What is Reactive Airway Disease?

Mary McMahon
Mary McMahon
Mary McMahon
Mary McMahon
Inhaling smoke from a wildfire can lead to reactive airway disease.
Inhaling smoke from a wildfire can lead to reactive airway disease.

Reactive airway disease, also known as reactive airways dysfunction syndrome (RADS), is a respiratory condition characterized by wheezing, shortness of breath, and coughing. It is sometimes confused with asthma, a related condition, but there are some important distinctions between asthma and reactive airway disease which can have a profound impact on treatment approaches. Some clinicians oppose the use of the term “reactive airway disease,” arguing that it gets used as a catch all which can inhibit a proper diagnosis.

Coughing is common with reactive airway disease.
Coughing is common with reactive airway disease.

People with reactive airway disease generally develop respiratory symptoms after exposure to an irritant which causes inflammation in their respiratory tracts. For example, someone may start coughing and wheezing in the wake of a serious wildfire, as a result of irritation caused by the smoke and particulates. Typically, mucus production is increased, which leads to additional inflammation and discomfort for the patient. The irritation to the airways leads to a chronic syndrome of symptoms.

The human respiratory system.
The human respiratory system.

Doctors may also diagnose young children with RADS when they experience symptoms such as wheezing and coughing because it is difficult to diagnose asthma at a young age. Rather than assuming that a child has asthma and putting him or her on a regimen of asthma drugs, the doctor may approach the situation from a perspective which involves addressing the inflammation and discomfort until additional tests can be used to determine whether or not the child has asthma.

Wheezing may be detected through the use of a stethoscope.
Wheezing may be detected through the use of a stethoscope.

The key difference between asthma and reactive airway disease is that people with asthma fit a specific profile, which includes certain diagnostic criteria. Individuals with RADS may experience the same symptoms as asthmatics, but their condition does not have a known cause, and it may not be alleviated with the use of asthma drugs. It usually takes just a single exposure for reactive airway disease to develop, and people with this condition experience less sensitivity to environmental pollutants than asthmatics.

A chest X-ray can be used to diagnose reactive airway disease in patients.
A chest X-ray can be used to diagnose reactive airway disease in patients.

Because RADS is sometimes used as a quick diagnosis for a patient in lieu of further investigation, patients may want to see a respiratory specialist or ask their doctors for additional information if they are diagnosed with this condition. Adults should receive pulmonary function tests which can be used to distinguish between reactive airway disease and asthma, and additional diagnostic tools can also be used on children to explore the cause of the respiratory syndrome. Failure to get a proper diagnosis for a respiratory condition can lead to long term problems and delays in treatment.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

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Discussion Comments


I was researching RADS and I am amazed at all the people with problems as I have never heard of this before. Someone I know was diagnosed with this. I myself have horrible reactions to things but undiagnosed as anything specific. It has cost me jobs.

I have one suggestion for sufferers. Do all you can to have clean pure air. No harsh cleaning products or fragranced products of any kind including fragrance free laundry soap/softeners/dryer sheets, no perfumes/colognes Plug in type "air fresheners", candles, incense, etc. Just have pure air. Many things are scented without our knowledge like garbage bags, toilet paper, cat litter (had a cat allergic to it as they lick their paws...) etc. This has helped me at home very much. I buy shampoo and soap from all natural stores and have found some I really like and don't cause symptoms.

Reducing exposures will help elderly, small children and pets as well.


I have been coughing for eight years. It never completely stops but I have had periods up to two months that have been almost cough free. The pulmonologist originally said I had asthma but recently did asthma testing and I had no reaction so they took me off daily inhaler. They said I could continue with rescue inhaler and nebs as needed. They say nothing is wrong with my lungs. This year I have been on antibiotics and prednisone eight times after visits to ER and solumedrol injections which so far get it back under control until these meds are done and out of my system.

My ENT doctor recommended allergy testing and I was allergic to tree and weed pollens so I have started immunotherapy allergy injections that will last at least three years. I'm praying this will help as this coughing till I vomit feels it will kill me eventually. I am in my 60s.


RADS can be caused by our beloved pets. If you are allergic to a specific animal's pet dander, that's enough to set off the allergy response. Allergy responses that affect the sinuses, nose and/or throat can then affect our airway. An allergist can determine if you are allergic to animal dander.

Infants/young children that have been diagnosed with RADS: Have they also been worked up for reflux and/or aspiration? These conditions can also cause an ongoing and frequent dry cough.

If the coughing is harsh enough, it will cause vomiting.

