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How Is Asthma Diagnosed?

If you or your child experience symptoms such as wheezing, frequent cough, shortness of breath or chest tightness, it is important to see a healthcare provider to determine if the symptoms point to asthma.

To diagnose asthma, a doctor will evaluate these symptoms, ask for complete health history, conduct a physical exam and look at test results.

Today, asthma is no longer thought of as a single disease. Asthma is often categorized into different types based on the triggers identified by the doctor and the patient that cause breathing problems and make asthma symptoms worse. They include:

  • Allergic asthma
  • Aspirin-induced asthma
  • Cough-variant asthma
  • Exercise-induced asthma
  • Nighttime asthma
  • Steroid-resistant asthma
  • Occupational asthma

Some people have asthma that is very difficult to treat that does not respond well to inhaled corticosteroids.

Depending on the type of asthma, there are different management steps and treatment options that can help.

Researchers have started to look deeper at the role that inflammation plays in asthma. They believe that all people with asthma have some degree of inflammation of the airways. They have categorized these into four biological pathways of inflammation, or endotypes:

  • Eosinophilic
  • Neutrophilic
  • Mixed eosinophilic and neutrophilic
  • Non-inflammatory (Paucigranulocytic)

Health History

You will be asked for some medical history, which should include family members with asthma, allergies, smoking and exposure to secondhand smoke, and exposure to pollutants in your workplace.

Testing for Asthma

There are also several breathing tests your healthcare provider may perform. The most common lung function test is called spirometry. This lung function test uses a device called, a spirometer, to measure the amount and speed of the air you blow out. This helps your healthcare provider see how well your lungs are working.

Other tests could include allergy testing (blood or skin), a blood test to check for cells responsible for inflammation, exhaled nitric oxide or FeNo test, and challenge tests, such as methacholine. Other lung diseases may cause some of the same symptoms as asthma. If your doctor thinks you might have something else, he or she may order additional tests.

Breathing Problems During Exercise

If you have chest tightness, cough, wheeze or shortness of breath during exercise, your doctor may perform extra tests to see if you have a type of asthma called, exercise-induced asthma or exercise-induced bronchospasm. For some people, they will only have asthma symptoms during exercise. There are many benefits to exercise, so work with your doctor to find the best management steps and treatment options for you.

Diagnosing Asthma in Children

A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if:

  • a parent has asthma
  • the child has signs of allergies, including the allergic skin condition eczema
  • the child wheezes even when he or she doesn't have a cold or other infection

To help your child's healthcare provider make a correct diagnosis, be prepared to provide information about family history of asthma or allergies, the child's overall behavior, breathing patterns and responses to foods or possible allergy triggers. Lung function tests are often used to make an asthma diagnosis, but they are very hard to do with young children. The doctor may use a 4- to 6-week trial of asthma medicines to see if they make a difference in your child's symptoms. Get more information for parents of children with asthma.

Discussing an Asthma Treatment Plan

If you are diagnosed with asthma, you and your doctor will discuss a treatment plan just for you, including the use of medicines. Make sure you know how and when to use these medications—ask your doctor, asthma educator or pharmacist.

    Resources
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    Getting Ready for Your Office Visit [PDF]

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    Webpage Resource

    Questions to Ask Your Doctor about Asthma

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    Reviewed and approved by the American Lung Association Scientific and Medical Editorial Review Panel. Last reviewed May 27, 2018.

    Page Last Updated: July 11, 2019

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