriate routine for you.
- Gentle airway clearance. Once secretions have been softened with moisture, gentle controlled coughing or huffing will help move them up and out. To try this, imagine trying to fog up a mirror with your breath, this is a great way to practice the huff technique. Try to avoid repeated forceful coughing, which can irritate the airway without being more effective.
- Consider higher humidification HME. Some HME's provide more humidification than others. If you are consistently struggling with thick secretions speak to your clinical team about whether switching to a higher humidification HME might help.
When to seek urgent help: if secretions become so thick that your airway feels blocked or you are having difficulty breathing, this is a medical emergency. Seek help immediately via 999.
What can you do?
Carry spare HMEs
If your HME feels damp or saturated, replace it with a fresh one. A wet HME cannot do its job properly.
Clear your airway proactively
Rather than waiting for a flood of secretions to happen, try clearing your airway at a convenient time when you know you are going into a humid or triggering environment. This gives you more control and can prevent unexpected episodes in social situations.
In steam rooms or very humid environments
Some people find it helpful to use a lower-humidification HME (such as an Energy HME) in these environments, as the air is already very moist. This is something to discuss with your clinical team before trying, as it is important to use the right HME for the right situation.
If your airway seems reactive or sensitive
Switching to a Protect HME, which has better filtering properties, may help reduce sensitivity to particles and irritants in the air. This is also something you should discuss with your clinical team before trying.
If allergies may be involved
If you suspect pollen or another airborne allergen is triggering your symptoms, an antihistamine trial may be worth discussing with your GP or specialist team
Looking after your skin
If you are producing more mucus than usual, the skin around your stoma can become wet for longer periods. Prolonged moisture against the skin can cause it to become sore or break down (this is called maceration). To protect your skin:
- Keep the area around your stoma as dry as possible
- Change adhesives regularly and check your skin at each change
- If you notice redness, soreness, or skin breakdown, contact your clinical team promptly