What Is Reactive Airway Disease?

Reactive airway disease sounds concerning enough when you first hear it, but what does it actually means? Depending on the person diagnosing the condition, it may be used to characterize anything from a severe episode of wheezing to a chronic respiratory illness like asthma.

The non-specificity of the term is not meant to either worry or confuse you. Rather, it is commonly used as a catch-all phrase to describe a condition that has either been fully diagnosed or understood, particularly in emergency situations where the breathing restriction may be severe.

Some doctors will use the term "reactive airway disease" to suggest that an individual is reacting to something that is causing the breathing problem, even if they are not certain what it is. Others will use the term synonymously with asthma, perhaps with the presumption that "reactive airway disease" is an easier concept to understand.

In the end, an exact definition of reactive airway disease does not exist. While it may help explain asthma to a parent or individual, the term is not clinically useful since it suggests neither a clear cause nor a means of diagnosis or treatment.

The problem, therefore, is that assigning a diagnosis like this may lead a person to make the wrong assumption. In the end, not all wheezes are related to asthma and not only respiratory illnesses are chronic. To some, the very term suggests that they are.

You could be said to have a reactive airway disease if you are experiencing wheezing, shortness of breath, and a persistent, productive cough. Broadly speaking, these types of symptom are triggered by specific physiological responses,

Among them:

• Breathing restriction is typically caused by the tightening and narrowing of the smooth muscles in the airway passages.
• Inflammation is part of the body's immune defense during which vascular tissue will swell to allow immune cells access to an infection. However, by doing, the breathing passages will be further narrowed.
• Both of these responses can trigger the overproduction of mucus, clogging air passages.

Depending on the cause, the symptoms can range from mild to life-threatening.

Pediatricians will sometimes use the term "reactive airway disease" when a child's wheezing is serious but is otherwise unrelated to asthma.Others may diagnose reactive airway dysfunction syndrome (RADS) when the breathing problems are caused by exposure to toxic chemicals in vapors, fumes, or smoke.

In some cases, it may be used as a definitive diagnosis, meaning that it has a high level of certainty. Whether the diagnosis meets this criterion is highly debatable, but it would suggest that the cause and effect are short-term and acute rather than long-term and chronic.

More often than not, terms like RADS will be used a presumptive diagnosis, meaning that further investigation will be needed. This may include tests to either confirm or exclude likely causes, such as:

• Chronic obstructive pulmonary disease (COPD)
• Congestive heart failure
• Pulmonary embolus
• Cystic fibrosis
• Hypersensitivity pneumonitis
• Gastroesophageal reflux disease (GERD)
• Vocal chord dysfunction

There are no clear treatment guidelines for either RADS or reactive airway disease.

However, in emergency situations, the diagnosis of reactive airway disease would warrant immediate medical interventions, including:

• Emergency oxygen therapy
• Monitoring of cardiac and respiratory function
• Pulse oximetry to assess oxygen saturation
• Inhaled rescue bronchodilators (or intravenous bronchodilators in severe cases)
• Epinephrine injections if the breathing restriction is suggestive of an allergic anaphylaxis