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Showing content from https://www.webmd.com/asthma/understanding-wheezing-basics below:

Causes, Diagnosis, Treatment, and Remedies

Wheezing is a whistling sound you may hear when you breathe.

Chronic obstructive pulmonary disease (COPD) and asthma are the most common causes of wheezing, but respiratory infections such as acute bronchitis can also cause it. Many people with respiratory allergies know that wheezing often happens during the hay fever season.

Wheezing can come with a variety of health conditions. If you wheeze a little bit with a cold, but it doesn’t bother you much and goes away on its own, you may not need treatment. But see your doctor if you have trouble breathing, your breathing gets fast, or your skin turns blue for a short time. Go to the ER if you start wheezing during a severe allergic reaction.

Several treatments can ease wheezing. Depending on the cause of your wheezing, you may need to see a specialist such as an allergist or pulmonologist.

A wheezing cough is when you are coughing along with wheezing. Wheezing happens because your airway is narrowed, and coughing usually happens because something is irritating the airway and your body is trying to expel it, says Mark Moss, allergist and associate professor of medicine and pediatrics at the University of Wisconsin School of Medicine and Public Health.

“Someone might have wheezing because their airway is narrowed because it has mucus in it and it’s a bit swollen, but they also cough to try to clear that mucus out,” Moss says.

Sometimes, wheezing makes it hard to breathe. But other times, it may not cause any breathing problems, and you may not be able to feel it.

Wheezing can come with a variety of health conditions. But see your doctor if you have trouble breathing, your breathing gets fast, or your skin turns blue for a short time. Go to the ER if you start wheezing during a severe allergic reaction. (Photo Credit: Martinmark/Dreamstime)

Wheezing usually sounds like a high-pitched whistle. “Wheezing is a long-duration, high-pitched, musical sound when someone is breathing out,” although sometimes you can hear wheezing when you breathe in as well, Moss says. Wheezing may sound a bit like hissing.

Sometimes, you can’t hear wheezing yourself, but a health care provider can hear it through a stethoscope. 

Your breathing also may make a lower-pitched, rattling sound, somewhat like a snore or gurgling, called ronchi. People often describe this as coarse breathing. Sometimes, that’s considered a type of wheezing, but technically, those lower-pitched sounds are ronchi, Moss says. 

You might also have a wheezing cough. “We see people who come in and have asthma that’s flaring up for a variety of reasons, for example, a cold. And they may have wheezing on expiration, but also on inspiration, and accompanying low-pitched ronchi, and may cough as they’re taking deep breaths,” Moss says.

You may be wheezing and not realize it. “We’ll have someone come into the clinic and they’ll say, ‘I have a cold. I’m doing OK. I haven’t really used my inhaler much,’” and then, during an exam, the provider clearly hears wheezing when they’re breathing out, Moss says.

Wheezing when breathing out

Wheezing is usually most noticeable when you’re breathing out. This is because your airways normally narrow when you breathe out.

If your airways are partially blocked (or obstructed), the air moving through them creates a whistling sound, which is called wheezing.

Wheezing when breathing in

Although wheezing usually happens when breathing out, it can happen when you’re breathing in as well. 

If you’re wheezing both when breathing out and when breathing in, your airway may be more severely restricted than if you’re wheezing only when breathing out. If you have asthma and you’re wheezing, you may be able to hear wheezing when you’re inhaling and exhaling. 

Sometimes, you might have a wheezing cough on top of your wheezing.

Stridor vs. wheezing

Stridor is another type of noisy breathing that sounds somewhat like wheezing. It’s a high-pitched whistle or squeaking sound that usually happens when you breathe in. It’s a less musical sound, and it may happen because a small object is lodged in your airway.

Stridor often happens because of swelling in the middle airway, such as around the neck and the vocal cords, while wheezing from asthma originates deeper in the lungs, Moss says. 

The whistling sound happens when air moves through airways that are narrowed, much like the way a whistle or flute makes music. Wheezing happens when your lower airways are narrowed.

