My lung doctor diagnosed me with small airway disease, but also told me I don't have asthma. But Iv been having trouble with my lungs on and off for a couple years. When I went to the ER they told me I do have asthma. So what is the difference or is there?
My Answer. This is a very good question. Asthma is the most likely culprit for certain symptoms, so it's normal for ER doctors to go with this most common diagnosis and treat symptoms as though this were the issue. If this solves the symptoms, then the said diagnosis is usually not questioned.
Still, your primary doctor is the one who assesses you on a regular basis and would be the one to give you the most specific, most accurate, diagnosis. So, what I would do, is talk to your primary doctor and ask specifically what he or she means by small airway disease. Sometimes it refers to asthma, although asthma that affects the smallest airways.
But, sometimes it refers to other less common diseases that are not well known. Getting to that specific diagnosis may be what helps you get the best treatment for your symptoms. So, definitely talk to your doctor about this. Hope this helps.
Your Question: Can you provide more information on small airway diseases?
My answer. There are different diseases that can affect the smallest airways. One of these diseases is asthma. Keep in mind that your bronchioles are your small airways. They are 0.5 microns in diameter. Asthma attacks cause these airways to become narrow. This is due to a combination of bronchospasm and increased mucus production. Both work to obstruct, but not completely block, airways.
Your smallest airways are the next generation of bronchioles. These airways are 0.2 microns in diameter. Asthma may or may not affect these smallest airways. When it does it may completely block them. This can definitely make you feel short of breath. But, asthma may not completely block them
So, if this is the case, it's asthma. A problem here is that small airway obstructions may not affect the flow of air detected by peak flow meters and PFT testing. In other words, it's possible for you to have a normal lung function. But, you will be short of breath.
There are also other diseases that can affect your lowest airways. One is COPD. Another is bronchiolitis. And both involve airway wall inflammation. The cause is somewhat different. The treatment may be the same for asthma. And that may explain why systemic corticosteroids helped to reverse the symptoms. I'm assuming corticosteroids here as that is the #1 most common medicine for treating asthma exacerbations in the ER. If your doctor is thinking asthma, then the treatment is corticosteroids.
This same medicine may also help with these other diseases affecting the lowest airways. But, if you want to treat these symptoms long-term, you will want to get to a most specific diagnosis. Asthma can be almost definitively ruled in or out by having you undergo some tests.
The most common of which is a PFT test. So, for one reason or another, your doctor thinks you don't have asthma, then he may make an educated guess (which is what doctors sometimes are left to) and determine that you have small airway disease. Now, keep in mind here what I said above about how asthma in the smallest airways may not show up on a peak flow or PFT. So, in this case, a doctor would have to rely on other tests to get to a proper diagnosis.
In your specific instance, it's impossible to know what your doctor is referring to. Do you have asthma? Do you have bronchiolitis? Do you have COPD? Do you have some other less known small airway disease? That's a question I would reserve for your doctor.
Hope this helps. John.
Attached below are a couple articles you may refer to.
1. Pathology Of Small Airway Disease
2. Small Airway Disease, Excluding Asthma And COPD
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