Allergies and wheezing: what you should know

Wheezing is a high-pitched sound, usually heard while breathing out. Pollen, dust mites, mould, animal dander or another trigger may start airway inflammation in a sensitive person. Wheezing can also occur with infections and other lung conditions, so a new episode deserves assessment rather than an assumption that allergy is responsible.

An allergic response can cause swelling and mucus in the breathing tubes while muscles around them tighten. Asthma commonly presents with wheezing, cough, breathlessness or chest tightness, and allergens may provoke these symptoms. Allergic rhinitis mainly affects the nose and eyes; wheezing suggests that the lower airways may also be involved.

Notice whether symptoms follow a particular exposure, season, room or activity. A written record of the trigger, breathing symptoms, medicines used and response can help a clinician separate an allergic pattern from acute bronchitis, COPD or another cause.

Move away from a suspected trigger and sit upright. If you have an asthma action plan, follow it and use your prescribed reliever exactly as directed. Do not use someone else’s inhaler or delay assessment because an over-the-counter allergy medicine eased nose or eye symptoms; antihistamines do not reliably open narrowed lower airways.

Arrange a medical review for first-time, repeated or night-time wheezing. The clinician may listen to your chest, check airflow and review possible exposures. Nebuliser treatment is used in selected acute situations after clinical assessment; it is not a substitute for identifying the cause or maintaining a prescribed prevention plan.

Call emergency services now if breathing is rapidly worsening, you cannot speak comfortably, your lips or tongue swell, your throat feels tight, you feel faint or your lips look blue or grey. These features can accompany anaphylaxis or a severe airway attack and require immediate treatment.

Seek prompt medical care if the prescribed reliever is not helping, wheezing keeps returning, breathlessness limits ordinary activity, or fever and chest pain occur. A baby or young child with noisy breathing, poor feeding, unusual sleepiness or visible effort between the ribs also needs urgent assessment.

Ask whether your symptom pattern fits asthma, which breathing tests may help, how to use any inhaler correctly, and whether you need a written action plan. Discuss suspected triggers, work or home exposures, smoking or vaping, recent infections and every medicine you take. Also ask which change in breathing should send you to urgent care.