Wheezing: Possible Causes and Treatment Options

A creaking whistle. A hoarse squeak. Wheezing.

These aren’t the sounds of deep and healthy breathing.

In fact, hearing an unsettling chorus when you go to take a breath is indicative of narrowing or obstructions in our airways.

This article will discuss the possible causes of wheezing and methods for care and treatment.

What Is Wheezing?

We might experience wheezing when our lungs, bronchi, trachea, or larynx are constricted or inflamed.

This audible symptom is categorized by a high-pitched, ragged, whistling sound during breathing. It’s easiest to hear when exhaling but may also present on inhalations in severe instances.

Wheezing is most commonly heard when our bronchial tubes are constricted, though can be symptomatic of tightness or blockages higher in the respiratory system.

It is often accompanied by shortness of breath or difficulty breathing.

Though it may sound alarming, wheezing doesn’t always require immediate medical attention.

It may be a sign of some respiratory diseases, or simply be caused by temporary or seasonal factors like allergies.

Possible Causes

Understanding the cause of your wheezing is a top priority.

Wheezing is most often associated with asthma but can have many possible causes.

Digestive Issues

Squeaking when breathing is one sign of choking, a common emergency that may require immediate assistance.

Airway blockage is the main symptom of choking, which can cause squeaks and whistles when inhaling. 

In adults, choking is usually caused by food lodged in the throat.

Children may also choke on small objects. In both cases, wheezing is one possible symptom. 

Gastroesophageal reflux disease (GERD) is a chronic experience of acid reflux and related symptoms.

People who have GERD often experience wheezing and difficulty breathing due to the irritation of the esophagus. 

This chronic irritation can also lead to other wheeze-producing health issues such as bronchitis.

Bronchitis

Bronchitis is the medical term for the swelling or inflammation of bronchial tubes.

This condition can be acute (short-term) or chronic (long-term).

One of the main symptoms of bronchitis is wheezing, accompanied by productive coughing and shortness of breath.

Acute bronchitis can be caused by:

• Viral infections like the common cold, flu, or COVID-19
• Environmental inhalants such as chemical fumes
• Bacterial infections 

Chronic bronchitis can be caused by:

• Cigarette smoking 
• Air pollution
• GERD

Bronchitis is sometimes mistaken for emphysema.

Both of these conditions can cause frequent wheezing. Understanding the differences between them can be helpful when determining the underlying cause of wheezing.

Together, these conditions are the two main forms of chronic obstructive pulmonary disease (COPD).

With COPD, lungs and airway tissues become damaged from long-term irritation, disrupting healthy respiration. 

Lifestyle Factors

Smoking cigarettes is the leading cause of COPD, and therefore a contributing lifestyle factor for wheezing.

This damage to the airway and lungs is a major cause of wheezing. 

One study showed that electronic cigarette use (vaping) also correlates with lung damage.

Vape users are almost twice as likely to exhibit wheeze compared to non-users.

Heart issues are another major cause of breathing difficulties.

A heart-healthy diet may help prevent conditions associated with wheezing.

Working or living in areas with poor air quality can cause long-term damage to lung tissue.

Wearing proper respiratory protection in those areas can help maintain lung health.

Lung Issues

Both external irritants and internal diseases can cause swollen airways or respiratory tissues.

Foreign material damage to the lungs resulting in wounds is another contributing factor.

Scarring of the lungs can lead to pulmonary fibrosis, debilitating the effectiveness of your lungs.

Doctors can’t always pinpoint the cause of this condition, and the damage is often irreversible.

Children who wheeze due to viral infections may be experiencing reactive airway disease.

This isn’t necessarily linked to asthma and can often be remedied with albuterol, which comes as a liquid solution to inhale orally using a special jet nebulizer or as an aerosol or powder using an inhaler.

If your child has allergies and wheezes often, an asthma evaluation is recommended.

Vocal Cord Issues

Your vocal cords may not properly open, effectively blocking the airway when inhaling.

This condition is known as vocal cord dysfunction (VCD) and is often misdiagnosed as asthma. 

One study showed that patients with VCD were misdiagnosed for an average of 4.8 years.

This leads to unnecessary medications and hospitalizations while delaying proper diagnosis and treatment.

Failing to treat the true cause can exacerbate symptoms.

Asthma

Wheezing is most commonly associated with asthma.

This respiratory condition has a wide array of causes and presentations, marking the importance of proper diagnosis.

Asthmatic responses can be triggered by things like viral infections, exercise, air pollution, and allergens.

Asthma can present itself differently in every person, so keep track of symptoms to share with your healthcare provider.

Allergies

As many as 60% of asthma sufferers experience allergic asthma.

This is caused by the immune system reacting to allergens such as dust, dander, mold, or pollen.

Some severe allergies can trigger constriction and closing of the airways, known as anaphylaxis.

This is commonly seen with allergies to:

• Nuts and sesame seeds
• Bee stings and insect bites
• Fish and shellfish
• Prescribed or over-the-counter (OTC) medications

Heart Conditions

Shortness of breath is a prominent symptom in patients with heart conditions.

Because your heart is central in oxygen transportation and carbon dioxide removal, issues with its function directly impact your breathing.

Heart failure can cause the lungs to fill with fluid, which may present audibly as wheezing.

This is one form of wheezing which requires immediate medical attention. 

Care and Treatment

At-Home Treatment

There are a few things you can do at home to lessen symptoms of wheezing and breathe a little easier.

• Light exercise: If possible, strengthen respiratory muscles with light cardio or breathing exercises, which can help improve ventilation and reestablish a natural rhythm. Pursed lip breathing focuses on long exhalations through pursed lips. Belly breathing involves inhaling deeply through your nose while using your diaphragm to expand your belly. 
• Moisten the air: Clean, humid air can soothe the lungs. Try breathing in steam from a basin of hot water, taking a warm shower, or using a humidifier. 
• Warm liquids: Warm teas and soups are helpful for soothing inflamed tissues along your airway.
• Avoid smoke and strong smells: Irritants in the air can worsen wheezing. Consider air purifiers to clean air indoors, and wear properly fitting dust masks if outdoor air quality is poor. 

Medical Treatment

Depending on the cause, medical providers may prescribe medications or lifestyle changes to treat and prevent wheezing, such as:

• Inhalers to open the bronchial tubes and allow for more airflow
• Anti-inflammatory medications to reduce swelling in the airway
• Antibiotics when the cause of wheezing is a bacterial infection

When to Seek Medical Attention

Any time you’re struggling to breathe, having difficulty speaking, or your lips or face are turning blue, call 911 or go to your nearest emergency facility. 

Seek medical attention if wheezing is any of the following:

• Accompanies blue-ish skin or difficulty breathing
• Occurs suddenly after bee or insect stings, taking medications, or eating meals
• Occurs after choking or swallowing small objects