Wheezing : Causes and Treatment

Lungs are responsible for the gas exchange between the blood and air. Air enters the lungs via the nose followed by tubes which progressively decrease in size to end in blind end air-filled sacs where blood exchanges gases with the inhaled air. Narrowing in the tubes through which air passes leads to a whistling sound called a wheeze. Wheezing is generally more prominent during expiration.

Causes of Wheezing 

Wheezing is caused due to narrowing of the tube through which air passes, this can be due to:

• Asthma
• Lodging of the foreign object in the tube
• Viral infection of the lung, especially in children below the age of 2
• Heart failure leading to ‘cardiac asthma’
• Swelling and build up of mucus in the airway like in bronchitis or bronchiolitis
• Smoking
• Allergic reactions
• COPD
• Pneumonia
• Some medications like aspirin.

Diagnosis of Wheezing

Your doctor will like to record a history of your symptom. This will be followed by a physical examination wherein your doctor will like to hear the breath sound from your lung with the help of a stethoscope. A few other tests may be requested to identify the cause of the wheezing:

• Lung function test: you will be asked to breathe through a spirometer and the volumes and rates will be noted down by the provider.
• Chest x-ray
• Arterial blood gas analysis
• If an allergic cause is suspected you might be requested to get various blood tests and skin tests to identify the cause of allergy.

Treatment of Wheezing

The treatment of wheezing depends upon the cause.

• Oxygen therapy: to ensure that your organs get enough oxygen
• If the wheezing is because of asthma:
• Inhaled bronchodilator: like albuterol, cause the airways to dilate hence reducing the symptoms
• Inhaled corticosteroids: like budesonide, beclomethasone, fluticasone, mometasone help in reducing inflammation and swelling in the wall of the airways
• Anti-cholinergic drugs: like tiotropium is a part of the maintenance regimen
• Anti-histaminic drugs: like cetirizine, fexofenadine is used to control the allergic reaction.
• If wheezing is because of an episode of bronchitis exacerbated by an infection, inhaled bronchodilators and antibiotics are prescribed.
• You might be advised to inhale warm steam periodically to help with your symptoms.

Resources 

• https://medlineplus.gov/ency/article/003070.htm
• www.lung.org