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Asthma – Diagnosis



Asthma Diagnosis is the first step in keeping this disease under control.


Early warning signs of asthma include

Ø     fatigue

Ø     coughing, even when the person does not have a cold

Ø     wheezing

Ø     difficulty breathing

Ø     tightness in the chest

Ø     runny nose

Ø     itchy throat


Anyone regularly exhibiting any of the symptoms should see a doctor or allergist as soon as possible.  The earlier it is diagnosed the earlier the condition can be controlled, and the more successful the treatment can be.


Initially, your doctor will ask about:

Ø     Periods of coughing, wheezing, shortness of breath, or chest tightness that come on suddenly or occur often or seem to happen during certain times of year or season.

Ø     Colds that seem to "go to the chest" or take more than 10 days to get over.

Ø     Medicines you may have used to help your breathing.

Ø     Your family history of asthma and allergies.

Ø     What things (triggers) seem to cause asthma symptoms or make them worse.


Your doctor will listen to your breathing with a stethoscope and look for signs of asthma or allergies.


Also, your doctor will probably use a device called a spirometer to check your airways. This test measures how much air and how fast you can blow air out of your lungs after taking a deep breath.  The results will be lower than normal if your airways are inflamed and narrowed, as in asthma, or if the muscles around your airways have tightened up. As part of the test, your doctor may give you some medication that helps open up narrowed airways to see if it changes or improves your test results.  Spirometry is also used to check your asthma over time to see how you are doing.


If your spirometry results are normal but you have asthma symptoms, your doctor will probably want you to have other tests to see what else could be causing your symptoms.


One test commonly used is called the bronchial challenge test.  For this test, a substance such as methacholine, which causes narrowing of the airways in asthma, is inhaled.  The effect is measured by spirometry.


Children under age 5 usually cannot use a spirometer successfully. If spirometry cannot be used, the doctor may decide to try medication for a while to see if the child's symptoms get better.


Besides spirometry, your doctor may also recommend that you have:

Ø     Allergy testing to find out if and what allergens affect you.

Ø     A test that uses a hand-held peak flow meter every day for 1-2 weeks to check your breathing (a peak flow meter is a device that shows how well you are breathing).

Ø     A test to see how your airways react to exercise.

Ø     Tests to see if you have gastroesophageal reflux disease (GERD).

Ø     Test to see if you have sinus disease.


Other tests, such as a chest x-ray or an electrocardiogram, may be needed to find out if a foreign object, or other lung diseases or heart disease could be causing asthma symptoms.


A correct diagnosis is important because asthma is treated differently from other diseases with similar symptoms.


Depending on the results of your physical exam, medical history, and lung function tests, your doctor can determine how severe your asthma is.  This is important because your asthma severity will determine how your asthma should be treated, and what the options are for treatment.


A general way to classify severity is to consider how often a person has symptoms when that person is not taking any medicine or when their asthma is not well controlled. 


Asthma Types - Based on symptoms, the four levels of asthma severity classification are:

Ø     Mild Intermittent: occurs when your asthma is not well controlled, you have asthma symptoms twice a week or less, and you are bothered by symptoms at night twice a month or less.

Ø     Mild Persistent Asthma: occurs when your asthma is not well controlled, you have asthma symptoms more than twice a week, but no more than once in a single day.  You are bothered by symptoms at night more than twice a month. You may have asthma attacks that affect your activity.

Ø     Moderate Persistent Asthma: when your asthma is not well controlled, you have asthma symptoms every day, and you are bothered by night=time symptoms more than once a week.  Asthma attacks may affect your activity.

Ø     Severe Persistent Asthma: when your asthma is not well controlled, you have symptoms throughout the day on most days, and you are bothered by night-time symptoms often.  In severe asthma, your physical activity is likely to be limited.


Anyone with asthma can have a severe attack-even those who have intermittent or mild persistent asthma.


Your doctor should provide most of the following information to you (and if they don't then ask them to provide it):

Ø     How to take your long-term daily medication correctly

Ø     What things tend to make your asthma worse and ways to avoid them

Ø     Early signs to watch for that mean your asthma is starting to get worse (like a drop in your peak flow number or an increase in symptoms)

Ø     How and when to use your peak flow meter

Ø     What medication and how much to take to stop an asthma attack and how to use it correctly

Ø     When to call or see your doctor

Ø     When you should get emergency treatment


This information will help you successfully manage asthma, so that you can lead a normal life.



At a Glance …  Asthma – Diagnosis

Ø     Asthma is a chronic inflammatory disease that makes airways (bronchial tubes) particularly sensitive to irritants, and this is characterized by difficulty in breathing.

Ø     If you have any of the warning signs for asthma, then it is important to seek urgent medical advice.

Ø     Common early warning signs of asthma include fatigue, coughing (especially at night), wheezing, difficulty breathing, tightness in the chest, runny nose, and itchy throat.

Ø     If you have some of these warning signs, then see a doctor as soon as possible, so that they can perform a thorough examination and diagnosis.



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