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Small Airway Disease (SAD): What Is It and What Are the Symptoms?

Small Airway Disease

Lung-related diseases are more prevalent in public conversations after the recent COVID-19 pandemic. People want to know how to prevent respiratory issues and the most common conditions. Small airway disease (SAD) is an ailment not many know about, but it affects people globally each year.

Here’s what small airway disease is, what causes it and what symptoms are most common for patients with a diagnosis.

You’ll better understand how to protect your lungs and what could signal that you need to check in with your doctor. A broader understanding of potential health conditions is an excellent way to keep yourself and your loved ones safe.

What Is Small Airway Disease?

Small airway disease is a condition that causes airways to shrink to less than 2 millimeters in diameter in patients with chronically compromised lung tissue. It most frequently occurs in people with chronic obstructive pulmonary disease (COPD), which causes mucus buildup in the lungs and air sac damage within their tissues. SAD further shrinks viable lung tissue when activities or coughing increases cellular inflammation

SAD isn’t something you can catch from another person. You don’t need vaccines, masks or quarantine guidelines to protect yourself or your loved ones. However, it can potentially affect the 15 million Americans with COPD, so it’s more common than people realize.

What Causes Small Airway Disease?

A recent study found that SAD is more common with frequent lung exacerbations for COPD patients due to increased cellular inflammation and the body’s response to it. COPD patients deal with more mucus produced by coughing than people without it. It triggers cellular irritation and swells airways until they’re too small to pass oxygen to the body.

People may experience SAD if their lifestyle doesn’t reduce their COPD symptoms. Remaining too active causes heavy breathing, which irritates lung tissue. It may trigger airway resistance because cellular inflammation repeatedly occurs throughout someone’s daily routine. 

What Are the Symptoms?

If you believe you or a loved one has SAD due to increased difficulty catching your breath, you should look for these other symptoms that point more toward this condition than contagious lung viruses.

1. An Existing COPD Diagnosis

A SAD diagnosis requires that most airways shrink to less than 2 millimeters. COPD patients commonly have compromised lung tissue inflamed enough to reach that tiny diameter requirement. People without COPD may not receive a SAD diagnosis unless they have another lung condition already compromising their airways.

You may have COPD if you experience daily or debilitating symptoms such as:

  • Mucus production when coughing
  • Wheezing during physical activity
  • Difficulty breathing during minor activities

Your doctor may examine your lung tissue during surgery or with a computed tomography (CT) scan. It depends on your medical history and potential environmental conditions influencing COPD development, like long-term exposure to particular matter or gases.

2. More Shortness of Breath Than Usual

Everyone gets a little out of breath during rigorous activities, but people with SAD will struggle to inhale any oxygen during minor activities. The inflamed air sacs in their lung tissue can’t inflate due to inflammation, so typically easy parts of their routine may become challenging. Measuring your respiratory rate can indicate if your inhalation abilities require medical attention.

Someone with shortness of breath can decrease lung inflammation in numerous ways, including eating a diet high in antioxidants, which relieves inflammation. Your doctor may recommend this in addition to medications. Lifestyle changes are a necessary part of living with and recovering from SAD. 

3. Increased Chest Tightness

When your lungs can’t expand to their total capacity, you’ll experience chest tightness. This occurs when your lung tissue becomes strained from the effort to breathe. It can also signify that your lung tissue is inflamed and needs more oxygen than your breaths deliver.

Sometimes chest tightness happens when people with COPD or SAD overexert themselves. It can also occur when the fight-or-flight response kicks in because increased adrenaline triggers the need for more oxygen. Recording when chest tightness happens throughout your day will provide logs that point out possible triggers.

4. Mucus When Coughing

Cilia hairs lining the airways produce mucus if irritants enter a set of lungs unafflicted by breathing conditions. This traps them so they’re easier to cough out. Someone with SAD or COPD experiences this process but can’t get a deep enough breath to expel the irritant.

The cycle produces mucus that continuously builds. People who struggle to cough it out may have COPD or SAD. Work with your doctor to practice the huff cough and utilize breathing techniques to bring the mucus up without trapping yourself in a coughing cycle.

5. Shrunken Airway Diameter

Someone may receive a COPD diagnosis for a combination of these symptoms but must undergo CT scans. Doctors have to locate compromised lung tissue and airways. They may need further testing to more accurately provide a SAD diagnosis if there are many compromised airways.

Someone with SAD will have 25% maximal expiratory flow left in their lungs. It’s difficult to see such small airways through CT imaging alone. Doctors may recommend a surgical lung biopsy to investigate further or pulmonary function tests if the patient requires a noninvasive diagnosis.

How to Treat Small Airway Disease

There are a few ways to manage SAD. First, patients can use inhaled corticosteroids through an inhaler to expand their airways like an asthma patient. It directly solves the problem of swollen airways by reducing inflammation.

More recent research also shows that when SAD patients inhale hydrofluoroalkanes (HFAs) smaller than 1.5 micrometers (µms), the particles reach peripheral and central airways to optimize the treatment of inflammation. This medication is available with pressurized metered dose inhalers. It also does not require a deep inhale to be effective, making it an optimal resource for people with COPD or SAD.

Learn More About Small Airway Disease  

Knowing what small airway disease is and what causes it makes it easier to understand and treat. It isn’t something people can diagnose themselves with at home. Instead, they should talk with their doctor if they’re concerned.

Proper testing and potential surgery will pinpoint SAD as the cause of a patient’s breathing challenges. Treatments are available to make SAD a liveable condition. Inhalers could be the best way to make patients comfortable while researchers work to find a cure.

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