Reactive Airway Disease

“Reactive airway disease” (RAD) is a term that healthcare providers use to describe asthma-like breathing symptoms when they don’t know the cause. The symptoms happen when the tubes that lead to your lungs (airways) swell and narrow. This makes it hard to breathe.

RAD isn’t an official diagnosis, and it doesn’t have a precise definition. It means that an unknown condition is affecting your breathing.

A healthcare provider may use the term “Reactive airway disease” for anyone who has breathing problems without a clear cause. But most of the time, they use it for infants and children who are too young to take a lung function test and get a more specific diagnosis.

Some providers use “RAD” and “asthma” interchangeably, but they’re not the same. Despite the similar name, RAD is also different from reactive airways dysfunction syndrome (RADS). Reactive airway disease should only be a placeholder term until you get an official diagnosis.

Symptoms of reactive airway disease

Reactive airway disease symptoms include:

• Chronic cough
• Shortness of breath
• Difficulty breathing
• Wheezing
• Chest tightness

Reactive airways disease causes

Triggers for reactive airway symptoms include:

• Allergies
• Bacterial infections
• Viral infections
• Chemical fumes or perfumes
• Smoke
• Exercise
• Cold or hot air, humidity or changes in the weather

Complications

Depending on the cause of reactive airway disease, you could be at risk for a serious asthma attack or anaphylaxis. Anaphylaxis is a life-threatening allergic reaction.

How doctors diagnose reactive airway disease

A provider will ask you about your symptoms and medical history and do a physical examination. They’ll listen to your lungs with a stethoscope. They may order tests to determine the cause of your symptoms, including:

• Spirometry, to test how well your lungs are working
• Chest X-ray or CT scan, to get pictures of your lungs, like a chest X-ray or CT scan
• Blood tests, to look for signs of infection or evaluate your overall health
• Allergy skin (scratch) test, to test for allergies that could be causing breathing issues
• Electrocardiogram (ECG or EKG), to rule out heart disease as a cause of shortness of breath
• Pulse oximetry, to measure how much oxygen is in your blood
• Exercise testing, to determine how well your lungs and heart work during physical activity

If your provider can’t determine the cause or make a diagnosis right away, they may say you have reactive airway disease.

How is reactive airway disease treated?

Treatment for reactive airway disease depends on the official diagnosis. You or your child might be treated with:

• Bronchodilators (maintenance and/or rescue inhalers), to help relax your airways
• Oxygen therapy, to get more oxygen to your lungs
• Epinephrine injection, if you’re having a severe allergic reaction or asthma attack
• Corticosteroids(oral or inhaled), to reduce inflammation in your lungs

When should I see my healthcare provider?

Talk to a healthcare provider if you or your child has symptoms that affect your breathing or if you have a cough that won’t go away.

Call your local emergency number or get to an emergency room right away if your symptoms aren’t responding to breathing treatments or you have:

• Difficulty breathing
• Weakness, dizziness or other signs of a drop in blood pressure
• Swollen face, lips, tongue or throat
• Fainting
• Confusion

What can I expect if I have reactive airway disease?

If you have reactive airway symptoms, what you can expect depends on the cause and a definitive diagnosis. Sometimes, people will eventually get an asthma diagnosis or learn they have another condition that affects their airways. Other times, the reactions may stop happening (this is more likely in young kids).

You might need to see a healthcare provider who specializes in lung conditions (pulmonologist). They can let you know what to expect.

How long can reactive airway disease last?

It depends on the underlying cause of your symptoms. Many conditions are manageable with treatment or by avoiding triggers. Some can be lifelong and may worsen over time.

Can this be prevented?

The best way to lower your risk of airway diseases is to:

• Avoid known allergens or other triggers.
• Use medications that prevent your airways from swelling.
• Quit smoking and avoid secondhand smoke.
• Wear a mask and work in a well-ventilated area while handling chemicals.

What’s the difference between reactive airway disease and asthma?

People sometimes use “reactive airway disease” and “asthma” interchangeably, but they’re not the same. Asthma is a chronic condition that irritates and narrows your airways. Reactive airway disease is a placeholder term providers use when something is affecting your airways, but they aren’t sure of the exact cause.

Is reactive airway disease the same as COPD?

Healthcare providers may sometimes describe COPD symptoms as reactive airway disease. But COPD (chronic obstructive pulmonary disease) is a specific diagnosis for chronic lung conditions that block your breathing. Providers may describe a condition — including COPD — as RAD until they can make an official diagnosis.