Well, on the asthma parents list, the topic came up, so I thought I'd delve into a bit in the place where I can be as opinionated as I like. (So glad blogs were invented!) Here's my little rant, followed by some legit info:
The way I see it, it's either asthma, or it's not. Nothing pissed me off more than the doctor at some practice or other who once corrected me when I referred to little B as being asthmatic. "He has Reactive Airways," she said. No, you stupid cow. He has asthma. Any kid who's on Flovent 220 and Singulair year-round, has been on Orapred more than half a dozen times before his third birthday, sees a Pediatric Pulmonologist on a regular basis, and has spent more time in the ER than both his parents put together deserves to be properly diagnosed. Don't use your stupid, namby-pamby, politically and legally safe terms to describe MY kid's asthma.
And while you're at it, give us parents some credit. We're very much in control of our son's health, and I think we know what we're dealing with.
Okay. Off the soapbox..
Here's the stuff I found about "Reactive Airway Dysfunction" (or "Disease," depending on your source):
Background: Not all children who wheeze have asthma. Most children younger than(Hmm...How are they getting peak flow readings from kids under the age of 3??)
3 years who wheeze are not predisposed to asthma. Only 30% of infants who wheeze go on to develop asthma. Reactive airway disease has a large differential diagnosis and must not be confused with asthma.
Clinical factors suggestive of childhood asthma include recurrent wheezing, symptomatic improvement with a bronchodilator, recurrent cough, exclusion of alternative diagnoses, and suggestive peak flow findings...
Here's an interesting paper on RAD and Irritant-induced asthma (IIA) by Thomas H. Milby, MD. Just one interesting snippet:
Once symptoms do become clinically apparent, both RADS and IIA behave clinically
like non-allergic asthma, which, of course is what they are.
Interestingly, this paper mentions nothing about RAD as a "pre-asthma."The author describes it more as a reaction of the respiratory system to an external substance, like a toxic gas or something. And the difference between RADS and IIA is the period of time before the reaction occurs. To me, this sounds like the most appropriate definition of the term "Reactive Airway." Read the article. See what you think. (This article also backs up the definition.)
Hmmm. Hold the phone. These are describing "Reactive Airway Dysfunction Syndrome." Is that different than "Reactive Airway Disease?" Must research. Must learn.
Ugh...I've spent over an hour looking for definitions for both, and I haven't found a THING. I suspect they are different. I'll keep looking and post more tomorrow.