Adults with GERD (Gastro-Esophageal Reflux Disease), or others who experience frequent heartburn or indigestion, often have chronic dry coughs. The only way to know if your cough is a result of these alone, you would have to consult your doctor. They would probably have you take a prescription dose of Prilosec or Nexium for 14 days. If your cough pretty much disappears, the likely cause is GERD/heartburn/indigestion.

There are also a number of medication side effects, both in children and adults, that produce a mild to moderate ongoing dry cough. Doctors are either not likely to know that or dismiss it for some other cause.

I had an elderly aunt who coughed for years. I strongly believe it was one of her many cardiac/heart medications. I encouraged her to talk about it with her cardiologist. When she did, her concerns were pretty much dismissed. Chronic and prolonged coughing is exhausting!

If you take prescription meds on a daily basis, google side effects and see what is listed R/T your specific symptoms. Your pharmacist is probably much more knowledgeable about side effects of drugs than your doctor.


I've been a nurse for over 30 years & recognize the importance of good physicians and am grateful for "modern medicine.”

But most doctors are trained to treat with pharmaceuticals. They do so with the best of intentions, but lack knowledge of all possible side effects for the very drugs they prescribe. Have you ever had a doctor look at you funny when you mention a side effect you've experienced from a medication? It's usually a more rare side effect and one that they are not familiar with, pretty much dismissing your symptoms.

Years ago I was prescribed a very potent antibiotic for a sinus infection. Within the first 24 hours, I developed a cough. It was harsh and became so severe that I felt as if I was going to pass out. I knew something was terribly wrong. I looked up the side effects of the antibiotic, and under the more rare side effects, there was listed "development of an unusual cough.” I immediately stopped the antibiotic and the cough stopped within 24 hours. When I relayed this to my ENT, he said "oh, I've never heard of that?" So maybe he learned something new that day and I didn't care if he was not familiar with that. It was real and happening to me!

Therefore, I also believe in homeopathic remedies as a cure. You have to be your own advocate and do your own research!

With regards to RADS and chronic cough, here are my suggestions:

If you haven't already, make an appointment with a good pulmonologist. They will do pulmonary function tests in the office and those results are immediate and gives the doctor great insight to what is going on with you.

An appointment with an allergy doctor is also key because your symptoms may be allergy-related. If you can learn what you may be sensitive to, you can try to avoid those very things.

I was recently told I fit into the RADS diagnosis. I live in Texas and our summers are brutally hot and humid. For the last seven weeks, I've had a horribly dry cough, nasal/sinus congestion and post nasal drip.

It's most likely environmental allergies and our substandard air quality here. I've never had such a rough summer. For me, it can be as simple as post-nasal drip (not infectious) that sets off the harsh cough. I've been on quite a number of meds and treatments.

Let me say to anyone out there with a dry cough: You need to try Delsym cough syrup. So many have still not heard of it! No one, including doctors, seems to understand the dry cough. If's it's not productive, then you might as well have incurable leprosy. Delsym is a cough suppressant only, not an expectorant, and works well on dry coughs. You take it every 12 hours. Please try it and give your upper airway a rest and time to heal! There are so many cough syrups out there and if you don't know what you're doing, your cough and other symptoms can actually worsen. If your cough is simply dry, you don't need and expectorant!

Sounds silly, but drink a lot of water, otherwise your cough will turn from just dry to harsh. I think they recommend that whatever your weight is in pounds, half that number, and that is how many ounces of H2O you should drink daily. If a large volume of plain water is overwhelming, you can add small amount of flavoring so you can get the amount of water you need.

Vitamin C is a must -- it's probably the best, natural anti-inflammatory out there. Vitamin-C Ester is better tolerated and easier on your stomach. I use Bluebonnet's Ascorbic Palmitate/Vit C Ester. Ascorbyl Palmitate is water and fat soluble, therefore targets more areas in your body. I started taking 1500 mg in the AM and same dose at bedtime. That pretty much a mega-dose, did that for two or three days and then bumped it down to 1500-2000 mg a day, in divided doses.

You have to be consistent with this. If you experience loose stools, then by all means lower your dose. You will not die from loose stools; it's just an indication that your body is utilizing the Vit. C.

Bronchodilators are really important for RADS, opens up the bronchioles for easier breathing. Your doctor can prescribe a bronchodilator via a hand-held inhaler that you can carry. My doctor also gave me a steroid inhaler that you use after the bronchodilator. I also have a small home nebulizer machine that I can give myself a breathing treatment with a bronchodilator. I also have used the nebulizer with a vial of sterile normal saline (for inhalation only) to just moisten the upper airway. Standing in a warm shower for 10-15 minutes will help moisten your upper airway. Don't make the shower hot; avoid passing out!

