If you or your child experience symptoms such as frequent cough, wheezing, chest tightness or shortness of breath, it’s important to see a healthcare provider to determine if the symptoms point to asthma. To diagnose asthma disease, a doctor will evaluate these symptoms, conduct a physical exam, ask for complete health history and look at test results.
Today, it is no longer thought of as a single disease. This disease is often categorized into different types based on the triggers identified by the doctor and the patient that cause breathing problems and make asthma symptoms worse. They include —
- Allergic asthma
- Cough-variant asthma
- Aspirin-induced asthma
- Exercise-induced asthma
- Night-time asthma
- Steroid-resistant asthma
- Occupational asthma
Some people have asthma that’s very difficult to treat that doesn’t respond well to inhaled corticosteroids. Depending on the types, there are different management steps and treatment options that can help.
Researchers have started to look deeper at the role that inflammation plays in asthma. They believe that all people with asthma have some degree of inflammation of the airways. They’ve categorized these into 4 biological pathways of inflammation, or endotypes —
- Mixed eosinophilic and neutrophilic
- Non-inflammatory (Paucigranulocytic)
Three main factors comprise an accurate asthma diagnosis: Medical history, observations during a physical exam, and results from breathing tests. A detailed family history of asthma and allergies can help your doctor to make an accurate diagnosis. It is also important to mention the personal history of allergies, as many share mechanisms with asthma and increase the risk.
Be sure to identify any health conditions that can interfere with asthma management, such as —
Young children who develop asthma symptoms before the age of five years, find it more difficult to receive a clear diagnosis. Doctors might confuse with those of other childhood conditions. If children experience wheezing episodes during colds or respiratory infections in early life, they are likely to develop asthma after 6 years of age. In this article we’ll discuss complete asthma treatment plan. So, keep reading till last…
A physical examination will generally focus on the upper respiratory tract, skin and chest. A doctor will listen for signs of wheezing, or a high-pitched whistle on breathing out, in the lungs during a breath using a stethoscope. Wheezing is a key sign of both an asthma and obstructed airway.
Physicians will also check for swollen nasal passages, a runny nose and soft growths on the inside of the nose and check for skin conditions including eczema and hives. These are allergic conditions that link to asthma and suggest heightened immune activity that could be causing any wheezing. People with this disease do not always show physical symptoms, and it is possible to have asthma without presenting any physical maladies during an examination.
Lung function tests are also used for asthma diagnosis. They measure how much air a person inhales and exhales and the speed with which a person can expel air from the lungs. A spirometry test can provide an indication of lung function. A spirometry can help assess lung function.
Spirometry is a non-invasive test that requires deep breaths and forceful exhalation into a hose. The hose links to a machine called a spirometer that displays two key measurements:
- Forced vital capacity (FVC), or the maximum amount of air a person can inhale and exhale
- Forced expiratory volume (FEV-1), the maximum amount of air a person can exhale in one second
The doctor then compares these measurements against what would be normal for another person of the same age. Measurements below the normal indicate obstructed airways and probable asthma. A doctor will often administer a bronchodilator drug to open air passages before retesting with the spirometer to confirm the diagnosis. If the results improve after using the drug, risk of an asthma diagnosis increases.
Children under the age of five years are difficult to test using the spirometry, so asthma diagnoses will rely mostly on symptoms, medical histories, and other parts of the physical examination process.
A bronchoprovocation test involves administration an airway-constricting substance, such as cold air, to deliberately trigger airway obstruction and asthma symptoms. This test is also known as a “challenge test”. A challenge test for exercise-induced asthma would consist of vigorous exercise similarly with the aim of triggering symptoms. The doctor then conducts a spirometry, and if measurements are still normal, they are not likely to reach a diagnosis of asthma.
Physicians might use allergy tests to identify the substances that may be causing asthma disease or making it worse. These tests don’t fully diagnose asthma, but they might help a doctor to understand the nature of asthma symptoms. Doctors also may test for other diseases with similar symptoms, like —
- Gastroesophageal reflux disease (GERD)
- Hay fever
- Sleep apnea
- Chronic obstructive pulmonary disease (COPD)
- Airway obstruction
- Airway tumors
- A blood clot in the lung, or pulmonary embolism
- Vocal cord dysfunction
- Congestive heart failure
- Viral lower respiratory tract infection
A doctor may test for these using the following methods —
- A chest x-ray
- Electrocardiogram (ECG)
- Complete blood counts
- CT scans of the lungs
- Gastroesophageal reflux assessment
- The induction and examination of sputum, or phlegm
Many people with this disease will not need to visit a specialist, as most primary care physicians have training for asthma diagnosis. People who require special asthma tests or have had the life—threatening asthma attacks in the past may need to visit an asthma specialist.
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