To accurately diagnose asthma, you need to undergo asthma testing. Diagnosing asthma requires a detailed medical history, a physical exam, and asthma-specific testing.
We may also run additional tests to rule out conditions other than asthma and determine if you have other conditions that may impact your diagnosis and treatment.
First, we will want to talk to you about your symptoms and health. This will help us determine if you have asthma or if something else is causing the breathing issues you are experiencing.
Here are a few types of questions that we may cover as we go over your medical history:
What type of symptoms are you experiencing? Does anything seem to be triggering these symptoms? When do they occur?
Do you smoke or vape tobacco?
Do you smoke or vape marijuana?
Do you have a blood relative, including parents, siblings, aunts/uncles, cousins, or grandparents, that have hay fever, allergies, or asthma?
Do you have hay fever?
Do you suffer from any other allergies?
Are you regularly exposed to airborne irritants such as chemical fumes, sawdust, dust, or tobacco smoke?
Do you have pet birds?
Do you have any health problems?
Do you use any medications or herbal supplements?
What is your occupation?
These questions are designed to help us see if you have any risk factors that could contribute to an asthma diagnosis. These questions will also help us rule out any other potential conditions impacting your breathing.
Next, we will conduct a physical exam. During a physical exam, there are a few specific things that we will be examining and listening for:
Listen to your breathing: It is important to listen to your breathing with a stethoscope. Wheezing, which is a high-pitch whistling sound when you exhale, is a primary sign of asthma.
Examine your skin: Your skin can provide signs of an allergic reaction or condition, which can appear as eczema or hives on your skin.
Examine your airways: We will examine your upper airways, throat, and nose.
After a medical history and physical exam, you will undergo a series of specific asthma testing to get an accurate diagnosis.
Methacholine Challenge Test
A methacholine challenge test is a test that uses a dose of methacholine to narrow your airways and test the reactiveness or responsiveness of your lungs. It can be used to help diagnose if you have asthma.
A methacholine challenge test is also known as a bronchoprovocation test.
An exercise challenge test is one tool used to diagnose asthma. Spirometry is completed before and after the exercise challenge test. You will be asked to work out using an exercise bike or a treadmill during the test.
Spirometry measures the rate at which you breathe air in and out. If you have asthma, you may experience a decrease in airflow while exercising or immediately after.
Lung function tests are designed to measure your breathing and to help diagnose and monitor asthma.
A range of lung function tests can be conducted to confirm an asthma diagnosis. They can also monitor your treatment and progress after an asthma diagnosis.
Almost all lung tests will have you breathe in and out while using a specific device. These tests are relatively simple and can be completed at the doctor’s office. Please note that you may need to stop using certain medications before the test to get accurate results. Your doctor will give you more details when your medical history is discussed before testing.
With a spirometry test, you will breathe into a mouthpiece connected to a spirometer. Or the device may be connected directly to a laptop. The purpose of spirometry is to measure how much air you can breathe in and out. It measures your lung capacity.
The test itself is simple. You take a deep breath and then exhale with as much force as possible. You may be asked to do this a few times to get the most accurate results.
Full Pulmonary Function Testing
Pulmonary function tests (PFTs) are noninvasive tests that let us see how well your lungs work. They measure a variety of things, including:
Rates of Flow
Tests under this category include:
Lung diffusion capacity
Cardiopulmonary exercise stress test
Pulse oximetry test
Arterial blood gas test
Most of these tests only take 15 to 30 minutes. You may feel a little tired after the test, but you will be able to resume normal activities quickly.
A few different elements can impact your test results. This includes:
Ability to follow medical directions
Normal test results are based on your age, height, and sex. If your results are outside of normal, you may have asthma or another lung condition.
Peak Flow Meter Test
A peak flow meter test uses a special, handheld device. You will be asked to breathe into the device. It specifically measures the rate at which you can push air out of your lungs.
The process for the test is simple. You breathe deeply and then blow into the device as hard and fast as possible. A peak flow meter can track your asthma and monitor your condition.
A provocation test is designed to create a mild asthma reaction in your body under laboratory conditions. If you don’t have asthma, the doses used to create an asthma reaction will not impact you. If you have asthma, the doses will produce an asthma reaction and help confirm an asthma diagnosis.
These are some of the most common lung function tests, although there are also other lung function tests that we can run. The purpose of lung function tests is to help diagnose and manage your asthma.
FeNO stands for fractional exhaled nitric oxide. This is a gas found in the atmosphere, and your body produces it when there is inflammation in your airways.
FeNO testing has been used since the 1990s to measure the amount of nitric oxide in your airways. A high level of nitric oxide is a sign of inflammation and is common in people with asthma, allergies, and eczema.
A FeNO test can diagnose asthma but can’t be used as the only diagnostic tool. It can help to confirm an asthma diagnosis and to rule out similar conditions.
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