If you also have nasal/sinus congestion and post-nasal drip, you have to treat that also. These conditions can create your cough or worsen the one you already have. If you have congestion, you need to clear it otherwise you may end up with a sinus infection.

I would avoid nasal sprays, since over-the-counter ones are quickly addictive. They clear your stuffy nose, but continued use after three days will give you a rebound effect. This means that the spray will now cause your nose to become and continue to be stuffy and congested. Doctors can prescribe nasal sprays. They work well for some, but not for many others. These sprays can also have not-so-good side effects, especially if they are not used correctly.

Try using normal saline spray or mist, over-the counter. Twice a day will help keep your nasal passages moist and help flush out allergens and bacteria.

My ENT years ago got me started me using a Neti Pot; look it up. Some people freak out because they're uncomfortable with putting things in their nose! If you're sick enough, you'll pretty much try anything. FYI though, if your nose is stuffy and congested, the Neti Pot or saline sprays will not work -- there is nowhere for the liquid to go because the passages are blocked. I use Sudafed (Pseudoephedrine) daily to unblock the congestion. Buying Sudafed varies from state to state. In some states, you can only get it by prescription from your doctor.

Some of these medications are stimulants, so avoid things that can further stimulate: excessive coffee, sodas and food high in carbs and sugars.

You can also take Mucinex-D instead of Sudafed alone. The Mucinex-D has the decongestant and loosens mucus. If you buy the wrong type of Mucinex, your symptoms may worsen, but you have to drink a lot of water to flush all that mucus out! If you have no problem drinking water, and lots of it, I would skip the Mucinex and keep to just Sudafed. If you have high blood pressure or thyroid disease, you have to be careful with some of these medications, so consult your doctor.

For that dry cough, if possible, sleep with a room humidifier until your cough is gone. That has really helped me! This might sound corny, but you have to eat well and get extra sleep, otherwise it will take you longer to heal.

Avoid foods high in carbs/ processed sugars: -candy, cake, ice cream, fruit juices, soda, etc.

Sugars cause inflammation in our bodies and mess with our immune symptoms. Many people do not know this!

Coughing is always worse at night, for everyone! Try sleeping propped up with an extra pillow. I find that hard to do, but it may work for you.

Though chronic coughing and RADS is not necessarily catastrophic, it can be physically and mentally tiring, right?! It can be downright discouraging and affects the quality of life for a time.

When you are not feeling well physically, especially for a prolonged period, negativity creeps into our thoughts. Try to stay positive and be proactive, this too shall pass! I would force myself to say "I will get better" throughout the day, even though I might not have believed it at first. Say it in front of your mirror and smile while you're saying it!

And, as always, I continue to pray for healing! Sorry this is soon long, but I hope it helps someone out there! Hang in there!


I have been coughing for approximately six months and was just diagnosed with RAD about a month ago. I was given Prednisone, an extreme night time cough medicine, and an inhaler.

After taking all of this and being nearly done with the inhaler, I was feeling a lot better and barely coughing. I then went to visit my sister, who had cats. I also got a cold, and when the cold was gone I again started coughing a lot. My coughs are rough and very painful, and there tends to be an itch on one of the sides of my throat (it changes). I can't breathe and I often feel like my face is being sucked back. I usually cough so hard I throw up.

I'm only 16 and a senior in high school and reading this is scary. I can handle it, but I can't cough so hard I throw up every day in school! My parents don't know what to do and I'm so tired of it. The thing is, I don't remember a starting "incident."

The only thing I can think of is we have a fireplace and used it a lot, but I didn't start coughing until end of February/ March. The doctor told me I had gotten a cold, and when the cold went away my airways, bronchial tubes, and lungs stayed irritated. The treatment almost worked until I went to my sister's. Any ideas, or help? My mom will be calling the family doctor soon, but it will be a different doctor than the one who diagnosed me.


Actually, RADS (Reactive Airways Dysfunction Syndrome) is just one type of Irritant-Induced Asthma that is uniquely defined by 8 parameters including (1) a massive one-time exposure and (2) symptoms presenting themselves within 24 hours of initial exposure. The onset of RADS is usually associated with an accident such as a chemical spill or a fire, or some type of spraying within a confined space.


