Reactive airway disease is a general term often used interchangeably with asthma. Symptoms of wheezing, shortness of breath and cough are symptoms of reactive airway disease (RAD), but despite the similarity, those symptoms don't necessarily mean you have asthma. The two are different. RAD causes the airways to become inflamed, swollen and produce mucous, leading to sputum production. The result also leads to shortness of breath. In turn, more inflammation occurs as blood cells are released through a series of complex events. How do you know if it's asthma?
Confusing though it may seem, the term reactive airway disease is non-specific. Closely related is RADS (reactive airways dysfunction syndrome). RADS more concisely defines an asthma-like illness. Usually, it follows inhalation of fumes or smoke. Also related is the term hypereactivity of the airways--a condition that causes asthma-like symptoms following exposure to specific irritants. It is a component of asthma. Reactive airway disease is most often used as a diagnosis for children who may or may not have asthma. It's difficult to give tests to children that measure lung function. You can't get them to perform the breathing exercises needed for documentation. Reactive airway disease can accompany a viral respiratory infection or pneumonia. Not all components of asthma may be present, but the symptoms can be the same. When that happens, your doctor may make a diagnosis of reactive airway disease versus asthma until otherwise determined.
Identifying asthma requires a formal diagnosis, with specific documentation, that includes a combination of typical history of the onset of cough, wheezing and shortness of breath. If you've been told you have reactive airway disease, your doctor may need to look further for a more specific diagnosis. As mentioned, symptoms that cause airway inflammation, wheezing and shortness of breath can be the result of a virus, pneumonia or even chronic bronchitis. Treatment should be targeted to the specific cause. What's causing the airways to react by becoming inflamed, causing cough and sputum?
According to the American Journal of Respiratory and Critical Care Illness, "reactive airways" and "reactive airways disease" are highly nonspecific terms that have no clinical meaning. The authors, John V. Fahy and Paul M. O'Byrne (Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, California; and the Department of Medicine, McMaster University, Hamilton, Ontario, Canada) write: "The diagnostic label 'reactive airways disease' is an annoyance to those of us who want to maintain diagnostic clarity in our discipline." See their comments in Resources below.
The term reactive airway disease was coined by S.M. Brooks and colleagues in 1985. The original connotation described anyone who developed asthma-like symptoms after being exposed to high levels of fumes, vapors or smoke. As time went on, reactive airway disease became the most useful term to apply to children who are not old enough to perform diagnostic pulmonary function tests for asthma. Only 30 percent of infants with reactive airway disease later develop asthma. See more information on children's asthma in Resources below.
Several sources of irritation can cause the airways to inflame, leading to a diagnosis of reactive airway disease. Heredity, allergy to environmental stimulus, infection and virus are thought to play a role in reactive airway disease. A definite diagnosis should be made before your physician makes a diagnosis of asthma. A CBC (complete blood count) will reveal the presence of viral or bacterial illness when dealing with respiratory symptoms that mimic asthma. If there is no family history of asthma and fever is present, an X-ray may reveal the presence of fluid or infiltrate in the lungs to help differentiate the cause. Allergy and exercise tolerance tests can also help your doctor pinpoint the source of symptoms. Children over age 5 should have a spirometry test--a simple, noninvasive test that measures the volume of air forcibly exhaled when blowing into a cylinder through a mouthpiece. A pediatric lung specialist for children--or a pulmonologist for adults--should be consulted to find the underlying cause of reactive airway disease. Targeted treatment and diagnosis should help you know if it's asthma, virus or other causes of reactive airway disease.