Asthma Diagnosis and Symptom Analysis

Among both children and adults, asthma is one of the most common chronic illnesses in countries including the United States and much of Europe.  Because asthma is considered a chronic illness, treatment regimens for patients must be followed accordingly in order to reduce the affects and ongoing health problems that can result from mismanagement of the condition.

Although a family physician can treat asthma, it is perhaps better to see a specialist. Research shows that getting asthma care from an allergist can help reduce the number of asthma control problems and result in less severe symptoms.

There is currently no cure available for asthma, however new discoveries in the medical research field are increasing the medications and techniques used to monitor and treat asthma in patients with the disease.

An asthma patient has particularly sensitive air passages, or airways, resulting in difficult breathing for the patient when these air passages are irritated from an introduced substance or atmospheric change.

The diagnosis or ruling out of asthma in a patient exhibiting any of the common symptoms of asthma, especially if a manifestation of those symptoms causes a dangerous situation for the patient, is of the utmost importance.

People with asthma do not generally suffer continuously, rather they tend to experience flare ups that are technically called asthma attacks. The symptoms of an asthma attack vary from patient to patient, but are generally characterized by symptoms as simple as coughing and as life-threatening as breathlessness and sever breathing difficulties.

Asthma attacks are generally sudden, however some patients may experience pre-attack symptoms that indicate that they are about to experience an asthma attack. These early warning signs are sometimes missed by patients but can include any of the following:

  1. Allergic induced itching of the nose or other skin areas
  2. Fatigue
  3. A loud cough that appears suddenly
  4. Running Nose
  5. Dizziness or lightheaded feeling
  6. Wheezing

Anyone who is showing these symptoms without explanation for an extended period of time should make an appointment to see their physician as soon as possible. Since one of the major problems for asthmatics is that their initial diagnosis is untimely in preventing the possibility of severe attacks and future residual health problems.

While listening to the patient’s breathing patterns with a stethoscope, a physician will normally question the patient as to any family history of breathing problems, asthma, allergies, etc.  They will also as that the patient provide information regarding what allergens seem to trigger asthma attacks and how often these attacks seem to be occurring, and to what extent.

The questioning will also migrate to what medications, if any the patient takes regularly or as needed for their breathing problems. And finally, the physician will address the number of colds the patient has had that migrate quickly to the chest region. This also holds true for upper respiratory infections, both viral and bacterial.

Once the initial examination is completed, the patient will be requested to take multiple deep breaths and to blow out all of their air into a device known as a spirometer. This device is utilized to examine the airflow a patient is providing upon exhalation. There is a set of determined norms, and patients experiencing asthma flare up – or those with inflamed airways will experience decreased airflow in comparison to their own normal and the normal numbers determined by researchers. 

If the patient s exhibiting reduced airflow, an inhaled medication may be administered to the patient in order to determine the effects of a particular medication on the patient. This allows the physician to try a treatment method and test it for effectiveness when repeating the spirometry. 

Spirometry is a useful diagnostic tool used by physicians in the diagnosis of asthma as well as testing the effectiveness of fast acting medications on their patients.

If the results of spirometer testing show that the patient is likely suffering from asthma, it is likely that the physician will recommend additional testing for the patient including a procedure called the Bronchial Challenge. To the patient this test is identical to the testing performed by the physician.

The difference is that the more intensive testing is performed by having the patient inhale a substance called Methacholine into the lungs in order to induce airway constriction. The effects of that substance on the lungs are generally measured by the patient exhaling multiple times into a spirometer to get an average result.

These testing methods commonly used in diagnosing asthma have proven effectiveness, and therefore they tend to be the two most popular testing methods among physicians and scientists alike.

Some other examples of tests that might be requested by the physician include:

  1. Testing for Gastro esophageal Reflux Disease (GERD).
  2. Testing for exercise related asthma symptoms.
  3. Allergy tests.
  4. Examination of your sinuses and other upper respiratory areas.

A diagnosis of asthma often results only after many other illnesses and conditions are eliminated – as a result of extensive patient testing.

In addition to diagnosis asthma, it is necessary for the physician to analyze the severity of the condition in order to determine the best course of treatment for a newly diagnosed patient.  Once the diagnosis of asthma has been certified through testing, the physician will begin to closely examine the symptoms of the particular patient.

The Levels of Severity

The physician will most likely ask the patient to describe their asthma attacks, ranging from the mildest onset of symptoms to the most severe attack they have ever experienced.  Additional testing may be requested in order to allow the physician to actually see the types of reactions induced in the patient.  The four common ranking assigned to asthma patients are:

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

  • Mild Intermittent: Symptoms appear in patients once or twice a month, and are very mild in all experienced asthma attacks.
  • Mild Persistent: Symptoms are more severe and may begin to affect certain activities in the patient’s life.  The symptoms may at this level of severity appear weekly, or even a few times per week.
  • Moderate Persistent: Symptoms appear commonly and regularly during the patient’s sleep. Activities are definitely reduced as a result of the symptoms, and attacks may occur daily.
  • Severe Persistent: Symptoms interfere in nearly every aspect of a patient’s life. They have problems coping with the symptoms while doing normal expected activities.  Symptoms appear several times per day, and most nights during sleep.

Once a patient has been diagnosed with asthma, and the treating physician has familiarized him/herself with the presented symptoms, and the rate of occurrence and severity of those symptoms, a plan for treatment will be given to the patient.  This often includes:

  1. Prescription medication presented with the instructions for taking those medications.
  2. A list of known allergens that irritate asthmatics in general and the particular patient.
  3. A list of symptoms that an allergy attack is oncoming.
  4. Instructions for using a peak flow meter, and a chart to record the results of testing.
  5. Instructions on when to see the physician, when to consider medication adjustments and a list of situations that warrant a visit to the office.
  6. Perhaps most importantly, the patient will be instructed on when and how to seek medical emergency treatment in the event of a life-threatening asthma attack.

A diagnosis of asthma often results only after many other illnesses and conditions are eliminated – as a result of extensive patient testing.

Overview... Diagnosis of Asthma

  • Asthma is a chronic inflammatory disease that makes airways (bronchial tubes) particularly sensitive to irritants, and this is characterized by difficulty in breathing.
  • If you have any of the warning signs for asthma, then it is important to seek urgent medical advice.
  • Common early warning signs of asthma include fatigue, coughing (especially at night), wheezing, difficulty breathing, tightness in the chest, runny nose, and itchy throat.
  • 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.


Asthma Guide


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