How To Diagnose Asthma? Know More!

Introduction

Asthma causes inflammation of your lungs and bronchial tubes and makes breathing laboured. It can happen to both children and adults. The degree of asthma can range from mild and intermittent to severe and persistent. Asthma may not be curable, but with proper treatment, people can live a normal life. But it all starts with an accurate diagnosis of the type and intensity of your asthma. Asthma diagnosis will involve many steps to ensure it is faultless.

Medical History

When you visit a doctor, you will have to talk about your overall health and noticed any unusual changes lately. Then you will be asked detailed questions so that the doctor can ascertain whether the symptoms you have been experiencing are the ones triggered by asthma or some other but similar illnesses like bronchiolitis. You may also have to answer questions on your medical history, any illnesses you had contracted in the past, and some standard queries about your family’s health history as well. You can expect questions like these-

• What exactly are the symptoms, and when do they become profound?
• Do you know what triggers the symptoms?
• Had you been exposed to allergens or irritants?
• Do you have a fever, allergic reaction or infection?
• Does anyone in the family have asthma, respiratory problems, or a persistent case of allergies?
• What you do for a living, and are you exposed to chemicals, dust, pollutants, etc.?
• Do you have pets?
• What medicines are you taking?

Then your doctor will ask if you had experienced these particular symptoms-

• Coughing – especially at night when you go to bed
• Breathing difficulty
• A sensation of pressure or tightness in your chest
• If the symptoms become aggravated in cold weather or after a sustained period of physical activity

Undiagnosed and untreated asthma may worsen the functioning of the lungs and cause permanent damage, early identification and treatment of asthma with inhaled corticosteroids can decrease airway inflammation and may result in more optimal disease control in the long term.

Dr. Ashish Bajaj, M.B.B.S., M.D. in Clinical Pharmacology and Toxicology

Physical Examination

Once your doctor has asked the relevant questions, the next step is the physical examination.

The doctor will first peer into your eyes, ears, and nose and look into your throat and upper airways with a flashlight. Your skin will be closely examined for signs of an allergic reaction. Then with a stethoscope, your breathing patterns will be noted, whether you make a whistling high-pitched sound as you breathe out, which is an indicator of asthma.

Asthma Diagnosis Test to Determine Lung Capacity

Once asthma is suspected, your doctor will recommend further tests to confirm the asthma diagnosis. These tests will determine just how efficient your lungs are, and the results will help the doctor understand the degree of your condition.

1. Spirometry Test

This is the standard asthma diagnosis test that doctors use on anyone over the age of 5 years.

The spirometer is a device, which has a tube attached to it. The doctor will hold the other end of the tube to your nose or mouth. You will have to inhale fully. And then expel the breath of air forcefully into the tube. The spirometer will register the volume of the air you exhaled and how rapidly you can exhale. The readings will establish your pulmonary function. If the result is below normal, it could signify that your airways have become narrow because of asthma.

You may then be given asthma medicines in the form of an inhaler to clear up your bronchial tubes, and you will again have to breathe into the spirometer tube. If your reading improves, it will convince the doctor that it is a case of asthma.

Fractioned exhaled nitric oxide (FeNO) is a noninvasive marker of inflammation in asthmatic patients. FeNO can be used to monitor airway inflammation. This is another test in asthma monitoring apart from the ones mentioned in blog.

Dr. M.G. Kartheeka, MBBS, MD(Pediatrics)

2. Tests Based on Challenges

Since exercise can cause asthma attacks, your doctor may suggest you engage in some physical activity right there in the clinic. If you begin to witness the specific symptoms of asthma, you will be diagnosed with this chronic respiratory disorder.

If the spirometer results are not conclusive, for example, they verge on the threshold level of normal or near-normal, you will have to undergo a bronchial challenge test. You will be asked to inhale methacholine which will make your airways swell up a little. If you then exhibit the signs of asthma, then it will confirm the spirometer test’s conclusion.

3. Peak Airflow Asthma Diagnosis Test

This is another asthma diagnosis test that determines how much air is flowing out of your lungs. This test can also tell your doctor if your airways have become narrow.

4. Exhaled Nitric Oxide Asthma Diagnosis Test

This asthma diagnosis test is similar to the spirometer test with the difference that a machine will determine how much nitric oxide your breath contains when you breathe into a tube. We all exhale this gas but when the airways are swollen, your body produces more nitric oxide than usual.

5. Other Tests

Your doctor will recommend a few more tests just to rule out other diseases that trigger similar symptoms-

• Blood tests and skin tests to determine if you have specific allergies.
• CT (computerized tomography) scans of your lungs for signs of chronic obstructive pulmonary disease.
• X rays of the sinuses and the chest or cardiac CT scan (to trace sinusitis or myocardial ischemia).
• Gastroesophageal reflux test.
• Presence of phlegm in your lungs.

If these test results come back negative (meaning you have not contracted these diseases), the conclusion will be asthma.

Asthma Diagnosis for Children

The spirometer test is not recommended for children under 5 years of age. Asthma is diagnosed chiefly based on the symptoms, history of illnesses and a physical examination. However, doctors sometimes prescribe bronchodilators- drugs that dilate the airways and make breathing easier. This is an asthma medication, and if it helps, that indicates that the child has asthma.

The diagnosis of asthma is a long and careful procedure. There are quite a few other illnesses that mimic asthma. Remember to answer your doctor’s questions honestly and clearly and undergo the required tests.

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