Wheezing

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Wheezing

Definition

Wheezing is a high-pitched whistling sound associated with labored breathing.

Description

Wheezing occurs when a child or adult tries to breathe deeply through air passages that are narrowed or filled with mucus as a result of:

allergy
infection
illness
irritation.

Wheezing is most common when exhaling. It is sometimes accompanied by a mild sensation of tightness in the chest. Anxiety about not being able to breathe easily can cause muscle tension that makes wheezing worse.

Causes and symptoms

Wheezing is the symptom most associated with asthma. It can be brought on by:

exposure to allergens (food, pollen, and other substances, that cause a person to have an allergic reaction)
fumes
ice-cold drinks or very cold air
medication
strenuous exercise
weather changes
foreign objects trapped in the airway
cystic fibrosis and other genetic disorders
illnesses such as pneumonia, bronchitis, congestive heart failure, and emphysema

Diagnosis

A family physician, allergist, or pulmonary specialist takes a medical history that includes questions about illness, allergies or unexplained symptoms that may be the result of allergic reactions. If the pattern of the patient's symptoms suggests the presence of allergy, skin and blood tests can be performed to identify the precise nature of the problem.

A pulmonary function test may be ordered to measure the amount of air moving through the patient's airways. X rays are sometimes indicated for patients whose wheezing seems to be caused by obstruction, chronic bronchitis or emphysema.

In 2004, researchers in Japan discovered a new method for diagnosing asthma in infants by testing for certain antibodies in their sputum (mucus that spits up from the bronchi).

Treatment

Mild wheezing may be relieved by drinking plenty of room temperature or warm juice, water, weak tea, and broth. Cold drinks should be avoided.

A vaporizer can help clear air passages. A steam tent, created by lowering the face toward a sink filled with hot water, placing a towel over the head and sink, and inhaling the steam, can do likewise.

Bronchodilators (medications that help relax and widen narrowed airways) may be prescribed for patients whose wheezing is the result of asthma. Newer asthma medications taken daily can help prevent asthma attacks, as can avoiding asthma and allergy triggers.

Antibiotics are generally used to cure acute bronchitis and other respiratory infections. Expectorants (cough-producing medications that help bring up mucus) or certain bronchodilators are prescribed to remove excess mucus from the airways.

If wheezing is caused by an allergic reaction, antihistamine medications may be prescribed to neutralize body chemicals that react to the allergen.

Medical emergencies

Wheezing can be a sign of a life-threatening medical emergency. Under some conditions wheezing requires immediate medical attention. If the airways are blocked treatment is unsuccessful, and the person dies from lack of oxygen. In cases where the airway is restored after the critical period passes, there may be permanent brain damage. Emergency medical attention is required whenever an individual:

turns blue or gray or stops breathing
becomes extremely short of breath and is unable to speak
coughs up bubbly-pink or white phlegm
seems to be suffocating
develops a fever of 101 °F (38.3 °C) or higher and has breathing problems
wheezes most of the time, and coughs up gray or greenish phlegm.

Alternative treatment

Certain yoga positions (Bridge, Cobra, Pigeon, and Sphinx) may relieve wheezing by improving breathing control and reducing stress and can be practiced in conjunction with traditional medical treatments. Individuals whose wheezing is related to asthma, chronic bronchitis, or emphysema may benefit from these techniques, but should continue to have their condition monitored by a traditional physician.

Prognosis

Wheezing is a symptom, not a disease. Improvement in wheezing depends on controlling the underlying disease that causes this symptom. Temporary, mild wheezing caused by infection or acute illness usually disappears when the underlying cause is eliminated. Chronic wheezing caused by lung conditions such as chronic obstructive pulmonary disease (COPD) or emphysema may worsen with time depending on the progress of the lung disease. Allergic reactions can cause swelling of the throat tissues. The wheezing that results is a symptom of a medical emergency and can be fatal.

Health care team roles

The health care team involved in treating wheezing depends on the disease or condition causing this symptom. Family physicians, allergists, pediatricians, and pulmonary specialists all may treat diseases that cause symptoms of wheezing. Respiratory therapists may be involved in treating wheezing when the symptom is caused by smoke or chemical inhalation. Emergency medical personnel treat life-threatening wheezing caused by airway obstruction.

KEY TERMS

Allergies— An overreaction of the immune system to inhaled, ingested, touched, or injected substances that do not cause a response in non-allergic people. Allergies can cause rashes, wheezing, swelling or other symptoms.

Allergen— A substance that causes an allergic reaction.