@madmanandy27: This is AngelicFlame. Have you been deemed "disabled" due to your RADS? Has anyone out there, for that matter? I've been in a constant legal battle ever since being diagnosed and continue to get denied by SSI/SSDI. It's been over two years now and I have no idea what to do or who/where to turn to for help.

I recently moved to Florida as there are specialists here who are familiar with RADS. However, no income = no health insurance. So I'm totally stuck! If only I could connect with the right physicians to provide the right documentation to SSI/SSDI describing how debilitating my condition is. I can't even go out in public without experiencing an "attack" when exposed to other peoples' perfumes, colognes, cigarettes, as well as the cleaning products, air fresheners, gases, fumes, etc. found out there in the world.


I just came upon this forum. I was looking for help for a nagging cough that I've had for over 20 years! I've had all the tests going and have had no proper diagnosis.

I worked in an industrial paint factory for 30 years where they used irritant solvents, flammable chemicals, epoxy resins, etc. I recently had a lung function test and the radiographer said my lungs were clear, but there was a definite restriction in my airway. No one had ever said this before, so it will be interesting to see what my consultant says. I have been informed that I may be able to claim compensation for industrial disease. I would rather they kept the money and just got rid of my cough!


I would rather die than have another fire season suffering from reactive airway disease. The wildfires will either kill me or I would pray they do.


@anon292106: Many things can cause RAD, although this would be the first time I have heard of it being caused by pets. Doctors put many lung problems in the category of RAD at the start if they are unable to identify the problem initially. I hope the child is O.K.


Would having a newborn in an apartment that is not well ventilated, with pets such as cats and a chinchilla possibly cause RAD?


@anon286157: Sorry to hear that your son is going through this. It's such a terrible thing for a young boy.

I would certainly recommend seeing a lung specialist to get a vigorous assessment of your son's condition.


My son has recently been diagnosed with RAD. He is 4 years old. The main triggers for him are if he gets to hot or if he starts crying. Then he will start gasping for air, coughing, and will throw up everything he has eaten all day.

About a year ago he had a spell were I woke up to find him gasping for air and his lips had turned blue. Recently, he had a very bad spell where he could not catch his breath at all. I was tempted to call 911 but tried his breathing machine first. Thankfully that seemed to work, but you could tell it took a toll on his little body. Is it time to have his Pediatrician recommend a specialist?


@ts1963: No, RAD is not terminal. I think what the doctor means is there is no cure for RAD and saying that he would just make your niece comfortable is merely saying he would provide treatment and advice to make your niece more comfortable with the symptoms,e.g., keep her away from dusty areas sprays etc and provide inhalers.

I would personally recommend air purifiers in the bedrooms to take particles out of the air during sleep. I have one and it helps a lot.

Angelic flame and ts1963, I would be happy to give you any answers to any questions I can answer with my ongoing RAD experience.


My niece was recently diagnosed with reactive airway disease. She has suffered from asthma since she was a child. This new diagnosis has actually scared her to death because her doctor made it seem that the disease was terminal/fatal, telling her when asked what was going to be done that he was "just going to make her comfortable." What the hell is that supposed to mean? He got her thinking she was going to die. She has two small children and getting upset because she is unsure about their future without her.

All the information I have come across doesn't show that this disease is fatal or terminal. I suggested that she get second opinion from a specialist. Am I wrong? Is this disease fatal/terminal?


I'm so glad I came across this page. I had a chemical exposure at a hospital I worked at back in 2007. I was left in the contaminated office for four straight hours. Within 10 minutes, I was already experiencing symptoms.

Since then, my life has been a complete wreck! My sensitivity to non-organic chemicals, smoke, fumes, perfumes, deodorants, sprays, etc. has made it impossible for me to find work because I can't be around the public. I haven't had any income, don't have health insurance and am struggling just to stay alive on a daily basis. I've been trying to apply for disability since January of this year, but they keep telling me I'm not "disabled". If the people who make that determination could only spend a day in my shoes, they would clearly see just how disabled I am. Anyway, I would love to speak with anyone who has had this for a while and how it's affected your life.

My heart goes out to all those who have been diagnosed with RADS and who continue to suffer from it.


I am hoping to get an answer from poster anon122860: What did they treat you with for the pneumonia? I have the same problem and am hoping that the same treatment will alleviate my cough. I have had this for 18 years! Please post the meds they used?


@anon144: It really depends. In some people it passes over time, but in some they have it forever. As you were exposed to asbestos and diagnosed with rads, there are not many treatments for the condition almost all do not have any effect on the very sensitive bronchial airways that are hyper sensitive now.

