Reactive airway disease describes a group of symptoms that make it difficult for people to breathe. It is not a diagnosis but a temporary term doctors use to describe the issue until they can determine the underlying cause for the symptoms. Although some people use asthma and reactive airway disease interchangeably, reactive airway disease is different than asthma, chronic obstructive lung disease (COPD), or emphysema.
A trigger is anything that activates a condition or causes symptoms. Many substances or situations can trigger reactive airway disease, including chemicals, indoor air pollutants such as smoke, dust mites, pet dander, and mold. Stress, exercise, infections, and exposure to extremely hot or cold conditions can also cause breathing problems. Health care providers may temporarily diagnose these problems as reactive airway disease.
Triggers cause an inflammatory response, the immune system’s way of protecting the body from harmful substances. Irritants that enter the bronchial tubes result in inflammation that narrows these tubes and makes it harder to breathe. Bronchospasms occur when muscles on the walls of the bronchial tubes contract, constricting the airway and making it hard to breathe.
Coughing, difficulty breathing, sneezing, and wheezing are some of the symptoms individuals with reactive airway disease may experience. Bronchial constriction can cause wheezing and is a sign of asthma or reactive airway issues. Some people experience tightness in the chest, which can be frightening, painful, and interfere with daily activities. The individual may also be asymptomatic for extended periods. The condition is diagnosed as chronic when flare-ups occur frequently.
Anyone may develop reactive airway disease. Children with a history of viral lung infections such as respiratory syncytial virus (RSV) and babies breastfed for three months or less face an increased risk. Children and adults with a family history of respiratory illnesses and those exposed to air pollutants such as second-hand smoke are also more susceptible, as are those who work where they come in contact with chemicals and fumes.
It is common for clinicians to describe respiratory issues in young children as reactive airway disease. While infants and toddlers may have respiratory infections that cause asthma-like symptoms, testing for asthma at such a young age does not yield accurate results. Parents can give insight into the type of breathing issues a child experiences, and a healthcare provider can use these findings to treat symptoms.
Until there is a definitive diagnosis, healthcare providers may classify respiratory issues in adults as reactive airway disease, as well. A patient may see a doctor for difficulty breathing, wheezing, or coughing after exposure to airway irritants in the workplace. Adults working in extreme weather conditions may find that hot and humid weather causes airway constriction. Cold air can dry out the airways leading to sneezing, sinus issues, and bronchial constriction. However, further investigation is required to determine if COPD, emphysema, or another chronic airway disease is causing the symptoms.
The healthcare provider will obtain a thorough health history, including whether the patient smokes or works at a high-risk job. Evaluating reactive airway disease in children requires investigating the child's history and environmental factors, such as breathable irritants in the environment and activities that trigger breathing difficulties. Certain tests can assist in diagnosis. Spirometry measures how much air an individual can exhale and how quickly. A doctor may also measure the amount of nitric oxide in the blood; high levels signify inflamed airways. Skin scratch tests can identify if a patient is allergic to substances like pollen and mold.
Determining the underlying cause for reactive airway disease symptoms is the first step in successful treatment. Until then, health care providers may prescribe various therapies to help alleviate or manage the symptoms, including bronchodilators, antihistamines, and oxygen. Bronchodilators may be inhaled or taken as oral medications; they reduce airway constriction and inflammation, increasing airflow. Antihistamines prevent the release of histamine, an organic compound that causes inflammation and airway constriction. Oxygen therapy helps open the airway and makes breathing easier for individuals with severe or life-threatening symptoms.
Individuals diagnosed with reactive airway disease may be able to avoid reoccurrence when symptoms are acute and not related to asthma, COPD, emphysema, or another chronic illness. For example, if exposure to second-hand smoke causes temporary coughing or discomfort, staying away from that substance can prevent issues. Likewise, individuals diagnosed with asthma or other specific reactive airway diseases can reduce flare-ups by avoiding triggers. Taking medication as prescribed and having an inhaler nearby can keep reactive airway disease under control and reduce the need for emergency room visits or hospital admission.
Reactive airway disease is not a clinical diagnosis. Anyone told they have the condition should request additional tests to determine whether asthma or another respiratory condition is the problem. Chronic respiratory ailments such as asthma can become worse without proper treatment. Furthermore, medications prescribed for general reactive airway symptoms may mask the real illness.
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