Wheezing: Causes, Treatment, and When to See a Doctor

Wheezing can be a sign of a serious underlying issue.

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There are certain health symptoms, like randomly sneezing here and there, that you might find easy to brush off. Wheezing is not one of those things.

Wheezing can be a sign of a breathing problem and, in some situations, it's incredibly serious. Of course, you're not born knowing the ins and outs of wheezing, and you probably have some questions if you or a loved one suddenly starts wheezing. Here's what you need to know.

What Is Wheezing?

Wheezing is a high-pitched sound that's made during breathing, according to MedlinePlus. It usually sounds "almost like a whistle," Shweta Sood, MD, a pulmonologist at Penn Medicine, tells Health. The sound is most obvious when exhaling, but it may also be heard when inhaling.

The wheezing sound happens when air moves through narrowed passageways. That narrowing and inflammation can occur in any part of the airway, from your lungs up to your throat, per the Mayo Clinic, but it most often affects the small breathing tubes (aka, bronchial tubes) deep in the lungs.

"It's often associated with a blockage or limitation of air flow," Reynold Panettieri, MD, pulmonologist and vice chancellor for translational medicine and science director at the Rutgers Institute for Translational Medicine, tells Health.

While it's possible to have wheezing without any other symptoms, Dr. Panettieri says that most people tend to have chest tightness and a cough along with their wheezing.

What Causes Wheezing?

There's a laundry list of potential wheezing causes, and they can be linked to issues in your lungs, vocal cords, and even heart. According to the Cleveland Clinic, any of the following can cause wheezing:

Asthma

This is a chronic condition that causes spasms and swelling in your bronchial tubes, the tubes that let air into and out of your lungs, Dr. Sood says. Asthma is one of the most common causes of recurrent wheezing.

Chronic Obstructive Pulmonary Disorder (COPD)

Chronic Obstructive Pulmonary Disorder (COPD) is a condition that causes long-term inflammation and damage of the bronchial tube lining. This is the other most common cause of recurrent wheezing.

Bronchitis

This is an inflammation of the lining of your bronchial tubes. Chronic bronchitis actually falls under the COPD umbrella, but acute bronchitis is very common and often develops from a cold or other respiratory infection. Acute bronchitis might also be referred to as a chest cold and usually improves within a week to 10 days, according to the Mayo Clinic.

Bronchiolitis

Bronchiolitis is inflammation of the small airways, called bronchioles, in your lungs. It's a common lung infection in young children and infants.

Cystic Fibrosis

This is an inherited disorder that affects many organs in the body, including the lungs. Cystic fibrosis is caused by a genetic mutation that makes mucus thick and sticky. That mucus can clog the airways of people with cystic fibrosis and make it hard to breathe, according to the Mayo Clinic.

Breathing a Foreign Object into Your Lungs

The act of swallowing or drinking something into your lungs instead of your esophagus and stomach (aka, when something goes down the wrong pipe) is called aspiration. According to Dr. Panettiere, you can develop wheezing when the air you breathe tries to move around the object. That foreign object could also cause inflammation or an infection of the lungs or large airways, known as aspiration pneumonia, one of the symptoms being wheezing.

Pneumonia

Pneumonia caused by a foreign object is just one type of pneumonia. There are other kinds, classified by the types of germs that cause it and where you got the infection, but pneumonia is most commonly caused by a bacteria or virus. No matter the type, all involve inflammation of the air sacs in one or both lungs, per the Mayo Clinic.

Respiratory Syncytial Virus (RSV)

Respiratory Syncytial Virus (RSV) is a common respiratory virus that causes infections of the lungs and respiratory tract. People infected with RSV typically show symptoms within four to six days after getting infected, and one of those symptoms is usually wheezing.

Vocal Cord Dysfunction

This condition causes your vocal cords to close instead of opening when you breathe, which makes it harder to get air into or out of your lungs. The high-pitched wheezing sound that comes from vocal cord dysfunction happens when you inhale and is known as stridor, per the Cleveland Clinic.

Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD) is a health issue that causes acid from your stomach to come back into your esophagus, or a tube that connects your stomach to your throat. Chronic acid reflux can relax the lower esophageal valve, causing wheezing.

Allergies

Allergies are your body's reaction to an allergen, like pollen, pet dander, or dust. When you come into contact with the allergen, your immune system's reaction can inflame your airways.

