Wheezing is a whistling or abnormal noise made during exhalation and / or inspiration. It is a characteristic symptom of asthma but can also occur in other clinical settings.

Hissing is a high-pitched noise made when breathing (most often when exhaling). It is due to a narrowing of the respiratory tract: bronchi, bronchioles, trachea, etc. We sometimes talk about wheezing.

Wheezing may be accompanied by other symptoms, including:

• difficulty breathing;
• a cough, which occurs more readily at night;
• chest tightness;
• shortness of breath (especially on exertion).

Wheezing or wheezing is due to a narrowing of the diameter of the airways. Compressed air causes a whistling sound as it passes, most often on exhalation, but also sometimes during inhalation.

The narrowing of the airways can be caused by several factors, for example:

• constriction of the bronchi (bronchospasm or bronchoconstriction);
• inflammation or edema;
• an obstruction (by an object, a tumor, etc.);
• the presence of too thick secretions.

Wheezing and possible other respiratory symptoms can be triggered by several factors:

• respiratory infection;
• physical exercise ;
• atmospheric pollution ;
• stress;
• pregnancy ;
• smoking;
• meteorological factors;
• or even allergens.

The most common cause of wheezing when breathing is asthma, which affects about 7% of the population. Asthma is a chronic respiratory disease which causes inflammation of the bronchi and makes them very sensitive to certain substances or situations (this is called bronchial hyperresponsiveness).

Chronic obstructive pulmonary disease (COPD) or chronic obstructive pulmonary disease (COPD) is also a common cause of wheezing. It is a disease usually caused by tobacco consumption.

That said, the wheezing can also appear in other pathologies, in particular:

• heart failure, which is a “weakness” of the heart that results in shortness of breath;
• the allergies ;
• anaphylaxis (severe allergic shock);
• a respiratory infection such as acute bronchitis, pneumonia, or bronchiolitis;
• a tumor (of the lung or respiratory tract);
• epiglottitis, a serious infection that can affect children;
• bronchiectasis, resulting from damage to the airways;
• or the presence of a foreign body in the respiratory tract.

Asthma is a disease that can cause serious attacks or even lead to death if it is not properly controlled by treatment. In fact, severe asthma is poorly controlled in one in 4 patients, mainly due to poor adherence to treatments or their misuse.

COPD, on the other hand, is a progressive disease with a poor prognosis. It is most often caused by smoking and is characterized by a gradual (slow) decline in respiratory function.

In all cases, wheezing should lead to a consultation: this is a sign of difficulty in breathing which should not be taken lightly.

Regarding asthma, many treatments exist and are effective. With proper treatment, the vast majority of asthmatics can lead completely normal lives.

There are two types of treatment: crisis treatment and disease-modifying treatment, which is the cornerstone of the treatment of persistent asthma. The aim of this treatment is to normalize respiratory function, to suppress symptoms (including wheezing) and to prevent seizures by reducing inflammation and hyperresponsiveness of the bronchi. Depending on the severity of the asthma, the doctor may prescribe a bronchial anti-inflammatory drug (DMARD) to be taken regularly, often daily, even in the absence of symptoms.

These are most often corticosteroids to be taken by inhalation (budesonide, beclamethasone, fluticasone). Medicines to take in the event of a seizure are called bronchodilators.

Other treatments can be administered in the event of persistent asthma: long-acting beta2-mimetic (formoterol, salmeterol), antileukotriene (montelukast), theophylline, etc.

In cases of very severe asthma, oral corticosteroids (prednisone, prednisolone, methyl-prednisone, betamethasone, dexamethasone) can be administered for courses of a few days.

With regard to COPD, the treatment consists in relieving the symptoms, because unfortunately there is no therapy capable of modifying the course of the disease. In particular, bronchodilator drugs (beta-2-agonists, anticholinergics, theophylline) and inhaled corticosteroids are used.

For other situations associated with wheezing, medical treatment will be offered depending on the cause, on a case-by-case basis.