What Causes Wheezing & How is it Treated?

What is Wheezing?

Wheezing is a high-pitched, whistling type of sound which is produced upon breathing. Wheezing usually occurs during expiration (breathing out), but can also occur during inspiration (breathing in). Wheezing can be a symptom of some underlying conditions, such as COPD, hay fever, asthma, bronchospasm, acute bronchitis, mucus in the airways, swelling in the airways or some obstruction in the throat. If the patient is having difficulty in breathing along with wheezing, then immediate medical attention should be sought.

What Causes Wheezing?

What Causes Wheezing?

Wheezing occurs as a result of narrowing of the airways and is an indication of difficulty in breathing. There are many causes for the narrowing of airways, such as inflammation due to asthma, allergic reaction, infection, physical obstruction etc. Asthma is the most common cause of recurrent wheezing. Some of the other causes for wheezing include:

  • Anaphylaxis, which is a fatal allergic reaction, to anything e.g. medication or an insect bite.
  • Allergies.
  • Asthma.
  • Bronchiolitis (particularly in young children).
  • Bronchiectasis, which is a chronic lung condition where there is abnormal widening of the bronchial tubes which prevents the mucus from clearing.
  • Bronchitis.
  • COPD (chronic obstructive pulmonary disease) and other lung conditions.
  • Childhood asthma.
  • Emphysema.
  • Inhalation of any foreign object.
  • Epiglottitis.
  • Gastroesophageal reflux disease (GERD).
  • Lung cancer.
  • Heart failure.
  • Medications, especially aspirin.
  • RSV (Respiratory syncytial virus), particularly in young children.
  • Pneumonia.
  • Respiratory tract infections (particularly in children under 2 years of age).
  • Obstructive sleep apnea.
  • Vocal cord dysfunction.
  • Smoking.

Symptoms of Wheezing

  • The symptoms of wheezing include a whistling or a musical type of sound.
  • The patient has labored breathing, especially when exhaling.
  • The labored breathing may be accompanied by a symptom of tightening sensation in the chest.
  • The wheezing can be heard clearly with the help of a stethoscope or by plugging the ears and exhaling rapidly.
  • Stridor is a type of wheezing sound, which is heard during inhalation and is commonly caused due to narrowing of the vocal cords or windpipe.
  • Seek immediate medical attention if the wheezing is accompanied by symptoms of difficulty in breathing or rapid breathing, bluish skin color, if there is abrupt onset of wheezing after a bee sting or taking some medication or food, if the wheezing starts after choking on food or a small object.

Diagnosis of Wheezing

  • The underlying cause of wheezing is determined by asking the patient’s medical history and taking physical examination.
  • Questions are asked of the patient regarding the symptoms and what triggers them.
  • If the patient does not have a history of lung disease, but tends to wheeze at a certain time of year or after eating some type of food, then it indicates that the patient has some respiratory or food allergy.
  • The doctor listens to the lungs using a stethoscope to identify the location of the wheezing and the amount of wheezing the patient has.
  • Chest x-ray can also be done to find the cause of the wheezing.
  • Spirometry, which is a breathing test, can also be done. Other than this blood tests and further procedures are done if needed.

How is Wheezing Treated?

The aim of treatment for wheezing is controlling the inflammation in the airways and widening the breathing tubes. The inflammation is controlled or reduced by prescribing anti-inflammatory medications. These medicines also help in reducing the excess mucus in the airways. These medicines to treat wheezing can be used in the form of inhalers and long-acting tablets. Syrups are prescribed for wheezing in young children.

Quick-acting bronchodilators are used for opening up the breathing tubes. They help in treating the wheezing and relieving the cough. Bronchodilators function by relaxing the surrounding smooth muscles of the breathing tubes. If the cause of wheezing is a chronic illness, such as asthma or COPD, then both the anti-inflammatory medications as well as bronchodilators may be prescribed.

In some cases patient may need to have a breathing tube put down his/her throat.

If allergy is the cause of wheezing, then different types of tests are done to diagnose the type of allergy, such as blood and skin tests.

Treatment for Wheezing Caused by Asthma

  • The doctor prescribes a fast-acting bronchodilator inhaler, such as albuterol and levosalbutamol. These medicines work by dilating the constricted airways which help with the respiratory symptoms.
  • Inhaled corticosteroids, such as ciclesonide, mometasone , beclometasone, flunisolide, fluticasone and budesonide are prescribed.
  • The patient can also be prescribed a combination of corticosteroid and a long-acting bronchodilator, such as fluticasone/salmeterol and budesonide/formoterol.
  • Medicines, which help in controlling asthma, are also prescribed which help in reducing the inflammation in the airways and include montelukast and zafirlukast.
  • Antihistamine medications can also be prescribed, such as loratadine, fexofenadine and cetirizine.
  • Prescription nasal sprays, such as triamcinolone acetonide, fluticasone propionate, mometasone furoate, are prescribed for nasal allergies.

Treatment for Wheezing Caused by Acute Bronchitis

  • Bronchodilators such as albuterol and levalbuterol are given to alleviate the wheezing as the infection abates.
  • An antibiotic can be prescribed if the patient has a bacterial infection or an underlying chronic lung condition.
  • Mild wheezing occurring with acute bronchitis disappears as the infection subsides.

Emergency Treatment for Wheezing

  • A shot of epinephrine is given to open up the blocked airway passages.
  • Oxygen is given.
  • Corticosteroids, such as prednisone or methylprednisolone are given.
  • Nebulizers and mechanical ventilators can be used to help with the breathing.

Home Remedies for Wheezing

  • A humidifier can be used to moisturize the air, which helps in easing the wheezing.
  • A steamy shower also helps in moisturizing the air.
  • Tobacco smoke should be avoided as active or passive smoking worsens wheezing.
  • Drinking warm liquids help in relaxing the airways and in loosening the sticky mucus present in the throat.
Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:January 24, 2019

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