What is wheezing?
Wheezing is the shrill, coarse whistling or rattling sound your breath makes when your airway is partially blocked.
Some wheezes can only be heard with a stethoscope, but often they can be heard with the human ear. Wheezing is more obvious when you breathe out (exhale), but can also be heard when you breathe in (inhale). The tone of the wheeze can vary depending on which part of the respiratory system is blocked or narrowed. Narrowing in the upper respiratory system may make for a hoarser wheeze. Lower obstructions may have a more musical tone, similar to a how a wind instrument like a clarinet might sound.
Anyone – from infants to elderly adults – can develop wheezing. Children with asthma often develop it. Wheezing is also quite common in infants; it’s estimated that up to 25% to 30% of infants develop wheezing in their first year of life.
Wheezing may be more common in babies because of their smaller airways. Also, children under two are susceptible to a common, but easily treatable condition called bronchiolitis. This is caused by a viral respiratory infection and inflammation. In adults, smokers and people with emphysema or heart failure are most prone to wheezing.
What causes wheezing?
Wheezing is usually caused by an obstruction (blockage) or narrowing of the small bronchial tubes in the chest. It can also be caused by an obstruction in the larger airways or vocal cords. The causes range from chronic (long-term), usually manageable conditions such as asthma, to very serious conditions that include heart failure. The most common causes of wheezing include problems with your:
- Asthma is a chronic condition that causes spasms and swelling in the bronchial tubes. Wheezing in asthma can be triggered by exposure to airborne allergens such as pollen, mold, animals, or house dust. Viral illnesses can also make asthma symptoms worse.
- Bronchitis is inflammation of the lining of the bronchial tubes.
- Bronchiolitis is most common in young children.
- COPD is chronic obstructive pulmonary disorder, a long-term inflammation and damage of the bronchial tube lining, most commonly from smoking cigarettes.
- Cystic fibrosis (CF). In people who have CF, thick mucus clogs the airways and makes breathing difficult.
- Pneumonia is an inflammation of the lungs caused by a virus or bacteria.
- Respiratory Syncytial Virus (RSV) is a seasonal lung infection that can lead to bronchiolitis or pneumonia.
- Aspirating (breathing) a foreign object into the lungs.
- Vocal cord dysfunction. VCD causes your vocal cords to close instead of opening up when you breathe in and out, making it harder to get air into or out of your lungs.
The digestive tract:
- GERD. Chronic acid reflux can relax the lower esophageal valve, causing wheezing.
- Allergies triggered by allergens such as dust mites, pollens, pets, mold spores and foods.
- Anaphylaxis, an acute (severe) allergic reaction caused by foods or insect stings.
- Heart failure. Cardiac asthma is from fluid in the lungs caused by left heart failure.
- Smoking increases your risk of developing COPD and emphysema. Smoking and second hand smoke makes asthma harder to control.
Wheezing in these cases is best managed by treating the underlying conditions.
If you develop wheezing, call your healthcare provider as soon as possible. If you’re experiencing wheezing along with a severe shortness of breath or a blue tinge to your skin, seek health care right away.
Care and Treatment
How is wheezing treated?
Your treatment for wheezing depends on its underlying cause. If wheezing is severe or interfering with breathing, you may need to be hospitalized until your breathing improves.
Asthma. If your wheezing is caused by asthma, you’ll likely be prescribed a type of inhaler to reduce inflammation and open your airways (a bronchodilator, for example). Inhaled corticosteroids and pills such as montelukast (Singulair®) are anti-inflammatory medicines used to treat asthma.
Bronchitis. If your doctor determines bronchitis is causing your wheezing, you may be prescribed a bronchodilator such as albuterol (Proair® HFA, Proventil® HFA, Ventolin® HFA) or an antibiotic to heal a bacterial infection. This should help you breathe better as you recover.
Other causes of wheezing may require specific treatments. Your doctor will prescribe a plan to treat the underlying cause of your condition, as well as soothe symptoms to help you feel better faster.
What can I do at home to treat wheezing?
There are a number of ways you can improve your wheezing:·
- Breathing exercises have been shown to help relax your airways if you’re asthmatic. Practice yoga breathing (prayanama) preferably in a moist, humid environment. If you’re not familiar with prayanama breathing, any slow, deep breathing exercises will help expand your lung capacity and relax your airways.
- Drink hot herbal tea. The warmth and moisture of the tea will help relax your bronchial tubes. Some studies show green tea to have antibacterial properties as well.
- Don’t smoke. Smoking irritates your lungs and inflames your airways. Avoid second-hand smoke as well.
- Use an air purifier with a HEPA filter to eliminate potential allergens in your home.
- Vaporize your air with a vaporizer or humidifier.
When to Call the Doctor
When should wheezing be treated by a healthcare provider?
See your healthcare provider if your wheezing is new, if it keeps coming back, or if it’s accompanied by any of the following symptoms:
- Shortness of breath.
- Chest tightness or chest pain.
- Rapid breathing.
- Unexplained swelling of your feet or legs.
- Loss of voice.
- Swelling of the lips or tongue.
- A bluish tinge around your skin, mouth or nails.
When should I go to the Emergency Room?
If your skin, mouth or nails are turning blue, then you aren’t getting enough air into your lungs. This is a medical emergency and you should have a family member or friend take you to the nearest urgent care or emergency room. If you’re alone, call 911 and describe your breathing.
If you suddenly start wheezing after a bee sting, after you take a new medication or eat a new food, that could indicate an allergic reaction and you should go to the emergency room immediately.
Whatever the cause of your wheezing, there are things you can do to get relief. Follow your healthcare provider’s directions, don’t smoke, take all medications as prescribed and run a vaporizer or humidifier to moisten the air. Doing all of these things will help you breathe easier.