• Bronchospasm—Adult

    Reactive Airway Disease, Reactive Airways Dysfunction Syndrome, Occupational Asthma

    Definition

    Bronchospasm is a reversible narrowing of the airways in response to a stimulus. Bronchospasm is not a diagnosis.
    Reactive airway disease is a term that may be used for a one-time event or until a more specific diagnosis can be made. If the condition lasts more than 6 months, it may be called asthma.
    Reactive airways dysfunction syndrome is used to define a chronic disease of bronchospasm after exposure to high levels of an irritating chemicals.
    Airways to Lungs
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Bronchospasm symptoms is caused by an increased sensitivity of the airways to certain triggers, such as allergens, cold air, or chemicals. 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.
    It is not clear what causes the tissue to overreact. It may be caused by a combination of factors including environment, genetics, and biology.

    Risk Factors

    Factors that may increase your chance of bronchospasm include:
    • Family history of reactive airway disease or asthma
    • Smoking
    • Occupational exposure to chemicals, smoke, fumes or vapours. This may include:
      • Fire fighters, police, and other emergency services workers
      • Cleaners
      • Farmers
      • Welders

    Symptoms

    Bronchospasm may result in:
    • Coughing
    • Tightness in the chest
    • Wheezing
    • Shortness of breath
    • Difficulty breathing

    Diagnosis

    You will be asked 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 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

    Treatment 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.
    • Avoiding triggers: If chemicals and strong scents are triggers:
      • Avoid breathing in chemicals or anything with a strong scent like perfumes, cigarette smoke, or scented candles.
      • Use an exhaust ventilation system or an approved respiratory protection device.
      • If the chemical is needed in your daily life or work, consider using substitute that is less irritating.
      • Be cautious around wood-burning stoves or fireplaces. These can be triggers for some.
      If allergens are a trigger:
      • Keep windows closed when possible. This is especially important during high pollen seasons in late morning and afternoon.
      • 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, and your pillow is washable, 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.
    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 bronchospasm.

    RESOURCES

    American Academy of Asthma & Immunology http://www.aaaai.org

    Family Doctor—American Academy of Family Physicians http://familydoctor.org

    CANADIAN RESOURCES

    The Asthma Society of Canada http://www.asthma.ca

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

    References

    Reactive airways dysfunction syndrome. Health Navigator New Zealand website. Available at: https://www.healthnavigator.org.nz/health-a-z/r/reactive-airways-dysfunction-syndrome/. Updated August 23, 2017. Accessed August 28, 2017.

    Asthma in adults and adolescents. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114449/Asthma-in-adults-and-adolescents. Updated February 22, 2017. Accessed August 28, 2017.

    Brooks S. Reactive airways dysfunction syndrome and considerations of irritant-induced Asthma. J Occup Environ Med. 2013 Sep;55(9):1118-20.

    Chronic cough in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T146529/Chronic-cough-in-adults. Updated February 22, 2017. Accessed August 28, 2017.

    Revision Information

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