What Is Reactive Airway Disease?

When Your Wheezing Can't Be Explained Quite Yet

Reactive Airway Disease
Reactive Airway Disease. Photo © A.D.A.M.

Your doctor may diagnose you or your child with reactive airway disease the first time you wheeze. Some doctors use the term as a synonym or catch phrase for asthma. Others use it as a term before an exact diagnosis is made so that you are not inappropriately labeled.

The Symptoms of Reactive Airway Disease

You could be said to have a reactive airway disease if you are experiencing any of the following symptoms:

But Reactive Airway Disease Is Just a Name

An exact definition of reactive airway disease does not really exist. While it may help explain asthma to a patient or parent, the term is not really all that helpful clinically because there is no accepted or precise meaning.

The lack of specificity about its meaning makes me not like its use. As a result, I try not to use the term, but will discuss it a little bit more because of its common use both clinically and among patients.

There are many children, especially infants, who will wheeze and never develop asthma. In fact, only about a third of wheezing infants will ever be diagnosed with it. Whether RSV or some other virus, it's important to remember that all wheezes are not related to asthma.

Pediatricians and general practitioners have used the term "reactive airway disease" to be able to tell parents that their child is wheezing, but does not have asthma.

Some doctors are using the term to refer another condition known as "reactive airways dysfunction syndrome" or RADS. RADS refers to wheezing, coughing, and shortness of breath in someone suffering lung damage after exposure to toxic chemicals contained in vapors, fumes, or smoke. RADS often mimics asthma but is not asthma per se.

What Is Going On In My Lungs?

In reactive airway disease, three primary changes are taking place in your lungs:

  • Increased Mucus. Your airways become irritated and inflamed, causing the cells in your airways to produce mucus. The thick mucus produced can clog the airways of your lung, making it difficult to breathe.
  • Inflammation and Swelling. Just as your arm swells from the irritation of being stung by a bee or wasp, airways of your lungs swell and become inflamed during an episode.
  • Muscle Tightening. The smooth muscles in the airways of your lungs tighten and the airways become smaller, making it more difficult to breathe.

The narrowing of the airways and subsequent symptoms may occur suddenly or may develop more gradually. The symptoms of reactive airway disease range from very mild to very severe.

What Else Could It Be?

While your doctor will surely consider asthma if you are showing symptoms of reactive airway disease, a number of other diagnoses will also be considered. Your doctor will talk to you about your symptoms and possibly do lab or other tests.

Other diseases that may produce reactive airway disease symptoms:

  • Cystic Fibrosis
  • Hypersensitivity Pneumonitis
  • GERD

Reactive Airway Disease Treatments

Depending on your symptoms and what your doctor believes your diagnosis to be, there are a number of different potential treatments. These could include quick-acting bronchodilatorslong-acting bronchodilators, and inhaled steroids.

Source:

Fahy JV, O'Bryne PM. Reactive Airways Disease - A Lazy Term of Uncertain Meaning That Should Be Abandoned. American Journal of Respiratory and Critical Care Medicine. 2001;163(4):822-823.

Allergy/Asthma Information Association.  A Patient's Guide to Asthma Care.

National Heart, Lung, and Blood Institute.

 Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma. 2012.

Brooks SM. Then and Now Reactive Airways Dysfunction Syndrome. Journal of Occupational and Environmental Medicine. 2016;58(6):636-7.

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