Can I Stop Wheezing Without An Inhaler?

Areas To Focus On That May Help You Decrease Inhaler use

Stop Wheezing Without An Inhaler
Can I Stop Wheezing Without An Inhaler?. Photo courtesy of www.istockphoto.com.

A patient walked into my office once and asked me if it was possible to learn how to stop wheezing without an inhaler?

I was a little taken a back as this patient had never really asked me anything like this before. When I delved a little more into her story I had a better understanding of how difficult of a time she was having. She was out of breath and was having a hard time breathing. The summer was super hot and where I live summer allergies had been bothering almost everyone– even those without a severe allergic condition.

To make matters worse, she was an asthmatic gardener and being in the garden was making her sneeze and wheeze even more.

While she was disappointed in my answer, I told her that she was not going to learn how to stop wheezing. On the other hand, I thought there were a number of things we could do to get her asthma under better control lessen asthma symptoms such as:

Some patients with questions like this are looking into complementary and alternative approaches (CAM) for their asthma. National surveys indicate that asthma is the 13th most common disease that adult patients seek complementary and alternative treatments. Similar studies for children rank the conditions as the 8th most common disease parents look at CAM for their kids.  Though this ranking has increased in recent years, their remains little scientific support.

Studies looking at accupuncture or the placing of needles at specific points in the body, but have not shown great efficacy.

A few studies demonstrated decreases in medication use and quality of life improvements, but most studies that included sham treatments did not show improvements in actual asthma symptoms.

Interestingly a 2011 study showed benefit of placebo where patients receiving placebo inhaler and simulated acupuncture had improvements in symptoms such as chest tightness and the sense of difficulty breathing.

Lung function, however, did not improve.

Learn To Avoid Asthma Triggers

While one of the common asthma myths is that moving away might help improve
her asthma control, a much more palatable solution is avoiding asthma triggers such as:

Weather Matters

Where I live in the South, it seems allergy season never ends. At the end of a really long and hot summer we are often in drought conditions that mean more dust and pollen will be in the air when the winds come up.

Severe thunderstorms can lead to to increased aerosolization of fungal spores and pollen. Extreme heat is often times associated with extreme humidity that allows for dust mites and molds to thrive.

Staying indoors can be beneficial or avoiding the hottest parts of the day may help you avoid many asthma triggers. Additionally, you can check your local air quality at an EPA website.

Manage Pets

Dead skin, droppings, urine, and saliva can all trigger asthma symptoms.

While not allowing pets in the home is the most effective method to avoid these allergens, many people do not find this a realistic option. A potential “happy medium” is to declare “pet free” areas in the home. The bedroom is one of the best places to not allow your pet. Other additional ways to manage pets in the home include:

  • Clean your house frequently
  • Avoid carpet in favor of hard wood or laminate flooring if possible
  • Do not choose upholstered furniture if possible
  • Do not pick stuffed toys and animals (wash frequently if you do

Watch Certain Foods

While food allergy is not a common cause of wheezing, you want to make sure you are mindful of the following foods:

  • Egg
  • Fish
  • Peanuts
  • Shellfish
  • Soy
  • Tree nuts
  • Wheat

It is important to remember viral illness is a much more common cause of wheezing. With food allergy I would expect only when a patient is exposed to a particular food and that wheezing would occur each time they are exposed.

Breathing Exercises

Unlike the other suggestions in this article where you are avoiding triggers, this is something you can actively do to improve your asthma. Buteyko breathing, breathing exercises were developed by Ukrainian physician Konstantin P. Buteyko in the 1960s, focuses on decreasing both the volume and the number of breaths you take per minute. Through a series of exercises you retrain how you breathe. The exercises have been shown to improve a number of asthma outcomes. Studies have demonstrated trends towards improvements in clinical symptoms, but not enough for some guidelines. The British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) UK Asthma Guideline gives agrade-A recommendation to the statement "Breathing exercise programmes (including physiotherapist-taught methods) can be offered to people with asthma as an adjuvant to pharmacological treatment to improve quality of life and to reduce symptoms.” The Global Initiative for Asthma (GINA) statesthat “breathing exercises may be a useful supplement to medications”

Alternative Medicine

Alternative medicine practices or therapies may be used as an adjunct to (complementary) or in place of (alternative) traditional medical treatment for asthma. In fact more than 60% of asthma patients report that they have tried some sort of complementary or alternative asthma treatment.

If you choose to pursue a complementary or alternative asthma treatment, you must discuss with your doctor. While some studies have shown that you may be able to decrease symptoms, frequency or dose of your asthma medication, it is unlikely you will be able to forgo your traditional asthma treatment.

Acupuncture is part of traditional Chinese medicine and involves the use of needle to stimulate specific points on the body. While studies have been mixed with some showing benefit and many showing no benefit, acupuncture is a generally safe practice that us unlikely to worsen your asthma.

Buteyko breathing exercises, a specific breathing strategy, decreases both the need for rescue inhaler use and the number of acute asthma flares in a number of different studies.The September 2003 Cochrane Review examining breathing exercises for asthma and the the British Guideline on the Management of Asthma in 2008 both found some benefit.

While it may sound really odd (it certainly does to me), some Central and Eastern European countries developed an alternative practice using caves and other subterranean environments for asthma treatment. The practice is called speleotherapy and is not common or recommended in the United States. These caves have a micro environment of salt that is thought to help respiratory diseases. While a 2009 Cochrane Review found that there may be benefit for some patients with cystic fibrosis, another Cochrane review found insufficient evidence to support its use in asthma.

Sources

  1. McHugh P, Aitcheson F, Duncan B, Houghton F. Buteyko Breathing Technique for asthma: an effective intervention. NZ Med J. 2003;116:1187.
  2. Bowler SD, Green A, Mitchell CA. Buteyko breathing techniques in asthma: a blinded randomised controlled trial. Med J Aust. 1998;169(11–12):575–8.
  3. Centers for Disease Control. Asthma.
  4. National Heart, Lung, and Blood Institute.. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma.
  5. Tips to Remember. American Academy of Allergy, Asthma and Immunology. Indoor Allergens
  6. Consumer Information. Environmental Protection Agency.  Asthma Triggers: Gain Control
  7. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA). Date last updated: August 2014.
  8. British Thoracic Society, Scottish Intercollegiate Guideline Network. British Guideline on the Management of Asthma, 2014. www.brit-thoracic.org.uk/document-library/clinical-information/asthma/btssign-asthma-guideline-2014 Date last updated: October 2014.

  9. Wark P, McDonald VM. Nebulised hypertonic saline for cystic fibrosis. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD001506. doi:10.1002/14651858.CD001506.pub

  10. Beamon S, Falkenbach A, Fainburg G, Linde K. Speleotherapy for asthma. Cochrane Database Syst Rev. 2001;(2):CD001741.

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