Understanding Wheezing -- Diagnosis & Treatment

How Do I Find Out the Cause of My Wheezing?

To determine the cause of your wheezing, your doctor will ask questions about your symptoms and what triggers them. For example, if you have no history of lung disease and you always wheeze after eating a certain food or at a certain time of year, the doctor may suspect that you have a food or respiratory allergy.

The doctor will listen to your lungs with a stethoscope to hear where the wheezing is and how much wheezing you have.

If this is the first time you've been evaluated, your doctor will probably ask you to perform a breathing test (spirometry) and may also order a chest X-ray.

Other blood tests and procedures may be necessary, depending on what the doctor learns from interviewing and examining you.

If it seems like allergies may be related to your wheezing, there are a variety of other tests your doctor may use to verify allergies, including skin testing or blood tests.

What Are the Treatments for Wheezing?

First off, see a doctor to determine the cause of your wheezing and then receive treatment for the specific cause.

If wheezing is caused by asthma, your doctor may recommend some or all of the following to reduce inflammation and open the airways:

• A fast-acting bronchodilator inhaler -- albuterol (Proventil HFA, Ventolin HFA), levalbuterol (Xopenex) -- to dilate constricted airways when you have respiratory symptoms
• An inhaled corticosteroid -- beclomethasone (Qvar), budesonide (Pulmicort), ciclesonide (Alvesco), flunisolide (Aerospan), fluticasone (Flovent), mometasone (Asmanex)
• A long-acting bronchodilator/ corticosteroid combination -- budesonide/formoterol (Symbicort), fluticasone/ salmeterol (Advair)
• A long-acting anticholinergic -- tiotropium bromide (Spiriva Respimat). This drug is used in addition to a regular maintenance medication for better symptom control, and is available for use by anyone age 6 years and older.
• An asthma controller pill to reduce airway inflammation -- montelukast (Singulair), zafirlukast (Accolate)
• A non-sedating antihistamine pill -- cetirizine (Zyrtec), fexofenadine (Allegra), loratadine (Claritin, Alavert) -- or a prescription nasal spray -- budesonide (Rhinocort), fluticasone propionate (Flonase), mometasone furoate (Nasonex), triamcinolone acetonide (Nasacort AQ) -- if you have nasal allergies. Flonase, Nasacort Allergy 24HR and Rhinocort Allergy are also available over the counter.

If you have acute bronchitis, your doctor may recommend some or all of the following:

• A bronchodilator -- albuterol (Proventil HFA, Ventolin HFA), levalbuterol, (Xopenex) -- to help ease the wheezing as the infection clears.
• An antibiotic is usually not needed unless you have an underlying chronic lung problem or your doctor suspects a bacterial infection may be present.

Generally, any mild wheezing that accompanies acute bronchitis disappears when the infection does.

Call 911 if you have any difficulty breathing. In emergencies, a medical team may administer any of the following:

• A shot of epinephrine to open clogged respiratory passages
• Oxygen
• A corticosteroid (such as methylprednisolone or prednisone)
• Frequent or continuous nebulizer (breathing) treatments
• A mechanical ventilator to help you breathe

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