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What Causes Wheezing? 10 Possible Reasons

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What Causes Wheezing

Wheezing is whistling sound that’s produced when you breathe and usually indicates respiratory problems. Medical conditions like asthma, cardiac asthma, bronchiolitis, bronchiectasis, pneumonia, acute bronchitis, chronic obstructive pulmonary disease, and gastroesophageal reflux disease can cause it. So can a foreign object stuck in your airways and reactions to medications or insect bites.

Wheezing is a whistling sound that can be heard while breathing. This sound develops as air moves through narrowed airways and is most noticeable when you exhale though it can also be heard when you breathe in. Sometimes you can produce a kind of whistling sound when your nose gets congested too. This usually happens when you have a cold or nasal allergy. But unlike wheezing breathing will not be tight in this case. And rinsing your nasal passages with saline water can make the sound disappear.1 Wheezing usually points to deeper breathing problems. Let’s take a look at some conditions that can cause it:

What Causes Wheezing

1. Asthma

Wheezing is common in children. But the good news is that less than one-third of babies who wheeze constantly during their first 3 years develop asthma when they grow older.2

Asthma causes the airways in your lungs to swell up and the muscles around the airways to become tight. This causes your airways to become narrow making it tougher for air to pass through. In people who are susceptible asthma can be triggered by many factors like dust mites, dander, medicines like aspirin, mold, pollen, cigarette smoke, chemicals, cold weather, respiratory infections like the common cold, stress, and exercise. Other than wheezing, people with asthma can also have symptoms like shortness of breath that worsens with activity or exercise, cough with or without phlegm, a feeling of tightness in the chest etc. Do get emergency medical attention if you experience symptoms like confusion or drowsiness, severe breathing trouble, sweating, a rapid pulse, severe anxiety because you’re finding it difficult to breathe, or a bluish tinge to your skin.

What to do: Your doctor will work with you in creating a written down asthma action plan that details things like instructions for taking medication, your triggers and how you can avoid them etc. She may prescribe medication that when taken every day can be helpful in preventing attacks as well as medication that can bring relief when you have an attack.3

2. Cardiac Asthma

Cardiac asthma is a condition that’s caused by fluid backing up in the left side of your heart. This can cause symptoms similar to asthma like wheezing, shortness of breath, and cough. However, unlike asthma, this fluid backup is indicative of a congenital heart defect, a leaky valve, or weakly pumping heart and points to heart failure.4

What to do: Your doctor will advise treatment which may include medicines to remove excess fluid and control blood pressure as well as modifications to your diet. Surgery might also be required in some cases.

3. Breathing In A Foreign Object

If a foreign object is inhaled into your nose or respiratory tract it can get stuck and make it difficult for you to breathe. Children between the ages of 1 and 3 are most likely to breathe in foreign objects. Examples of things that might be inhaled include foods like nuts and seeds, and other small objects like buttons, beads, and marbles. This can cause choking, coughing and wheezing. It might also lead to infection and inflammation.5

What to do: If your child is having trouble breathing her airways might have become completely blocked and she might need immediate medical attention. And if symptoms like choking and coughing have gone away keep a look out for signs of infection.

4. Bronchiolitis

Bronchiolitis is the most common cause of wheezing in children below the age of 2.6

When the small airways in your lungs get swollen and have mucus building up you have a condition known as bronchiolitis. This condition generally develops due to a viral infection. And the virus known as Respiratory syncytial virus (RSV) is the most common culprit. Other viruses which can cause bronchiolitis include Influenza, Adenovirus, and Parainfluenza. The infection is spread by coming in contact with fluids from the throat or nose of someone who is infected. For instance, by breathing in respiratory droplets when someone sneezes near you, or by touching an object like a toy that been contaminated by an infected person’s respiratory droplets. Bronchiolitis usually affects children below the age of 2 and a baby has a higher chance of getting this condition if she’s younger than 6 months, is not being breastfed, was born prematurely, or is exposed to cigarette smoke.

Other symptoms of bronchiolitis include coughing, shortness of breath, fever, fatigue etc. Do seek emergency medical attention if your child gets bluish skin, has difficulty breathing, starts breathing rapidly, is extremely tired, or her nostrils flare or chest seems to sink in when she tries to breathe.

What to do: It usually gets easier to breathe by the third day and the condition should resolve in about a week. Meanwhile, have plenty of fluids and get some rest. Using a humidifier can help loosen mucus.7

5. Bronchiectasis

Bronchiectasis is a condition where the large airways in your lungs become wider. This damage to your airways is often due to repeated infection or inflammation in your airways. It can sometimes begin in your childhood after a severe lung infection or after you breathe in food, or a foreign object. Medical conditions like cystic fibrosis, an illness which results in the building up of thick mucus in your chest, allergic lung disorders, leukemia, and autoimmune conditions like Crohn disease and rheumatoid arthritis can also cause bronchiectasis.

In addition to wheezing people with this condition experience symptoms like a chronic cough, smelly sputum, bad breath, shortness of breath that worsens with exercise, night sweats, low fever, weight loss, and fatigue. They may even cough up blood.

What to do: Your doctor might prescribe antibiotics for infection, bronchodilators to open your airways, and expectorants to get rid of phlegm. In some cases, surgery that removes a part of your lungs might be required.8

6. Pneumonia

Pneumonia is a lung infection can be caused by bacteria, viruses, and fungi. Bacteria are the most common culprits in adults particularly bacteria known as Streptococcus pneumoniae though other bacteria can be responsible too. Common viruses such as those that cause the flu can also lead to pneumonia. Meanwhile, a fungus known as Pneumocystis jiroveci can cause pneumonia in people whose immune systems have been compromised. You can get pneumonia when germs from your nose, mouth, or sinuses spread to your lungs, you breathe in germs into your lungs, or you inhale vomit, food, or fluids from your mouth to your lungs. Conditions like lung disease, brain disorders like dementia or stroke, a compromised immune system, heart disease, diabetes etc. can increase your risk for pneumonia. So can smoking.

