Reactive Airway Disease Treatment

When children under the age of 5 years experience asthma-like symptoms, they might receive a reactive airway disease diagnosis. This is mainly attributed to the fact that doctors might not be in the favor of conducting bronchial challenge test or other lung function tests to confirm the diagnosis of asthma in pediatric population.

The test results might not be accurate, as children in this age might not be able to follow the directions for breathing maneuvers properly.

The airways are an integral part of our respiratory system. The air that we inhale is carried into the lungs through the two main bronchial tubes and secondary bronchial tubes called bronchioles. Asthma is one of the common conditions that is characterized by the chronic inflammation of the airways.

 It can affect both children and adults. However, there are other conditions that could cause the airways to become inflamed. A viral infection caused by the respiratory syncytial virus (RSV) is a common contributing factor for bronchiolitis and bronchial pneumonia, which are conditions that are characterized by the inflammation of small airways.

 They cause asthma-like symptoms (wheezing, coughing, or breathing difficulty) in infants under the age of 6 months.

The diagnosis of asthma in children is quite difficult. Unlike older children and adults whose lung function can be measured accurately with spirometry or pulmonary function tests, checking the lung capacity in young children is not easy.

Moreover, wheezing in infants might also be due to the anatomy of lungs. It is believed that newborns might have highly responsive airways. Wheezing might be due to turbulent airflow, which in turn might be associated with the smaller size of their airways.

To add to that, not every case of wheezing might progress to asthma. Therefore, a general, non-specific term called 'reactive airway disease' might be used for signifying a condition that is characterized by wheezing due to the inflammation and constriction of the airways.

There have been times when pulmonologists have referred to the 'reactive airway disease' as a term with no clinical significance. For instance, two pulmonologists named Dr. John V. Fahy and Dr. Paul M. O'Byrne, called it a 'lazy term of uncertain meaning that should be abandoned.'

Basically, this condition is often diagnosed in severe cases of bronchiolitis due to RSV that might require hospitalization.

It is characterized by the inflammation of small airways and hyper-responsiveness of the inner lining of the small airways, which gives rise to symptoms such as cough, runny nose, and wheezing.

In majority of the cases, the condition resolves once the child reaches the age of 3-4 years. However, the condition might progress to asthma, if there's a family history of asthma.

In majority of the cases, the condition resolves once the child reaches the age of 3-4 years. However, the condition might progress to asthma, if there's a family history of asthma.

It is believed that the risk of this condition might increase in children, if the mother smoked tobacco during pregnancy, or the newborn is exposed to tobacco smoke in the first year.

The common symptoms of this disease include:

♦ Wheezing (high-pitched whistling sound that is produced while breathing)
♦ Coughing with sputum production
♦ Shortness of breath
♦ Labored breathing or difficulty breathing
♦ Tightness in the chest

These symptoms appear when one is exposed to an environmental irritant or allergen. When the irritant or allergen is inhaled into the lungs, it might cause airway inflammation and bronchoconstriction.

Breathing problems often arise, when the smooth muscles of the airways tighten and the passage of air is further restricted due to the increased production of mucus by the cells of the airways.

One is most likely to be diagnosed with reactive airway disease, if there's a difficulty in confirming the diagnosis of asthma. It basically indicates that the affected person has an airway problem.

Though the symptoms of asthma and reactive airway disease are somewhat similar, the drugs that might help in treating asthma, may not necessarily have a positive effect on a person affected by reactive airways. However, the treatment options are almost the same. It is also essential to identify the triggers to prevent flare-ups.

The treatment usually involves the use of bronchodilators, corticosteroids, or combination treatments. Since the airways become constricted due to inflammation, increased mucus production, and tightening of the smooth muscles, sufficient amount of air is unable to pass through the airways.

This gives rise to dyspnea or labored breathing. Therefore, it becomes essential to reduce the inflammation and open up the constricted airways.

This can be achieved with the help of drugs, which can be delivered with the help of a metered-dose inhaler with spacer, nebulizer (dispenser or machine that delivers the drug in the form of mist), or dry powder inhaler.

Also called rescue drugs, these short-acting bronchodilators help relax the muscles of the airways. These medicines produce quick results, which is why they are used to provide relief from acute breathing problems that appear suddenly. The drugs that might be prescribed include Albuterol, Levalbuterol, Pirbuterol, etc.

As the name suggests, these drugs are used for long-term relief. These are often referred to as controllers. These are prescribed for reducing the incidence of breathing problems or preventing flare-ups. The drugs that might be prescribed include Serevent, Foradil, etc.

Corticosteroids are prescribed for reducing inflammation and mucus production. These can be administered with the help of an inhaler or nebulizer. These can also be taken by mouth.

More often than not, corticosteroids are given in combination with bronchodilators, if the bronchodilators alone are not helping. For instance, the use of Advair and Symbicort might be recommended for quick relief.

In some cases, oxygen therapy might be required. In case of young children, parents must educate their children about the right way to use inhalers or nebulizers. It would be best to opt for metered-dose inhalers with spacers, as the spacers slow down the delivery of the drug from the inhaler, making it easier for the drug to reach the lungs.

Since asthma-like symptoms can also appear due to bronchitis or bronchiolitis, blood culture or sputum analysis must be conducted to rule out respiratory tract infections. The reactive airway disease treatment includes avoidance of the triggers and the use of inhaled bronchodilators and corticosteroids.

A trial of treatment with these drugs can help confirm the diagnosis of asthma. Usually, doctors look for marked clinical improvement during the treatment and worsening of the symptoms with the discontinuation of the treatment. A careful analysis of the pattern of symptoms and assessment of family history can help doctors confirm the diagnosis.

In cases where asthma is suspected, doctors usually give a written action plan after the evaluation of the child's symptoms. Parents must strictly adhere to the action plan recommended by the doctor, in order to help the child deal with respiratory distress.

They should help the child avoid the risk factors and make sure that the child takes the drugs in the right manner. They should also be able to identify the symptoms, and take action when the symptoms seem to be worsening. Last but not the least, medical assistance must be immediately sought in case of severe respiratory distress.

Disclaimer: The information provided in this story is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.