How to stop wheezing
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Summary
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These studies suggest that inhaled corticosteroids, bacterial lysate therapy, and a combination of fenoterol and ipratropium bromide are effective in reducing wheezing, while other treatments like tiotropium bromide and probiotics show promise but require further research.
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Effective Strategies to Stop Wheezing
Wheezing, a high-pitched whistling sound during breathing, is a common symptom in both children and adults, often associated with respiratory conditions like asthma. Here, we explore various strategies to manage and prevent wheezing based on recent research findings.
Inhaled Corticosteroids for Wheezing Prevention
Early Use of Inhaled Fluticasone Propionate
Inhaled corticosteroids, such as fluticasone propionate, are commonly used to manage wheezing in children. However, a study found that early use of inhaled fluticasone propionate in preschool children did not significantly affect the natural history of asthma or wheeze later in childhood. It also did not prevent lung function decline or reduce airway reactivity. This suggests that while inhaled corticosteroids can control symptoms, they may not offer long-term preventive benefits.
Continuous or Intermittent Inhaled Corticosteroids
Other studies indicate that inhaled corticosteroids, whether administered continuously or intermittently, can reduce the risk of virus-induced wheezing episodes in preschool children. This highlights their role in managing acute symptoms rather than long-term prevention.
Bacterial Lysate Therapy
Immunomodulatory Effects
Bacterial lysates, which are preparations of bacterial components, have shown promise in reducing wheezing episodes and asthma exacerbations in children. A meta-analysis revealed that bacterial lysates decreased both wheezing episodes and asthma exacerbations, likely due to their immunomodulatory effects, which include increased T-helper (Th)1-cell activation and Th2-cell suppression. This suggests that bacterial lysates could be a beneficial add-on therapy for managing wheezing in children.
Nutritional Supplements
Role of Vitamins and Fish Oil
Nutritional supplements, particularly vitamins and fish oil, have been investigated for their potential to prevent wheezing. Early and regular supplementation of vitamin D during infancy may help prevent respiratory tract infections, although it does not significantly prevent wheezing or asthma. Additionally, the early introduction of fish in the diet has been shown to be protective against the development of wheezing and asthma.
Pharmacological Interventions
Tiotropium Bromide
Intermittent use of tiotropium bromide, an anticholinergic medication, has been found to be effective in increasing the proportion of episode-free days in children with episodic wheezing. This treatment was more effective than intermittent fluticasone propionate or as-needed albuterol sulfate alone. This suggests that tiotropium bromide could be a viable alternative for managing episodic wheezing in children.
Combination Therapy with Beta Agonists and Anticholinergics
Combining beta agonists with anticholinergic agents like ipratropium bromide has been shown to be more effective than beta agonists alone in reducing wheezing and dyspnea during acute attacks in infants. This combination therapy can provide better symptom relief during acute wheezing episodes.
Probiotics as Adjunct Therapy
Immunostimulatory Benefits
Probiotics, when used alongside inhaled steroids, may reduce the occurrence of wheezing and have beneficial immunostimulatory effects. A study found that infants receiving a mixture of probiotics and beclomethasone had reduced wheezing episodes and significant changes in cytokine levels, indicating an enhanced immune response. This suggests that probiotics could be a useful adjunct therapy for managing recurrent wheezing in infants.
Conclusion
Managing and preventing wheezing involves a multifaceted approach, including the use of inhaled corticosteroids, bacterial lysates, nutritional supplements, pharmacological interventions, and probiotics. While inhaled corticosteroids are effective for symptom control, bacterial lysates and probiotics show promise as preventive and adjunct therapies. Nutritional supplements like vitamin D and fish oil can also play a role in reducing respiratory infections and wheezing. Combining beta agonists with anticholinergics provides better relief during acute episodes. Further research is needed to optimize these strategies and tailor treatments to individual needs.
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