When Should I Worry About...

When Should I Worry About Wheezing?

March 10, 2022 - Katie McCallum

With a bodily process as essential as breathing, it's certainly concerning when you notice a change — even if it's just a slight difference in how it sounds, like a wheeze.

If you're wheezing when breathing out, it's a sign that air in your airway isn't flowing as optimally as it usually does, likely because the airway is narrowed or partially blocked.

"Wheezing isn't always a significant cause for concern, but it can indicate an underlying health issue in some cases — a few of which are very serious — so it's important to know when wheezing needs to be evaluated," says Dr. Rodney Folz, a pulmonologist at Houston Methodist.

What causes wheezing?

"Wheezing occurs when there's an obstruction in the airway that is affecting airflow," says Dr. Folz. "This obstruction could be due to the airway muscles becoming spastic in response to an allergen, the airway lining becoming inflamed and narrowed or even mucus or foreign objects physically blocking airflow. There are a handful of illnesses and underlying conditions that can contribute to such obstructions."

The most common causes of wheezing are:

  • Asthma, either allergic or exercise-induced
  • Chronic obstructive pulmonary disease (COPD)
  • Bronchitis
  • Pneumonia
  • Upper respiratory viral illness, such as a cold, the flu or COVID-19

"Asthma is the most common cause of wheezing in younger adults, while COPD is the more common cause in older adults age 50 and beyond," says Dr. Folz.

Other, much less common causes of wheezing include the lodging of a foreign object in the airway, vocal cord dysfunction, the cardiac asthma that can sometimes accompany heart failure or even a tumor in the airway.

What does wheezing sound like?

"With wheezing, we're listening for a continuous sound that's most obviously heard during exhalation," says Dr. Folz. "As air passes by the obstruction, it creates a high-pitched tone that sounds almost musical."

Perhaps best described as a whistling sound, wheezing is just one of the various sounds you might hear while listening closely to your breathing.

"Wheezing can be confused for other sounds that signal other lung issues," says Dr. Folz. "For instance, crepitus in the lungs sounds like a popping, crackling or grating sound that is distinct from wheezing and attributed to other causes. A doctor can listen to your lungs and identify what type of breathing sound you're hearing."

When should you go to the doctor for wheezing?

Wheezing when exhaling isn't a reason to see a doctor by itself. For instance, during a respiratory illness, you may hear some wheezing — a sign that your airways are irritated and inflamed — but this is typically temporary.

"If it's not otherwise affecting you, you don't necessarily need to see anyone about wheezing that accompanies mild temporary illness," says Dr. Folz. "It will likely be gone within days or weeks."

But when it's new and unexplained, or if it's accompanied by certain symptoms, or if it persists, wheezing becomes more concerning.

"If you're also short-winded, short of breath or unable to do something you were able to do just a few weeks or months prior, it's important to have your breathing checked by your doctor," says Dr. Folz.

Your doctor will ask you when the wheezing occurs and take a listen to your lungs. He or she will also perform spirometry, a breathing test that can measure pulmonary function and help identify whether an airway obstruction truly exists. From there, your doctor will work to identify and treat the cause of your wheezing, whether it be asthma, COPD, pneumonia or something else.

For causes of wheezing that are more complex or severe or that progress despite treatment, you may be referred to a pulmonologist, a doctor who specializes in breathing and lung health.

"Additionally, there's this interesting paradox in which an abrupt disappearance of existing wheezing becomes a reason to visit your doctor since it could be a sign that the partial obstruction has developed into a full obstruction that is blocking airflow completely," warns Dr. Folz. "A complete airway obstruction is very serious, so I strongly recommend consulting your doctor if you have existing wheezing that stops abruptly."

How to stop wheezing

The best way to deal with wheezing is to treat the underlying condition that's causing it.

For asthma or COPD, your doctor will likely prescribe an inhaler or other medications that help keep your airways relaxed and free of phlegm and other obstructions. For the more rare causes of wheezing, like the presence of a lodged piece of food or vocal cord dysfunction, more advanced treatments are needed.

And when it comes to the mild wheezing that sometimes accompanies a cold, the flu or COVID-19, the sensation may come and go for the duration of your illness, unfortunately. To expedite your recovery, be sure to get plenty of rest and take any medications you doctor may have prescribed.

In the meantime, you can also try one of the following home remedies for wheezing:

  • Drinking warm fluids
  • Breathing moist air by taking a steamy shower or using a humidifier
  • Avoiding smoking or being exposed to smoke
  • Avoiding cold, dry air
  • Performing deep breathing exercises
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