Asthma vs RAD

[LizFizz]

Doctor says I have RAD, not asthma.  I've been researching, but can't put my finger on a definitive answer as to what makes the diagnosis one vs the other.

[National Jewish]

Viral infections like a cold can cause inflammation of the airways of the lungs.  Usually when this occurs, you may cough when you are active or laugh.  This inflammation can cause wheezing and coughing.  After the cold is gone, it is possible for the inflammation to linger.  This inflammation can last for several weeks.  Sometimes this inflammation may linger for 3 to 6 months.  Eventually the inflammation will go away, and then the wheezing and coughing will stop.  This is called reactive airways disease (RAD) and behaves a lot like asthma.  This inflammation often clears more quickly when it is treated with an inhaled steroid, which is used to treat asthma.  Your doctor is the best judge of this.

When this continues, it is generally considered to be asthma.  Testing can be helpful to show if your symptoms are due to asthma or RAD.  Generally testing starts with a simple breathing test called spirometry.  This test provides detailed information about how your lungs are working.  It will show if there is obstruction in your airways.

To really test for asthma it is best to repeat this test after using a rescue inhaler, an inhaled bronchodilator.  This measures how much the bronchodilator helps your lungs by reversing the problem.  When there is a 20% increase, the test is positive for asthma.

There are a variety of things that can make asthma worse.  These things are called triggers.  Smelling odors and infections are common triggers of asthma.  Also some people start to have problems with asthma only after having a severe respiratory infection.  Once you have asthma, you will always have asthma.  It does vary from person to person.  For some people the symptoms will come and go.  For others the symptoms are constant.  There is no cure at this time, but it can be controlled with medicine.

[AndyRRT]

I can understand why you are confused about this terminology since this is a confusing matter even to me. The term "reactive airways" applies to the hyper-reactivity or the hyper-sensitivity of the airways (HRA) induced by a variety of stimuli, including allergens (in sensitive individuals)and irritants like pollution and cigarette smoke. The usual way of assessing HRA is by inhalational challenge with methacholine or histamine.

Almost all asthmatics have HRA, however, HRA is also seen in a lower percentage of individuals with chronic bronchitis, allergic rhinitis without asthma, and even in some normals with no history of airways symptoms (except possibly with exposure to inhaled irritants and cold dry air). In the old days, they would called it "hay fever".  To make a diagnosis of asthma, one must document airway obstruction, rapidly reversible, spontaneously or following inhaled bronchodilators. (this is done with pre/post spirometries with a bronchodialator). This is generally manifest as prominent bilateral wheezing although some individuals, thought to have asthma have mainly a dry bronchial cough with little or no wheezing. A third manifestation of asthma is eosinophil inflammation of the airways, generally eosinophil predominant.As noted in the reference listed below, wheezing occurs commonly in young children associated with certain viral infection (particularly RSV). In only some of these children will wheezing recur in later years. Some physicians have been reluctant to call these childhood wheezers asthmatics (with the emotional, insurance, and other implications involved with assignment of this diagnosis). Therefore, they sometimes call this clinical presentation "reactive airways disease". I know...confusing as hell...but its hard to explain otherwise.

-Andy, RRT, CPFT

[LizFizz]

Thanks, Andy !

[abdullah]

astham is a reactive airway disease. there are many things to consider here; do you have allergy including allergic rhinitis, is so then you have to be tested for asthma as more than 60% of allergic rhinitis people have asthma as well, i agree with the test which is a breathing test called spirometry with pre/post bronchodilator measurment that should meet the American Thoracic Society criteria of reversibility (200ml increase or 12%). asthmatics can have different presentation including wheezy chest, cough with excercise, shortness of breath with excercise, breathing problems with dry cold air, allergy exposure, aspirin or other non-steroidal medications like ibuprofen, emotions etc. one variable presentation is work related asthma like symptoms (occupational asthma) that happens only at work. it's very improtant to have a diagnosis not description of a condition as the treatement and preventive measures may change outcome. some people may have wheezy chest after viral illness or chest infection and is called bronchitis (not the bronchitis of smokers)and usually resolve within 4-6 weeks.

lots of headache with terms ha..

[amethyst2667]

I have the same problem, been sick with a virus and now they are saying I have inflammation, put me on prednisone and Zithromax, now i am having post nasal drip which is wakign me up coughign at night. Cant hardly sleep. also put me on a albuterol inhaler which isn't helpiing my anxiety. I hope the prednisone will help the inflammation because I want to feel better.

[Purified Air]

I have a 21 year old son with asthma but since having an air purifier in my home that covers the whole house; I've found it to help all my children even in the midst of this WI winter - we've had no colds or flu or other respiratory ills.  Here's some obvious signs in your own home that can indicate a need simply for whole house air purification.
COMMON TRAITS OF INDOOR AIR POLLUTION
Affected Household Members initials: ____ ____ ____ ____ ____
Dust on furniture / Visible in air
House odors
Allergies
Asthma
Sinus problems
Headaches
Sleeplessness / Light sleeper
Snoring
Sore throats / Colds / Flu
Itchy/ Watery eyes
Coughing / Throat clearing
Lack of Concentration
Depression / Irritability
Fatigue / Naps
Mold / Mildew in basement & bathrooms
Pet dander and odors
Smoking
Wood / Coal heater
Static Electricity

As you fill this in and realize how much is affected by your indoor air; maybe you should try an ionizing/ozone air purifier like I have.  It's removed all respiratory ills in our family with 8 children 19 down to two.