Overview 

The causes of wheezing in children and adults are different. Children with colds or inflamed lungs are more likely to wheeze than adults. Also, infants have airways, which are smaller and not fully developed, so it happens often in infants. Heart failure or smoking is a more likely cause of wheezing in adults. Many times, wheezing is caused by an underlying condition. Some conditions in children include asthma, allergies, colds, bronchiolitis, and pneumonia.

Introduction

Wheezing is a clinical manifestation of any disease that can narrow the airways. It can be caused by various underlying conditions, and although it is a wide range, this article will help us well-informed about this respiratory issue, and will help make the right decisions about health care. It is important to know the causes of wheezing in relation to different age brackets. This is because some triggering factors in children would not apply in adults. Conversely, factors affecting airway constriction in adults differ from those in children. Here’s a practical example. Children are more prone to infections and viruses because their immune system is not fully developed yet. This makes them susceptible to infection like bronchiolitis. However, adults are susceptible to wheeze triggers like heart failure and COPD, which is unlikely in children. Understanding this will help in the diagnosis, treatment, and management of respiratory health in children and adults.  

What Is Wheezing?

It is a high-pitched gasping sound that is heard when breathing. It could be heard while inhaling or exhaling, although it is much more common when exhaling. However, if one has asthma, might have experienced wheezing during inhalation and exhalation. If the airways are somewhat constricted or blocked while trying to breathe, one might hear a screechy or raspy sound. This sound is called a wheeze.¹ It sustains for as long as when breathing and can sound somewhat alarming. Some also describe it as being musical. One might be wondering why it is important to know the different wheezing sound qualities. It is important because being able to distinguish the differences can help in identifying underlying conditions, how severe they are, or the location of obstruction. If it is in the upper respiratory tract, wheezing sounds hoarse. If it is in the lower respiratory tract, it sounds more musical. 

Why Is Wheezing More Common in Children?

Wheezing in children is prevalent. This is a common complication that a healthcare provider encounters. Studies show about 25 to 30% of infants have at least one wheezing incidence, and nearly 50% of children have a recurrence of wheezing before they are six years old.² Here’s why:

Anatomical differences

Children have smaller airways and bronchi that are not rigid enough, so their bronchi is more prone to collapsing and obstruction too. This is because their body structures are not yet properly developed. When the airways are obstructed or inflamed, it is harder for air to flow. This can cause wheezing. 

Immature immune system

Children’s immune systems are not fully developed. From infancy, their tissues, organs, and systems are immature. As they grow, their body becomes better built, and their immune system becomes better adapted to withstand infections. However, they are susceptible to infections at the early developmental stages. A viral infection that affects their immune system is the respiratory synctial virus (RSV). This infection triggers wheezing in children. Other examples of conditions that children are susceptible to are bronchiolitis, asthma, pneumonia, colds, and allergies. 

Environmental factors

Environmental factors play a huge role in triggering wheezing. When an infant or a prenatal is exposed to triggers like smoke, dust, pet dander, etc., it can cause allergies, inflammation, and wheezing.³ Infants and children are more susceptible to environmental factors than adults because of their developing lungs. 

Genetic factors

Some children have a family history of asthma and wheezing, and this predisposes them to wheezing. Their genes increase as their bodies respond to environmental triggers, which can lead to conditions like asthma. Other times, neonatal human papillomavirus infection,  present in infancy, can cause respiratory papillomatosis. This also causes wheezing.

How Do Causes of Wheezing Differ in Adults?

Unlike children, adults have developed organs and a mature immune system. One may then wonder the cause of wheezing in adults. Several factors contribute to adult wheezing. They are:

Chronic conditions

Conditions like asthma and chronic obstructive pulmonary disease (COPD) can lead to chronic inflammation, narrowing of the airways, and an increase in mucus production. This in turn leads to wheezing, and studies have shown that the severity of the disease can be gauged by the presence or absence and the frequency of wheezing.⁴  

Occupational exposures

Adults work; children do not. While a child can be indirectly exposed to smoke or dust, these are occupational hazards that adults are exposed to daily, depending on the nature of their job.   Exposure to chemicals daily exacerbates wheezing. Studies show that occupational exposures are responsible for about 16% of people who develop asthma in adulthood. Also, some adults with pre-existing asthma experience an exacerbation due to allergens or irritants they come in contact with at their workplace.⁵   

Lifestyle factors

Obesity has shown to increase asthma and wheeze. Also, people with a high body mass index (BMI) are more likely to experience asthma symptoms, including wheezing.⁶ Other lifestyle factors that cause wheezing include smoking, weather changes, air pollution, and irritants. These factors lead to airway inflammation, increased mucus production, and generally affect respiratory health. 

Other causes of wheezing in adults include allergic reactions, respiratory infections, and heart-related issues. These allergic reactions can be in response to certain medications or foods. Respiratory diseases such as bronchiolitis can also affect the elderly and cause wheezing. Heart-related issues like heart failures happen more in adulthood. Some heart conditions cause fluid accumulation in the lungs, which can make you cough and wheeze. This is called cardiac asthma. 

Symptoms Associated with Wheezing

The symptoms of wheezing vary between children and adults, and this is due to differences in underlying conditions and in the anatomy of children and adults. Some common symptoms of wheezing in both children and adults are whistling sounds, coughing, shortness of breath, chest tightness, and recurrent episodes. However, some additional symptoms in the children include retractions and nasal flaring. The differences are immune responses which are not fully developed in children. Also, it is easier for the adults to explain their experience, as children may cry because of discomfort. 

How to stop a wheeze?

To quickly stop a wheeze at home, you can:

• Take warm liquids. Drinking fluids helps, as it can decongest your airways and help with air passage⁷ 
• Use a humidifier to increase humidity. When the air is moist,  airways will not be dry or irritated
• Take a hot shower. This can open your airways and alleviate wheezing
• Inhaling steam works. Put hot water in a bowl covering the head with a towel. Take the steam for  10–15 minutes

Treatment Options: What Works Best for Each Age Group?

For children, medications like albuterol works better to give quick relief to children in the form of inhalers during wheezing incidences.⁸ This helps with breathing. Also, nebulizers can be used for children who have difficulty using inhalers. Nebulizers deliver medications in the form of mist, making it easier to inhale. If wheezing is triggered by allergies, it is advisable to use antihistamines to reduce the allergies, and in turn wheezing would stop. 

Albuterol can also be used to manage acute wheezing episodes even in adults. Long-acting beta-agonists are used for chronic management. They are used together with inhaled corticosteroids (ICS). Daily inhalation of corticosteroids can prevent wheezing incidences and also reduce airway obstruction. However, it is always better to see the healthcare provider instead of self-prescribing. 

When Should One  Seek A Doctor?

One  should seek medical attention if:

• If experiencing wheezing for the first time. It is advisable to see the healthcare provider so that its origin can be found
• When the wheeze keeps coming back
• There is tightness or pain in the chest
• When breathing is not stable or is faster than usual
• When lips or tongue are swelling

The provider would then carry out a proper examination and ensure health is cared for. They can ask about symptoms and can help accordingly. 

Summary

The causes of wheezing in children and in adults slightly differ. It is important to understand these differences and know the best to address each one. Knowing that wheezing is more common in children, parents are encouraged to observe for triggers, and children should not be exposed to them. Lifestyle adaptations in adults are equally important. The use of home therapies in wheeze alleviation should also not replace proper care from your provider. One must know timely seeking a healthcare provider, and adhere to the tailored treatment approaches.