Many health problems can cause wheezing, including:

• Asthma. This condition, in which your airways narrow, swell, and make extra mucus, can make it hard to breathe.
• COPD. With COPD, the damage to your lungs causes swelling and irritation that limits airflow in and out of your lungs.
• Allergic reactions to pollen, chemicals, pet dander, dust, foods, or insect stings
• Bronchitis
• A cold
• Cystic fibrosis. It damages your lungs and makes the mucus extra sticky and thick
• Obstruction of an airway because you’ve inhaled an object such as a piece of food
• Lung cancer
• Congestive heart failure
• Pneumonia. This infection inflames the air sacs in your lungs, and they fill with fluid or pus.
• Bronchiolitis. This lung infection inflames the airways and causes congestion, usually in children.
• Emphysema. It is a lung condition that causes shortness of breath.
• Smoking or breathing in smoke
• Respiratory syncytial virus. This can lead to bronchiolitis.
• Gastroesophageal reflux disease (GERD)
• Vocal cord problems
• Sleep apnea

Wheezing is common in infants. About 50% of children have a wheezing episode in their first year of life. 

Young children are more likely to wheeze because their airways are small, and they’re also more likely to get upper respiratory infections than adults are. When this happens, the infants’ small passages swell, and they often fill with mucus, which can cause wheezing and coughing. 

If your infant is wheezing, that doesn’t necessarily mean they have asthma. Even if it happens repeatedly, they may outgrow it when they’re older and not have asthma. Sometimes, doctors will wait until the child is 4 or 5 before confirming a diagnosis of asthma.

Wheezing can also mean that an object is lodged in the airway and needs to be removed. This is a concern especially with young children who may have put an object in their mouth. If a child starts wheezing out of the blue, this may be the reason, Moss says. 

 

To diagnose the cause of your wheezing, your doctor will perform an exam. They will also ask you some questions, such as:

• How long have you been wheezing?
• Does it happen when you exercise?
• Do you wheeze all the time?
• Do you wheeze more during the day or at night?
• Does rest help control your wheezing?
• Do you wheeze when you breathe in, out, or both in and out?
• Do you smoke?
• Do certain foods seem to cause your wheezing?

They’ll listen to your breathing and the sounds your lungs make. They might do certain tests, such as:

• X-rays to get a picture of your lungs
• Breathing tests to see how well your lungs are functioning
• A blood test to check your oxygen levels (too low levels could signal a lung problem)

If your child is wheezing, their doctor might check to see if they’ve swallowed or inhaled something small. 

If your wheezing is making it difficult to breathe, the treatment you get immediately may be:

Albuterol. This beta-agonist medication helps the muscles around the airways relax and open up the airways, Moss says. Albuterol can be given through an inhaler or a nebulizer, where a liquid form of the medication is put into a machine.

Oxygen. Oxygen can help you breathe more normally. This is often used for COVID and young children with respiratory syncytial virus (RSV), Moss says.

Oral steroid medications. Sometimes these medications are given to children and adults who have wheezing that needs immediate treatment, Moss says. 

If your wheezing is serious, you may need to stay at the hospital until you get better. 

After that, treatment depends on the cause of the wheezing. Some common causes and their treatments include:

Asthma. If your wheezing is caused by asthma, your doctor will probably prescribe:

• A bronchodilator medication, such as albuterol, to ease inflammation and open your airways
• Inhaled steroids, to fight inflammation
• Medications such as montelukast (Singulair) that treat asthma 

Other types of medications, including injectable medications, also treat asthma and wheezing. “There have been just tremendous advances in asthma treatment over the last 10 years for people who have ongoing asthma that is moderate or severe,” Moss says.

 Bronchitis. Your doctor may prescribe the following if your wheezing comes from bronchitis:

• A bronchodilator to open your airways
• An antibiotic to fight a bacterial infection

COPD. For COPD-related wheezing, some prescription options include:

• Bronchodilators
• Inhaled steroids 

“You shouldn’t wheeze,” Moss says. “Someone who is having repeated wheezing or episodic wheezing really should look at how much it’s impacting their quality of life, and know that it doesn’t have to.”

For example, Moss says, “We see people all the time who come in and will say, ‘I’ve been wheezing for a year.’ But they muddle through it — they do things to make it easier to breathe, such as taking the elevator rather than the stairs.” 

If wheezing is a persistent problem, you should see your doctor for treatment to get it under control.

If your wheezing is making it difficult to breathe, see a doctor so you can get the right treatment. 