Pneumonia can also cause symptoms like a cough with or without mucus, fever, sweating, shivering, shortness of breath which worsens with activity, chest pain, loss of appetite etc. A sense of confusion might also be experienced particularly by elderly people.

What to do: Your doctor may prescribe antibiotics if your pneumonia is caused by bacteria. You’ll also need to get sufficient rest and drink plenty of fluids so that you don’t get dehydrated.9

7. Acute Bronchitis

Inflammation and swelling in the main airways which carry air to your lungs is known as bronchitis and it can cause wheezing. You almost always get it after a flu or cold. The virus first infects your sinuses, nose, and throat then spreads to the airways leading to your lungs. Though it’s more uncommon bacteria can also cause this infection.
Discomfort in your chest, a cough with mucus, shortness of breath that worsens with activity, low fever, and fatigue are some other signs that point to acute bronchitis. It can be difficult to distinguish between pneumonia and bronchitis sometimes. But people with pneumonia are more likely to get chills and have a high fever.

What to do: The condition should resolve on its own in about a week. Meanwhile get plenty of rest and make sure you don’t get dehydrated.10

8. Chronic Obstructive Pulmonary Disease

Smoking is considered to be the main cause of COPD. Smoking can also worsen other conditions that cause wheezing.

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease which makes breathing difficult. This can happen because the walls of your air sacs or the walls between air sacs get damaged (a condition known as emphysema), or the lining of your airways is constantly irritated leading to the formation of thick mucus (a condition known as chronic bronchitis), or both.11 Smoking is considered to be the main cause of COPD. Long-term exposure to other things that can irritate your lungs like chemical fumes, air pollution etc. can also lead to COPD. In some cases, people who are genetically deficient in a protein known as alpha-1 antitrypsin can also develop this condition. COPD is usually observed in middle-aged or elderly people.

Other symptoms that indicate COPD include coughing with or without phlegm, shortness of breath that worsens with activity, and fatigue

What to do: COPD causes permanent damage to your lungs, however, there are some measures which can stop this condition from getting worse and help to ease symptoms. Your doctor may prescribe medicine and inhalers that can help you breathe better. Pulmonary rehabilitation exercises can also be helpful in teaching you to breathe better.12

9. Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is a condition where the contents of your stomach move backward from your stomach into your food pipe which connects your mouth to your stomach. This causes irritation in your food pipe. This condition develops when the muscles (known as lower esophageal sphincter) at the bottom of your food pipe do not close off properly allowing your stomach contents to leak back into your food pipe. Some factors that increase your risk for this condition include the consumption of alcohol, smoking, obesity, pregnancy, as well as medical conditions like a hiatal hernia where a part of your stomach moves into the lower chest, and scleroderma where the connective tissue in your body grows abnormally. Some medications used for conditions like high blood pressure insomnia, asthma etc. can also cause GERD. Your doctor will be able to let you know if this is a side effect of any medication that you’re using.

Other symptoms of this conditions include heartburn, a feeling that food is stuck behind your ribs, nausea after having food, trouble swallowing, cough, sore throat, hoarse voice etc. You might find that the symptoms are worse when you lie down, after you eat, or at night.

What to do: Measures like controlling your weight, eating smaller meals, and avoiding foods that can trigger symptoms can be helpful. Antacids, as well as stronger prescription medication, can ease symptoms too. In some cases, your doctor might recommend surgery that can stop acid from your stomach from leaking into the food pipe.13

10. Insect Stings And Medications

Insect stings which cause an allergic reaction are likely to cause wheezing. Wheezing can also be a side effect of certain medicines like aspirin. Do check with your doctor whether any medicine that you’re taking can be responsible for making you wheeze.

What to do: If you start wheezing or experience other symptoms like nausea, a fast heart rate, dizziness, trouble swallowing, or confusion after an insect bite do seek immediate medical help as you could be experiencing a severe allergic reaction.14 Wheezing that occurs immediately after taking a new medicine also needs urgent medical attention.

When Should You See A Doctor?

It’s a good idea to see a doctor when you first get wheezing. Since many symptoms of the conditions that can cause wheezing can overlap you may need a medical professional’s help in figuring out what’s causing it so that you can take appropriate action. Your doctor may listen to the sounds made while you breathe or do tests like an x-ray or a lung function test. Do seek emergency help if you also find it significantly difficult to breathe.15

References   [ + ]

1, 6. Wheezing(Other Than Asthma). University Hospitals.
2. Wheezing and Asthma in Infants. The Nemours Foundation.
3. Asthma. National Institutes of Health.
4. What Is Cardiac Asthma? University of Rochester.
5. Foreign object – inhaled or swallowed. National Institutes of Health.
7. Bronchiolitis. National Institutes of Health.
8. Bronchiectasis. National Institutes of Health.
9. Pneumonia – adults (community acquired). National Institutes of Health.
10. Bronchitis – acute. National Institutes of Health.
11. What Is COPD?. National Institutes of Health.
12. Chronic obstructive pulmonary disease. National Institutes of Health.
13. Gastroesophageal reflux disease. National Institutes of Health.
14. Insect bites and stings. NIS Direct.
15. Wheezing. National Institutes of Health.