What are the rales: Symptoms, Causes, Diagnosis, Risk Factors and Treatment


The rattles are sounds of breathing that may be normal or abnormal. These sounds come from the lungs when inhaled or exhaled. They can be heard with a stethoscope or simply by breathing.

They can occur when the lungs are inflated or deflated. In general, they are brief and can be described as wet or dry sounds. Excess fluid in the airways can cause these sounds.


Depending on the cause, rales can occur with other symptoms. These symptoms may include:

  • Difficulty breathing.
  • Fatigue.
  • Chest pain.
  • Asphyxia sensation
  • Tos.
  • Wheezing


Pneumonia: Pneumonia is an infection in the lungs. It can be in one or both lungs.

The infection causes the alveoli in the lungs to fill with pus and become inflamed. This causes coughing, difficulty breathing and cracking. Pneumonia can be mild or life-threatening.

Bronchitis: Bronchitis occurs when your bronchial tubes become inflamed. These tubes carry air to your lungs. Symptoms may include bibasal crackles, a severe cough that produces mucus and wheezing.

Viruses, such as a cold or flu, or lung irritants, usually cause acute bronchitis. Chronic bronchitis occurs when bronchitis does not go away. Smoking is the main cause of chronic bronchitis.

Pulmonary edema: Pulmonary edema can cause crackling sounds in the lungs. People with congestive heart failure (CHF) often have pulmonary edema.

Some non-cardiac causes of pulmonary edema are:

  • Lung injury
  • High altitudes
  • Viral infections
  • Smoke inhalation.
  • Interstitial lung disease.

The interstitium is the tissue and space that surrounds the pulmonary alveoli. Any lung disease that affects this area is known as interstitial lung disease. It can be caused by:

  • Occupational or environmental exposures, such as asbestos, smoking or coal dust.
  • Chemotherapy.
  • Radiation.
  • Some medical conditions
  • Certain antibiotics.
  • Interstitial lung disease usually causes rales.

Additional causes

Although they are not as common, rales may also be present if you have chronic obstructive pulmonary disease (COPD) or asthma.

A 2008 study showed that pulmonary crackles may be related to age in some asymptomatic cardiovascular patients.

Although more research is needed, the study found that after the age of 45, the appearance of crackles tripled every 10 years.


Your doctor may also use a stethoscope to hear abnormal breath sounds, which may include:

Roncus: They are low sounds.

Crepitations : Sharp sounds.

Wheezing : It is an acute whistling caused by the narrowing of the bronchial tubes.

Stridor:  It is a strong and vibratory sound caused by the narrowing of the trachea.

The creaks make a sound similar to the brush of the hair between the fingers, near the ear. In severe cases, the crunches can be heard without a stethoscope.

If you have rales, your doctor will take your medical history and possibly request diagnostic tests to look for the cause. These tests may include:

  • A chest x-ray or a chest CT scan to see your lungs.
  • Blood tests to check for an infection
  • Sputum tests to help find the cause of the infection.
  • Pulse oximetry to measure your oxygen level in the blood.
  • An electrocardiogram or echocardiogram to detect cardiac irregularities.


Getting rid of crunches requires treating their cause. Doctors usually treat bacterial pneumonia and bronchitis with antibiotics.

Viral lung infections often have to run their course, but your doctor can treat them with antiviral medications. With any lung infection, you should get enough rest, stay well hydrated and avoid lung irritants.

If the sounds are due to a chronic lung condition, you should make lifestyle changes to help control your symptoms.

If you smoke, give up the cigarette. If someone in your home smokes, ask them to leave or insist that they smoke outside. You should also try to avoid irritants of the lungs, such as dust and molds.

Other treatments for chronic lung disease may include:

  • Inhaled steroids to reduce inflammation of the airways.
  • Bronchodilators to relax and open their airways.
  • Oxygen therapy to help you breathe better.
  • Pulmonary rehabilitation to help you stay active.

If you have a lung infection, finish taking your medicine, even if you feel better. If you do not, your risk of getting another infection increases.

Surgery may be an option for people with advanced lung disease not controlled by medications or other treatments.

Surgery can be used to remove the infection or fluid buildup, or to remove a lung completely. A lung transplant is the last resort for some people.

Home remedies

Because they can be caused by a serious condition, you should not treat rales or any pulmonary symptoms on your own. You should contact your doctor to obtain an appropriate diagnosis and a recommendation for treatment.

If your doctor diagnoses a lung infection due to a cold or flu, these home remedies can help you feel better:

  • A humidifier to put moisture in the air and relieve cough.
  • Hot tea with lemon, honey and a pinch of cinnamon to help relieve cough and fight infections.
  • Steam a hot shower or steam tent to help loosen phlegm.
  • A healthy diet to stimulate your immune system.

Over-the-counter medications can help relieve symptoms such as cough and fever, these include ibuprofen. You can use a cough suppressant if you are not expectorating mucus.

Which are the risk factors?

The risk factors for rales depend on its cause. In general, several things put you at risk for lung problems:

  • Smoke.
  • Have a family history of lung disease.
  • Have a workplace that exposes you to lung irritants.
  • Be regularly exposed to bacteria or viruses.

Your risk of chronic lung disease increases as you get older. Your risk of interstitial lung disease may increase if you have been exposed to chest radiation or chemotherapy drugs.

What is the perspective?

When pneumonia or bronchitis is the cause of the rales and you see your doctor from the beginning, your prognosis is good and the condition is often curable.

The longer you wait to receive treatment, the more severe and serious your infection may be. Untreated pneumonia can be life threatening.

Other causes of rales, such as pulmonary edema and interstitial lung disease, may require long-term treatment and hospitalization at some point.

These conditions can often be controlled and slowed down with medications and changes in lifestyle.

It is also important to address the causes of the disease. The sooner the treatment begins, the better your prospects will be. Contact your doctor at the first signs of lung infection or lung disease.


Follow these tips to promote lung health and help prevent rales:

  • No fumes.
  • Limit your exposure to environmental and occupational toxins.
  • If you must work in a toxic environment, cover your mouth and nose with a mask.
  • Prevent infection by washing your hands often.
  • Avoid crowds during the cold and flu season.
  • Obtain a vaccine against pneumonia.
  • Get a flu shot.
  • Exercise regularly