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Reactive Airway Disease-Adult

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Definition

Reactive airway disease (RAD) is a reversible narrowing of the airways. RAD is sometimes called bronchospasm.

RAD is not a diagnosis. It is a term used until a more specific diagnosis can be made. If the condition lasts more than 6 months, it may be called asthma.

Airways to Lungs
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Causes

It is not clear what causes RAD. It may be caused by a combination of factors including environment, genetics, and biology.

RAD symptoms are caused by an increased sensitivity of the airways to certain triggers. These triggers cause tightening of the muscles around the airway. At the same time, the lining of the airways swell and produce excess mucus. All of these reactions narrow the airways and make it difficult to breathe.

Risk Factors

Factors that may increase your chance of RAD include:

  • Family history of reactive airway disease or asthma
  • History of allergies
  • Smoking
  • Obesity

Symptoms

RAD may cause:

  • Coughing
  • Tightness in the chest
  • Wheezing
  • Shortness of breath
  • Difficulty breathing

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may ask about possible triggers that were around when you developed symptoms.

Further testing may be done to look for or confirm the presence of allergies or other pulmonary issues. Tests may be done to look for pneumonia, viral infection, smoke inhalation, chemical exposure, or emphysema.

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

Medications

Medications may be used to prevent symptoms or treat a flare up. Options include:

  • Bronchodilators to open the airways
  • Corticosteroid medications to reduce inflammation
  • Mast cell stabilizers or leukotriene inhibitors that can prevent inflammation
  • Combination of these medications

Some of these medications may be delivered with an inhaler or a machine that makes a medicated mist.

Preventing Flare up

Keep a journal of flare ups and what was happening when they occurred. This may help you discover your triggers. When you know your triggers, take steps to avoid them.

Steps that may help you prevent future flare-ups include:

  • Take precautions by getting the seasonal flu and pneumonia vaccines.
  • If seasonal allergens are a trigger:
    • Keep windows closed when possible. This is especially important during high pollen seasons in late morning and afternoon.
    • Talk to you doctor about any adjustments that need to be made to your care plan around allergy season.
    • Consider getting allergy shots, if your symptoms are chronic and you are not responding to other treatments.
  • If household dust is a trigger:
    • Have someone else vacuum for you. If you must vacuum, wear a dust mask. Consider getting HEPA filters for your vacuum cleaner.
    • Use dust cover on mattress or pillows. If you don't have a cover on your pillow, wash it once per week in hot water.
    • Wash all towels and linens in hot water.
  • Avoid exposure to pets. Do not allow pets in the bedroom.
  • If chemicals and strong scents are triggers—Avoid breathing in chemicals or anything with a strong scent like perfumes or scented candles.
  • Be cautious around wood-burning stoves or fireplaces. This can be triggers for some.

Learn the early warning signs of a flare-up. This will allow you to treat the condition before it worsens. These signs may include wheezing, shortness of breath, and dry cough.

Prevention

There is no known way to prevent RAD, since the cause of RAD is not clear.

Revision Information

  • American Academy of Asthma & Immunology

    http://www.aaaai.org

  • FamilyDoctor—American Academy of Family Physicians

    http://familydoctor.org

  • The Asthma Society of Canada

    http://www.asthma.ca

  • Health Canada

    http://www.hc-sc.gc.ca

  • Asthma and reactive airway disease (RAD). Nationwide Children’s Hospital website. Available at: http://www.nationwidechildrens.org/gd/applications/heh/pdf/HH-I-11.pdf. Accessed July 8, 2013.

  • Benich JJ, Carek PJ. Evaluation of the patient with chronic cough. Am Fam Physician. 2011;84(8):887-892.

  • Brooks SM, Weiss MA, et al. Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures. Chest. 1985;88(3):376-384.

  • Harber P. Reactive airways disease syndrome. West J Med. 1988 Jan;148(1):79.