If your wheezing isn’t bothering you and you don’t need immediate treatment, here are some things you can do to ease or prevent wheezing:

• Keep the air moist. Use a humidifier, take a warm, steamy shower, or sit in the bathroom with the door closed while running a hot shower. 
• Drink something warm. It relaxes your airways and loosens sticky mucus.
• Don’t smoke, and stay away from people who do.
• Follow your doctor’s orders. Take your medications according to the instructions.
• Clean the air. Use an air cleaner with a HEPA filter. This will cut down on allergens that often lead to asthma attacks. 

Breathing exercises can reduce your wheezing and help your lungs work more efficiently. “Breathing techniques can also help the airway relax — help to change how a person is breathing and moving air in their airway,” Moss says. 

Try these breathing techniques:

Pursed-lip breathing. Breathe in through your nose. Breathe out for twice as long, with your lips pursed like you’re going to whistle. Breathing out through pursed lips increases the airway pressure and helps open your airways a bit, Moss says. 

Belly breathing or diaphragmatic breathing. Breathe in through your nose. Put your hands on your belly and pay attention to how it expands. Breathe out through your mouth for at least two to three times as long as you breathe in. If you’re wheezing, your chest may feel tight. When you focus on your belly or your diaphragm while breathing, it helps relax your chest, Moss says.

Buteyko breathing method. Breathe in and out through your nose for a few minutes. After breathing out, plug your nose and hold your breath, inhaling when you feel the urge to breathe. Breathe in and out through your nose a few times and repeat. This helps normalize breathing patterns.

Nasal breathing. Breathe in and out through your nose, relaxing your jaw and throat. Breathe slow and steady. This helps warm and humidify the air as you breathe it in.

Other breathing methods used in yoga or meditation can be helpful, too, Moss says. With these techniques, you’re “focusing your breathing deeper in your core, down to your belly, so that you’re getting a much deeper breath and you’re not breathing as shallowly,” he says.

Many breathing techniques are used in yoga and meditation, and they may help improve your breathing. They include:

Alternate nostril breathing. While sitting up, use your right thumb to close your right nostril, and inhale deeply through your left nostril. Use your ring finger to close your left nostril, and breathe out through your right nostril. Then switch, breathing in through your right, and repeat the process.

Bumblebee breath. While sitting, close your eyes and put your index fingers on your eyelids, thumbs in your ears, and rest of the fingers on your face. Take a deep breath through your nose, and as you breathe out, close the back of your throat to make a humming or buzzing sound. 

Mild wheezing, the type that happens when you have a cold, should go away when the illness does. If it’s not bothering you, you may not need to see a health care provider.

But you should see a doctor if you have:

• Trouble breathing
• Fast breathing
• Skin that briefly turns blue

Go to the ER if your wheezing:

• Starts soon after you’re stung by a bee or just after you take medication or eat food that you might be allergic to
• Comes with severe breathing trouble or bluish skin
• Happens after you choke on a bit of food

 

Wheezing can be caused by many different things, including chronic conditions such as asthma, having a cold, and being exposed to an allergen, such as pollen. If wheezing is making it hard for you to breathe, you should get immediate medical attention. The right treatment for your wheezing depends on the cause. It’s important to get treatment because it can ease your wheezing and prevent it from happening. Medications and breathing exercises can help.

How can I stop wheezing immediately?

If your wheezing is severe and making it difficult to breathe, you may need albuterol or oxygen treatment. If your wheezing is not severe, you can try breathing exercises, such as belly breathing, to help relax your airways. 

Can GERD cause wheezing?

Yes. Gastroesophageal reflux disease (GERD) is a condition that can cause wheezing. 

How can I stop wheezing without inhalers?

You may or may not need medication for your wheezing. Breathing exercises also may help you stop wheezing. Sometimes wheezing will go away on its own. “For example, someone who’s allergic to a cat and has asthma, and goes to a house where there's a cat, may notice that they start wheezing right away and leave the house, breathe some fresh air, and feel improvement within minutes because they’ve removed that trigger,” Moss says.

Can wheezing be cured?

Wheezing isn’t exactly a disease that can be cured, but it can be stopped. For example, if you’re wheezing because you have asthma, taking preventative medication daily can help stop your wheezing. “A lot of people wouldn’t necessarily call that being cured because they’re still taking medication preventatively. So, a lot of times we’ll describe it as wheezing or asthma that goes into remission,” Moss says.

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