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Bronchiolitis

Bronchiolitis is a respiratory illness that usually affects young children. This viral infection is usually caused by RSV (respiratory syncytial virus). This viral infection affects the lower respiratory tract. Tiny airways to the lungs (bronchioles) get inflamed and make breathing difficult. Since the bronchioles of an infant and young child are narrow, they tend to get blocked easily. Bronchiolitis is highly contagious and spreads through coughing, sneezing of the infected person.


Premature infants or those suffering from congenital heart defects are at increased risk for developing Bronchiolitis. Children growing in crowded environment or in day-care facilities are at higher risk for contracting Bronchiolitis. Formula-fed infants are at higher risk for developing bronchiolitis. Typical symptoms of bronchiolitis include runny nose and cough. There might be wheezing and rapid heartbeat. Children suffering from bronchiolitis may be irritable and have poor appetite. The infected child may have mild fever and breathing problems. In some cases, the baby may develop a bluish tinge on the lips or fingers.


Chest x-ray and blood test can help in diagnosing bronchiolitis. A nasopharyngeal swab can reveal presence of RSV or any other virus. While mild cases of bronchiolitis can be managed with home care, severe cases need hospitalization. Bronchodilator drugs can help alleviate breathing difficulties. Suction of the infant's mouth and nose provides relief from stuffiness and breathing problems.

Wheezing

Wheezing is a characteristic high pitched whistling sound made while breathing, a primary symptom of a chronic respiratory disease - Asthma. It is not uncommon in those with respiratory allergies, especially during the hay fever season. Sometimes, other respiratory infections could be accompanied by mild wheezing, especially when acute Bronchitis is experienced. It is also noticed in those with heart failure and Chronic Obstructive Pulmonary Disease COPD. While most commonly wheezing occurs during breathing out, it can sometimes also be related to breathing in.


Causes of Wheezing

Narrowing of airways results in breathing difficulty and wheezing. There could be several causes for narrowing of airways including inflammation from asthma, infection, allergic reaction or a physical obstruction such as tumor or foreign body inhalation. Among the possible causes of wheezing include allergies, insect bite or medication or pollen, pet dander, dust, foods, Bronchiolitis, bronchitis, childhood asthma, epiglottitis, GERD, heart failure, lung cancer, pneumonia, sleep apnea, smoking and vocal cord dysfunction.


Respiratory Syncytial Virus (RSV) Infection is also known as Bronchiolitis - inflammation of the bronchioles which in turn refer to the the narrow airways which branch from bronchi to the air sacs called as alveoli. This RSV infection largely affects infants and children.

To determine the cause of wheezing, your doctor will ask questions about any symptoms that triggers it. If you have no history of lung disease and develop wheezing after eating a certain food or in a certain season, respiratory allergy is suspected. The doctor checks the lungs with a stethoscope to find out where the wheezing is and how bad it is. During a first time evaluation, the doctor performs a spirometry - breathing test, and also a chest X ray.

Sometimes other blood tests and procedures become necessary depending upon the health condition. In case it is allergic wheezing, then a variety of tests to determine the allergies including dermatological examinations are done.


Wheezing problems

Wheezing is accompanied by difficult breathing, rapid breathing and briefly bluish skin color. Emergency care must be sought if wheezing begins suddenly after being stung by a bee, while taking medication, or eating an allergy-causing food or after choking on a small object or food.


Wheezing in infants

In case of a baby, wheezing could be due to cold or problematic asthma. But it is not always clear if the infant has asthma. It is essential to get a firm diagnosis and make sure that the child gets treated for any breathing problems. In some infants, Bronchiolitis could occur due to a viral infection. The airways swell making breathing difficult. As the airway of an infant is small, infants are easily affected. Wheezing could result due to Bronchiolitis, which may develop into asthma in later life. Otherwise a child could be born with a tendency to wheeze and therefore could be prone to bronchiolitis and asthma. Less common reasons for wheezing in infants include inhalation of a foreign object or piece of food into the lungs, premature birth, insufficiently developed airways and cystic fibrosis.


Treatment options

A variety of treatments are available to help alleviate wheezing. However, regular monitoring by a doctor is a must, especially if the patient has asthma, chronic allergies, severe bronchitis, emphysema or chronic obstructive pulmonary disease. In some, wheezing can be relieved by certain medications or by using an inhaler. Some might need insertion of a breathing tube into the throat. The doctor may recommend some or all of the following to reduce inflammation and open up the airways obstructing breathing to stop wheezing:


  • A bronchodilator inhaler, which can act fast to dilate constricted airways.
  • An inhaled Corticosteroid
  • A long-acting bronchodilator and Corticosteroid combination
  • A controller pill for asthma to reduce airway inflammation
  • A non-sedating antihistamine pill or a prescription nasal spray for nasal allergies, which are available over the counter.

Self-care measures to ease wheezing

Moisturize the air by either using a humidifier or a steamy shower or just sit in the bathroom with the door closed while running a hot shower. This is simply because moist air can help relieve mild wheezing in some cases.

Drinking fluids can relax the airway and loosen up sticky mucus in the throat.

Active or passive smoking can worsen a cough and hence it is best to avoid tobacco.


Emergency

Normally, mild wheezing that accompanies bronchitis disappears when the infection subsides. But in case of breathing difficulty, she needs to rush to the doctor who can administer the following:


  • A shot of epinephrine to open up the clogged respiratory passages.
  • Oxygen
  • Frequent nebulizer to ease breathing
  • A mechanical ventilator to help you breathe

It is for the doctor to determine the cause of wheezing and then treat the patient for the specific cause.



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Collection of Pages - Last revised Date: October 16, 2017