Anaphylaxis

Some allergies can trigger a severe reaction known as anaphylaxis. Anaphylaxis can cause someone to go into shock. One of the complications can include the swelling of bronchial tissues, which help carry air, according to the Mayo Clinic. That swelling can cause wheezing.

Heart Failure

Fluid can build up in the lungs when you have heart failure, leading to wheezing. That complication is known as pulmonary edema, per the Mayo Clinic. But heart failure can also cause fluid to build up in and around the airways.

Smoking

Smoking increases your risk of developing respiratory infections and COPD. It also makes it harder to control asthma. All of these conditions can lead to wheezing.

When Should You See a Doctor?

Wheezing in general is not a good thing, and you should never feel weird about flagging it for your doctor. If your wheezing has lasted for a few weeks, "it's usually a tip-off that you have an underlying undiagnosed condition that needs to be addressed," Dr. Sood says. Ditto if you already have a diagnosis, like asthma, but you're wheezing—that's a sign your treatment isn't working as well as it should be, she says.

You'll want to get help quickly if you notice your wheezing comes along with any of these symptoms, per the Cleveland Clinic:

  • Shortness of breath
  • Coughing
  • Chest tightness or chest pain
  • Fever
  • 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

Finally, if you're wheezing and you feel like your throat is closing; you started wheezing after a flying insect sting; or your skin, mouth, or nails start turning blue and you're wheezing, you'll want to go to the ER ASAP. "That is a medical emergency," Dr. Sood says.

Your doctor will be able to assess your health history and symptoms to determine what is causing your wheezing and what treatment, if any, would be best.

How Is Wheezing Treated?

It depends. Sometimes, mild wheezing that occurs along with symptoms of a cold or upper respiratory infection does not need treatment, per the Mayo Clinic. But other times, you'll need to treat the underlying cause of the wheezing, Dr. Panettieri says, and that treatment plan can look different depending on the cause. Here's a breakdown of typical treatment for more common causes of wheezing:

Asthma

Asthma is a very common cause of wheezing, Dr. Sood reiterates. "With asthma, the airways can spasm and suddenly narrow, making it hard for air to move out," she explains. "In certain asthmatics, their airways may always be a little inflamed." If you're having wheezing due to asthma, "an inhaler is often the first line of defense," Dr. Sood says. That usually means using an inhaler like a bronchodilator to reduce inflammation and open your airways, she says.

Bronchitis

If you're diagnosed with bronchitis, your doctor may prescribe a bronchodilator like albuterol, Dr. Sood says. And if they think the cause of your bronchitis is bacterial, you may be given an antibiotic to help clear things up.

Allergies

If your doctor suspects that allergies are behind your wheezing, they'll likely recommend that you do your best to avoid exposure to your allergen, Dr. Panettieri says. They may also look into putting you on allergy medication or tweaking your existing medication.

A Viral Illness

A viral illness can't be treated with antibiotics (they won't do anything), but your doctor may recommend that you use an inhaler like a short-term inhaled bronchodilator to temporarily help with your wheezing until it clears up, Dr. Sood says.

Other causes of wheezing will likely need specific treatments. Dr. Sood recommends talking to your doctor about what's behind your wheezing and taking your treatment from there.

Relief for Less Serious Conditions

If your wheezing comes and goes and it's been determined that there's nothing serious behind it, there are a few things you can do at home to alleviate it—in addition to taking any medication your doctor prescribes—Dr. Sood says. Those include:

  • Doing breathing exercises. "Sometimes, taking slow, deep breaths can help," Dr. Sood says.
  • Propping yourself up with pillows at night. If your doctor knows or suspects your wheezing is due to GERD or heartburn, they may recommend doing your best to be angled upright during the night to keep your stomach acid from irritating your windpipe.
  • Using a humidifier at night. Steam therapy can help, Dr. Sood says, but it's not for everyone. "Some people say it's a trigger for them," she points out. A good way to test it out: Run a steamy shower, hang out in the bathroom, and see how you feel.
  • Keeping pets out of your bedroom. If you have allergies or asthma that's triggered by pets, it's really best to keep them out of your sleeping space, Dr. Panettieri says. "If your wheezing is triggered by an exposure to an allergen, you should remove that allergen immediately," he says.
  • Running an air purifier. Using an air purifier with a HEPA filter can help pull allergens out of the air you breathe, Dr. Panettieri says.
  • Avoiding smoking. Smoking irritates your lungs and can make wheezing worse, Dr. Panettieri says.
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