Reactive Airway Disease

What is reactive airway disease?

“Reactive airway disease” (RAD) is a term that healthcare providers use to describe breathing symptoms that are similar to asthma, but they’re not sure of the exact cause. Your symptoms develop when the tubes that carry air to and from your lungs (bronchial tubes) swell, which causes narrowing of them. This makes it difficult for air to move into and out of your lungs, resulting in difficulty breathing.

Reactive airway disease isn’t the same as reactive airways dysfunction syndrome (RADS). The names, acronyms and symptoms are similar, but it’s important to keep them separate.

RAD isn’t an official clinical diagnosis, and it doesn’t have a precise definition. There’s controversy in the medical community over its use because some providers use the terms RAD and asthma interchangeably, but they don’t have the same meaning. Its use should be limited to being a placeholder term until providers can make an official diagnosis.

What are the symptoms of reactive airway disease?

Reactive airway disease symptoms include:

• Chronic cough that clears mucus (sputum) from your airways.
• Shortness of breath (dyspnea).
• Difficulty breathing.
• Wheezing.
• Chest tightness.

What does reactive airway disease feel like?

If a provider describes your condition as RAD, your chest may feel tight and it may be difficult to breathe.

What causes reactive airway disease?

The following may trigger symptoms that healthcare providers label as RAD:

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

How long can reactive airway disease last?

It depends on the underlying cause of your symptoms. Once a healthcare provider makes an official diagnosis, they can prescribe medicine or recommend treatment to relieve your symptoms. They’ll detail when you can expect to feel better.

Does reactive airway disease go away?

It depends on the cause. Talk to a healthcare provider about your symptoms. They can give you an idea of what to expect after making an official diagnosis.

Who does reactive airway disease affect?

A healthcare provider may use the term reactive airway disease for anyone who has breathing problems without a clear cause. However, providers are most likely to describe breathing and airway symptoms as RAD in infants and children who are too young to take a lung function test.

How is reactive airway disease diagnosed?

Talk to a healthcare provider if you or your child have symptoms that affect your breathing or if you have a cough that won’t go away. They’ll ask you about your symptoms and medical history. They’ll also conduct a physical examination. During the physical exam, they’ll listen to your lungs with a stethoscope (auscultation). A stethoscope is a medical device with a small, metal disc (diaphragm) that connects to earpieces with rubber tubing. They’ll also order tests to help them confirm their diagnosis.

What tests will be done to diagnose reactive airway disease?

To help determine the cause of your breathing problems, a healthcare provider may order the following tests:

• Spirometry: Spirometry is a common lung function test that measures how much air goes into and out of your lungs when you breathe.
• Imaging tests: Imaging tests are painless, noninvasive tests that help a provider take a closer look at your lungs, heart and bones. They may order a chest X-ray, echocardiogram (echo) or CT (computed tomography) scan.
• Blood tests: During a blood test, a provider will use a small needle (about the size of a standard earring post) to withdraw a small amount of blood. They’ll look at your blood under a microscope to see if you have any signs of an infection, allergies or inflammation.
• Skin (scratch) prick test: During a skin prick test, a provider will scratch small areas of your skin with different allergens to test for allergies.
• Electrocardiogram (ECG or EKG): An electrocardiogram checks how well your heart works. A provider may order this test to rule out heart disease as a cause of shortness of breath.
• Pulse oximetry: Pulse oximetry measures how much oxygen is in your blood.
• Exercise testing: Exercise testing measures whether your blood oxygen levels decrease when you exercise.

How is reactive airway disease treated?

Reactive airway disease treatment depends on an official diagnosis. In an emergency setting, providers may use:

• Bronchodilators: Bronchodilators (inhalers) help relax your airways. Providers commonly prescribe bronchodilators to treat asthma and chronic obstructive pulmonary disease (COPD).
• Oxygen therapy: Oxygen therapy helps give your body oxygen when you’re having a hard time breathing.
• Epinephrine injection: Providers may give an epinephrine injection if you have a severe allergic reaction (anaphylaxis) or asthma attack.
• Corticosteroids (steroids): Steroids help reduce inflammation in your lungs. Providers commonly provide steroids to treat asthma, COPD or allergies.

Does albuterol help reactive airway disease?

It depends. Albuterol (Accuneb®) is a type of bronchodilator that helps open up your airways if you have asthma, COPD and exercise-induced bronchospasm. It may not treat other RAD causes.

Can reactive airway disease be prevented?

The best way to lower your risk of RAD is to:

• Avoid known allergens or other triggers.
• Take medicines that prevent your airways from swelling.
• Quit smoking.
• Wear a mask or other respiratory protection while handling chemicals.

What can I expect if I have reactive airway disease?

If a healthcare provider says you have RAD, it means you have breathing problems, but they aren’t sure of the cause. They’ll conduct a physical exam and tests to help determine the cause of your breathing issues so you can get proper treatment.

They may also refer you to a healthcare provider who specializes in conditions that affect your lungs (pulmonologist).

What’s the outlook if I have reactive airway disease?

If a healthcare provider describes your symptoms as RAD, your treatment, recovery and management depend on an official diagnosis. Some conditions are treatable, while others may progressively get worse.

When should I see my healthcare provider?

See your healthcare provider if you have symptoms of reactive airway disease or if your symptoms don’t improve with treatment.

When should I go to ER?

Call your local emergency number or get to an emergency room right away if you’re using a lot of energy to breathe (severe respiratory distress), aren’t responding to breathing treatments, have low oxygen levels or notice anaphylaxis symptoms, including:

• Difficulty breathing.
• Drop in blood pressure.
• Swollen lips.
• Sudden weakness.
• Fainting (syncope).
• Confusion.

What questions should I ask my healthcare provider?

• What’s causing my reactive airway disease?
• Is there a cure for my condition?
• How can I improve my breathing?
• What medications do you recommend?
• What’s the correct way to use these medications?
• Should I see a pulmonologist?

What is the difference between reactive airway disease and asthma?

People sometimes use the terms “reactive airway disease/RAD” and “asthma” interchangeably, but they don’t have the same meaning. Asthma is a chronic condition that irritates and narrows your airways. It may also cause extra mucus production. Reactive airway disease is a placeholder term providers use to indicate that 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 they’re not the same. COPD is an umbrella term for chronic (long-lasting) lung conditions that affect your ability to breathe and progressively get worse. Providers may describe a condition — including COPD — as RAD until they can make an official diagnosis.

A note from Cleveland Clinic

Reactive airway disease isn’t an official diagnosis, but it doesn’t mean a healthcare provider is inaccurate if they use the term to describe your symptoms. It means that an unidentified condition is affecting your breathing, and they can’t make an official diagnosis until they can safely perform testing. If a primary care provider can’t diagnose your condition, ask them to refer you to a pulmonologist.