I'm so sorry to hear about this happening to you, but I'm sure you have put in a claim for compensation? If you're a smoker, it's much more difficult to claim because they have a defense that you may have caused it, at least partly, yourself. But if you are a smoker my advice is to give up now as it will really affect you badly.

I won my case with rads and i really do hope you get better over time and get the compensation you're due for being exposed to such a dangerous material. They will probably try you on flixotide steroid accuhaler and duovent and others such as salbutamol, also maybe steroid injections -- all which had no effect on me. You will probably get a methacholine bronchial responsiveness test which checks how sensitive your lungs are and you may have had this already.

But i really hope it works for you. All the best.

Keep in touch via this site let me know how you get on. If you have any questions i may be able to help with, please ask. if i can help, i will. best regards, andy


So if I say that I had 100 percent asbestos exposure on a job that has ended with the lung doctor giving me the RADS and bronchiolitis diagnosis as November 2010, what comes next for me?


my rad can be triggered with anything from coal fire, smoke and deodorant sprays, to chemicals with strong fumes, etc. and many many more things.

In my case, it was caused by chemical accident at work, although in theory, it may be similar. i would try keeping him away from sprays, etc., and see what happens as these severely affect me to the point of hospitalization, although i understand your son is milder than mine. I hope it stays like that. I wouldn't wish it on anyone, poor wee fellow.

Try avoiding irritants such as sprays, etc. and see how it goes anon136195


My son (whom is 19 months old) was recently diagnosed with RAD. Thus far his only triggers have been viruses such as colds and flus. He has had all vaccinations and flu shots but as he has just started day care and has two older school age siblings who bring home everything from school, we are at a loss for removing his triggers.

We have taken his pediatrician's advice and started him on a daily steroid inhaler. However, I am open to any additional advice in helping him with this.


Today after more than 10 years, I found out that I had reactive airway disease. When I read madmanandy27 posting, I said the post is talking about me. For 10 years, I coughed every hour, day, month and year. It did not matter what they gave me to stop the coughing, I continued to cough.

Earlier this year, I had pneumonia and was put on medication for five days. About two weeks later, I realized that I was not coughing anymore. It has been six months and am still cough-free.


I have had reactive airways disease for 10 years. It was originally called IIA (irritant induced asthma) then RADS (reactive airways dysfunction syndrome) and now RAD (reactive airways disease) with constant coughing that gets worse in the presence of diesel fumes, petrol fumes and any gas, hot and cold temperature changes, pollen, smoke from cooking, dust, exertion and many more things.

I was exposed to huge amounts of zinc that caused this condition. I totally disagree with this statement in the article above "people with this condition experience less sensitivity to environmental pollutants than asthmatics." No inhalers, steroids, etc. stop my symptoms. Asthma has instant relief from inhalers in most cases.

My symptoms persist all the time day and night, stopping me from sleeping and causing me to hallucinate due to being awakened in the middle of deep sleep with coughing. Which leaves me tired all the time and affects my moods day to day.


I live in one of the most heavily polluted areas in the country. It only took one bout of RADS for me to realize that I could not subject my four-year-old daughter to the awful coughing and nostril-flaring associated with this disease. Now, on days when there are warnings about pollution or if I can see the smog blanketing our area, I make sure to put a mask on her.

She, of course, was not receptive or cooperative about wearing a mask at first. So, I made a game out of it to make it seem more appealing. She is the "Incredible Mask Girl" on heavily polluted days. We pretend she's a super hero and I even let her wear a little pink cape to accompany the mask that we have decorated with glitter and foil stars.


Approximately 30% of all children who exhibit reactive airway disease symptom will have asthma in adulthood. It is important to take preventative measures in order to stave off RADS. The best way to keep your child from developing this unpleasant coughing or wheezing is to keep him/her away from pollutants and irritants.


This pulmonary disorder is caused by external irritants and is non allergic. Very similar to asthma, RADS can occur in people who are exposed to ammonia, chlorine, and sulphur dioxide.

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    • Inhaling smoke from a wildfire can lead to reactive airway disease.
      By: Charlie Oliver
      Inhaling smoke from a wildfire can lead to reactive airway disease.
    • Coughing is common with reactive airway disease.
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      Coughing is common with reactive airway disease.
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      The human respiratory system.
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      Wheezing may be detected through the use of a stethoscope.
    • A chest X-ray can be used to diagnose reactive airway disease in patients.
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      Reactive airway disease can cause problems including shortness of breath.