Table of ContentsView AllTable of ContentsRhonchiRalesKey DifferencesDiagnosisTreatmentPreventionSummary
Table of ContentsView All
View All
Table of Contents
Rhonchi
Rales
Key Differences
Diagnosis
Treatment
Prevention
Summary
Rhonchiandralesarelung soundsthat can be heard with astethoscope. Rhonchi are described as gurgling or bubbling sounds, while rales are described as crackling sounds. The sounds happen when air passes through accumulated fluids in the airways due to asthma, pneumonia, COPD, or other respiratory conditions.
The characteristics of lung sounds, including their pitch and whether they are heard on inhalation or exhalation, can offer clues as to the underlying cause.
This article looks at the causes of rhonchi and rales, how they differ, and what can be done to diagnose and treat them.
Verywell / Laura Porter
What Are Rhonchi?
Rhonchi are associated withobstructive lung diseasesin which damage to the airways causes air to leave the lungs slower than it should as you exhale.
Examples include:
What Are Rales?
Rales, also known as crackles, are small clicking, bubbling, or rattling sounds heard during inhalation (when you breathe in). They may either be high-pitched (“fine rales”) or low-pitched (“coarse rales”), depending on the severity of the illness.
Rales are associated withrestrictive lung diseasesthat mainly affect the parenchyma of the lungs. When these tissues are damaged, you cannot inhale as deeply as you should.
These include:
Rales can change as the underlying condition gets worse. Fine crackles are generally heard when the alveoli are affected, while coarse crackles are a sign that the larger airways are being affected. In severe cases, rales and rhonchi can be heard together.
Rhonchi vs. Rales: Key Differences
It can be hard to tell the difference between rhonchi and coarse rales. There are, however, some key differences:
RhonchiHeard when breathing outMay briefly disappear after coughingAffects the larger airwaysAssociated with obstructive lung diseasesRalesHeard when breathing inCoughing typically has no effectAffects functional lung tissues and alveoli (air sacs)Associated with restrictive lung diseases
RhonchiHeard when breathing outMay briefly disappear after coughingAffects the larger airwaysAssociated with obstructive lung diseases
Heard when breathing out
May briefly disappear after coughing
Affects the larger airways
Associated with obstructive lung diseases
RalesHeard when breathing inCoughing typically has no effectAffects functional lung tissues and alveoli (air sacs)Associated with restrictive lung diseases
Heard when breathing in
Coughing typically has no effect
Affects functional lung tissues and alveoli (air sacs)
Associated with restrictive lung diseases
In addition to diagnosis, listening to breath sounds is a form of monitoring the progression of a respiratory condition. This section, however, will focus on the next steps that should be taken in pinning down a specific diagnosis after a healthcare professional identifies rhonchi or rales on auscultation.
It is worth noting that addressing any immediate breathing problems such as decreased oxygen saturation should be taken care of before obtaining diagnostic testing.
If you are experiencing rhonchi or rales for the first time, and the cause is unknown, some of the following diagnostic tests are usually beneficial in identifying the cause:
Treatment for Rhonchi and Rales
There are no specific guidelines for the treatment of rhonchi or rales. The treatment is ultimately based on the underlying lung disease, broadly described as being either obstructive or restrictive. The resolution of the underlying cause will almost invariably ease the abnormal breathing sounds.
Rhonchi and Obstructive Lung Disease
Rhonchi are a feature of obstructive lung disease. Symptoms develop when there is either an acute flare-up of the disease (known as anexacerbation) or the onset of interstitial pneumonia.
Treatment measures may involve:
Rales and Restrictive Lung Diseases
Rales are associated with restrictive lung diseases and require many of the same treatments as obstructive lung diseases. With that said, the damage caused to the functional tissue of the lungs may require different interventions to improve breathing.
Depending on the severity of symptoms, the treatment may involve:
Rhonchi and rales can’t always be avoided, but certain lung diseases that cause rhonchi and rales can be prevented with relatively simple measures.
Among some of the key tips:
Rhonchi and rales are abnormal breathing sounds caused when air passes through accumulated fluids or secretions in the lungs.
Rales occur when you inhale, causing a low-pitched or high-pitched crackling noise. It is caused when collapsed alveoli suddenly snap open and is associated with restrictive lung diseases like interstitial lung disease and asbestosis. Coughing doesn’t relieve the abnormal lung sound.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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