Small airways disease

Small airways disease involves dysfunction or obstruction of the bronchioles, the smallest conducting airways in the lungs, and can significantly impair airflow and gas exchange. It may arise from chronic inflammatory conditions, environmental exposures, infections, or autoimmune processes. Patients often present with subtle early symptoms, such as persistent cough, wheezing, or exertional shortness of breath, making early detection challenging. Pulmonary function tests, high-resolution imaging, and clinical evaluation are essential for accurate diagnosis. Because the disease affects distal airways, conventional imaging may underestimate its extent, highlighting the need for advanced diagnostic tools and careful longitudinal monitoring.

Management focuses on addressing underlying causes, reducing inflammation, and preserving lung function. Pharmacologic therapy may include inhaled corticosteroids, bronchodilators, and anti-inflammatory agents tailored to patient-specific disease patterns. Environmental and lifestyle modifications, including avoidance of pollutants and smoking cessation, are essential preventive strategies. Pulmonary rehabilitation and breathing exercises help maintain airway function and improve exercise tolerance. Regular follow-up with pulmonologists allows adjustment of therapy and early intervention during exacerbations. Emerging research into small airway imaging and molecular markers promises to enhance personalized approaches to diagnosis and treatment, making small airways disease management increasingly precise and proactive.