Diagnosis for Asthma
It is often difficult to immediately certify that asthma is the diagnosis. To reach a conclusion, the doctor will need information on:
* The symptoms, such as wheezing, coughing, shortness of breath
* What triggers the symptoms or when do the symptoms get worse
* Medications that were taken prior and whether they helped
* Any family history of breathing problem, allergies or asthma. Acute episodes are usually straightforward to interpret but chronic, low-grade symptoms can be difficult.
How is asthma diagnosed?
Symptoms alone aren’t enough for a doctor to arrive at a diagnosis of asthma. He will also:
1. Evaluation based on patients history and the symptoms being displayed (such as sudden, severe episode or recurrent episodes of wheezing, coughing or shortness of breath) .
2. Patients family history should not be neglected, as it has a strong chance of influencing the patient – whether parents, brothers, sisters or children ever have been diagnosed with asthma, allergies, sinusitis or nasal growths?
3. A physical examination of the upper respiratory tract, chest and skin generally follows the history. Using a nasal mirror, the doctor may look inside the nose for signs of allergic disease such as increased nasal secretions, swelling or polyps. These signs may suggest that allergies are responsible for triggering suspected asthma.
4. Next, the doctor may use a stethoscope to listen to the sounds the lungs make while breathing. Wheezing sounds indicate one of the main signs of asthma: obstructed airways.
5. Finally, the doctor may examine the skin for signs of allergic conditions such as eczema or hives, which are often associated with asthma.
6. Breathing tests called spirometry – this test measures the amount of air blown out of the lungs over time. Spirometry measures three values that are important in diagnosing asthma:
* Vital capacity, which is the maximum amount of air that one can inhale and exhale
* Peak expiratory flow rate, also known as the peak flow rate, which is the maximum flow rate one can generate during a forced exhalation
* Forced expiratory volume, which is the maximum amount of air you one exhale in one second
If certain key measurements are below normal for a person your age, it may be a sign that the airways are obstructed.
7. Challenge test – During this test, a deliberate attempt is made to trigger airway obstruction and asthma symptoms by inhaling an airway-constricting chemical or taking several breaths of cold air.
8. Chest and sinus X-rays.
9. The doctor may also test a persons pulmonary function after administering him some asthma medication. This helps confirm that the blockage in the air passages that shows up on pulmonary function tests goes away with treatment.
Different tests used to diagnose asthma:
Different lung pulmonary tests that may be conducted in diagnosing asthma. Some of them include:
* Bronchial provocation test
* Routine pulmonary function test
* Exercise induced bronchoconstriction test
* Allergy intradermal skin test – although allergy tests aren’t used to diagnose asthma, they can help identify substances that may be causing or worsening asthma.
* Allergy prick skin test to identify the sources of sneezing
* Bone density test
* Bone scan
* CT scan of sinuses
* Exercise tolerance test
Asthma is a complicated and difficult disease to diagnose, and the results of airway function testing may be normal even if a person has asthma.
When to undergo diagnosis test for asthma?
If symptoms which are similar to asthma persist, the doctor may recommend an asthma test to get to the root of the problem. This is usually advised if any one of the following occur repeatedly:
* Severe bouts of asthma
* Conditions that complicate asthma such as chronic sinusitis, rhinitis, hayfever, nasal polyps.
* Frequent treatment with steroid tablets which are not curing the problem
* Confusion with the diagnosis
* Allergies are popping up
* Asthma seems to be getting worse
Asthma is a chronic condition, where symptoms and the condition change in time. If you feel that you are not making progress with your current treatment, talk to your doctor about alternative treatment.
Diagnosing asthma in children:
When dealing with children under 5 years of age, doctors rarely conduct lung function tests because young children usually have trouble following the instructions.
Instead, a hit and trial method is used. When a child’s symptoms, medical history and physical examination suggest asthma, the doctor may prescribe a bronchodilator a drug that opens the airways. If the child’s signs and symptoms improve after using the bronchodilator, an asthma diagnosis is likely.
The latest in asthma diagnosis – Exhaled nitric oxide:
As spirometry diagnosis tests aren’t always accurate, doctors are looking for better ways to diagnose asthma. One new approach is to measure a chemical marker of asthma nitric oxide in exhaled air. In general, higher levels of nitric oxide correspond with higher degrees of asthma severity.