What should you know about intermittent wheezing?

Wheezing often becomes noticeable when air moves through inflamed or narrowed tubes in the lungs. Triggers can include a viral chest infection, dust, pollen, smoke, cold air, exercise or an allergic reaction. Asthma can cause episodes that vary over time; COPD may cause wheeze alongside a persistent cough or breathlessness. In babies and young children, bronchiolitis is another possible explanation. Allergic rhinitis can add nasal congestion and may coexist with asthma. The sound can occur while breathing out, in, or both, and its pattern is useful information for a clinician.

Write down when the wheeze starts, what you were doing, possible exposures, and whether cough, chest tightness or fever accompanies it. Move away from smoke or a suspected irritant and rest in a comfortable upright position. If a clinician has prescribed a reliever inhaler, follow that personal plan and check your technique. Do not borrow another person’s inhaler. A GP can assess your breathing and decide whether testing or treatment is needed; nebuliser treatment is used in selected situations, not for every episode.

Seek emergency help if wheezing comes with severe breathlessness, difficulty speaking, blue or grey lips, faintness, confusion, or swelling of the lips, tongue or throat. Sudden wheeze after food, medicine or an insect sting may signal anaphylaxis and needs urgent action. Arrange prompt medical assessment when episodes are recurring, waking you, limiting activity, or occurring with chest pain, fever or a cough that is getting worse.

Could this pattern fit asthma, an infection or an allergy? Do I need breathing tests? Which symptoms should trigger urgent help? What should my inhaler plan be during an episode?