How Is Asthma Diagnosed?
Your primary care doctor will diagnose asthma based
on your medical history, a physical exam, and results from tests. He or she
also will figure out what your level of asthma severity isthat is,
whether it's intermittent, mild, moderate, or severe. Your severity level will
determine what treatment you will start on.
You may need to see an asthma specialist if:
- You need special tests to be sure you have
asthma
- You've had a life-threatening asthma attack
- You need more than one kind of medicine or higher
doses of medicine to control your asthma, or if you have overall difficulty
getting your asthma well controlled
- You're thinking about getting allergy
treatments
Medical History
Your doctor may ask about your family history of
asthma and allergies. He or she also may ask whether you have asthma symptoms,
and when and how often they occur. Let your doctor know if your symptoms seem
to happen only during certain times of the year or in certain places, or if
they get worse at night.
Your doctor also may want to know what factors seem
to set off your symptoms or worsen them. For more information on what causes
asthma symptoms to occur, see
"What
Are the Signs and Symptoms of Asthma?"
Your doctor may ask you about related health
conditions that can interfere with asthma management. These conditions include
a runny nose, sinus infections, reflux disease, psychological stress, and
sleep
apnea.
Physical Exam
Your doctor will listen to your breathing and look
for signs of asthma or allergies. These signs include wheezing, a runny nose or
swollen nasal passages, and allergic skin conditions such as eczema.
Keep in mind that you can still have asthma even if
you don't have these signs on the day that your doctor examines you.
Diagnostic Tests
Lung Function Test
Your doctor will use a test called
spirometry
(spi-ROM-eh-tre) to check how your lungs are working. This test measures how
much air you can breathe in and out. It also measures how fast you can blow air
out. Your doctor also may give you medicines and then test you again to see
whether the results have improved.
If the starting results are lower than normal and
improve with the medicine, and if your medical history shows a pattern of
asthma symptoms, your diagnosis will likely be asthma.
Other Tests
Your doctor may order other tests if he or she needs
more information to make a diagnosis. Other tests may include:
- Allergy testing to find out which allergens
affect you, if any.
- A test to measure how sensitive your airways are.
This is called a bronchoprovocation test. Using spirometry, this test
repeatedly measures your lung function during physical activity or after you
receive increasing doses of cold air or a special chemical to breathe in.
- A test to show whether you have another disease
with the same symptoms as asthma, such as reflux disease, vocal cord
dysfunction, or sleep apnea.
- A
chest
x ray or an
EKG
(electrocardiogram). These tests will help find out whether a foreign object or
other disease may be causing your symptoms.
Diagnosing Asthma in Young Children
Most children who have asthma develop their first
symptoms before 5 years of age. However, asthma in young children (aged 0 to 5
years) can be hard to diagnose. Sometimes it can be difficult to tell whether a
child has asthma or another childhood condition because the symptoms of both
conditions can be similar.
Also, many young children who have wheezing episodes
when they get colds or respiratory infections don't go on to have asthma after
they're 6 years old. These symptoms may be due to the fact that infants have
smaller airways that can narrow even further when they get a cold or
respiratory infection. The airways grow as a child grows older, so wheezing no
longer occurs when the child gets a cold.
A young child who has frequent wheezing with colds
or respiratory infections is more likely to have asthma if:
- One or both parents have asthma
- The child has signs of allergies, including the
allergic skin condition eczema
- The child has allergic reactions to pollens or
other airborne allergens
- The child wheezes even when he or she doesn't
have a cold or other infection
A lung function test along with a medical history
and physical exam is the most certain way to diagnose asthma. However, this
test is hard to do in children younger than 5 years. Thus, doctors must rely on
children's medical histories, signs and symptoms, and physical exams to make a
diagnosis. Doctors also may use a 4 to 6 week trial of asthma medicines to see
how well a child responds. |