• Reactive Airway Disease—Child

    (Bronchospasm—Child)

    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.
    Airways to Lungs
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Reactive airway disease symptoms are caused by bronchospasm, an increased sensitivity of the airways to certain triggers such as allergens, infections, cold air, or chemicals. These triggers cause a tightening of the muscles around the airway. At the same time, the lining of the airways swells and produces 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 a combination of factors, including environment, genetics, and biology.
    If the condition lasts more than 6 months, it may be called asthma. Other causes, such as viral bronchiolitis, bronchopulmonary dysplasia, pertussis, or cystic fibrosis may be diagnosed based on further testing.

    Risk Factors

    Factors that may increase your child’s risk of bronchospasm include:
    • Family history of reactive airway disease or asthma
    • History of allergies
    • Obesity

    Symptoms

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

    Diagnosis

    You will be asked about your child’s symptoms and medical history. A physical exam will be done. You may be asked about possible triggers that were around when your child 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, and chemical exposure.

    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
    • A combination of the above medications
    Some of these medications may be delivered with an inhaler or a machine that makes a medicated mist.

    Preventing Flare Ups

    The doctor will help to find what is triggering the bronchospasm. If possible, the triggers will be eliminated or managed to stop future flare ups. Steps will depend on the specific triggers but may include:
    • Getting the seasonal flu vaccine.
    • If seasonal allergens are a trigger:
      • Keeping windows closed during high pollen seasons in late morning and afternoon.
      • Allergy shots for chronic triggers that are difficult to avoid.
      If household dust is a trigger:
      • Using a high efficiency particulate air (HEPA) filter for your vacuum cleaner.
      • Using a dust cover on mattress and pillow.
      • Washing all towels and linens in hot water.
    • Avoiding chemicals or anything with a strong scent, like perfumes, cigarette smoke, or scented candles.
    • Avoiding wood-burning stoves.

    Prevention

    It is not clear what causes someone to become overly sensitive to certain factors, so it is not clear how to prevent it. However, a treatment plan should include ways to prevent flare ups.

    RESOURCES

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

    Healthy Children—American Academy of Pediatricians http://www.healthychildren.com

    CANADIAN RESOURCES

    About Kids Health—The Hospital for Sick Children http://www.aboutkidshealth.ca

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

    References

    Asthma and reactive airway disease (RAD) (wheezing). Nationwide Children’s website. Available at: http://www.nationwidechildrens.org/asthma-and-reactive-airway-disease-rad-wheezing. Updated February 2016. Accessed August 22, 2017.

    Asthma in children. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T500326/Asthma-in-children. Updated April 6, 2016. Accessed August 22, 2017.

    Reactive Airway Disease in Children. Boys Town National Research Hospital website. Available at: https://www.boystownhospital.org/knowledgeCenter/articles/EarNoseThroat/Pages/rad-in-children.aspx. Accessed August 22, 2017.

    Reactive Airway Disease in Children. Kaiser Permanente website. Available at: https://healthy.kaiserpermanente.org/health/care/consumer/health-wellness/conditions-diseases/he2/!ut/p/a1/hc7BboJAEAbgp-GoM4BS7A1tBKSgbU2lXJoFRiCuuwTWEvv0BeuhTdo4t8l88-eHBGJIBPuoCqYqKRgf9sR6X65e1vO57qDrekv0vQdXD3TXQNuCHSTQC%5FxnHBzuPyPWk5mNfrjwFn4UILrGFWwc9O0Qpzo6poW-tTWDuzDS0Z1cAZr-03eJjYW9DbbB6ywwEQ1YQVJwmV76vpVK1fcaaphJoUiohkRODTVaX4XLjHGCmMTo1N7CTJ3r3pbEuCpHJLJzxmVNecVufZZdlUN82tto4GAdkZp2AUlD-4GMT03fdAhoLwld140LKQtO40wetT9fStkqiH9LiDx5JKgPh2fv85F2tpqmZ7P7AmEp7Vo!/dl5/d5/L2dBISEvZ0FBIS9nQSEh/. Updated March 25, 2017. Accessed August 22, 2017.

    Revision Information

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