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.

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. 

An exercise challenge test is generally given if there is any indication that you may have exercise-induced asthma.

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. 

Pulmonary function tests (PFTs) are noninvasive tests that let us see how well your lungs work. They measure a variety of things, including: 

• Lung volume
• Capacity
• Rates of Flow
• Gas exchange

Tests under this category include: 

• Spirometry
• Body plethysmography
• 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: 

• Pain medication
• Stomach bloating
• Severe fatigue
• Pregnancy
• 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.

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. 

One type of asthma that you can have is allergy-induced asthma. If we think you have allergy-induced asthma, it is vital to identify your allergy triggers. This can be achieved with allergy testing.

We may run additional tests to ensure you don’t have something other than asthma. Some tests you may need include: 

• Blood tests
• CT scans of your sinuses
• Gastroesophageal reflux assessment
• X-ray or CT of your chest
• Examination of the phlegm in your lungs to check for bacterial or viral infection

We will also check if you have any of the following conditions that could make your asthma worse: 

• Sinusitis
• Hay fever
• Heartburn
• Allergies 

It can be challenging to diagnose breathing issues, especially in children. Additionally, asthma can coexist with other conditions that can impact your breathing. 

That is why we make every effort to diagnose your breathing issues properly so that we can come up with a comprehensive treatment plan for you. 

At West Hills Allergy & Asthma Associates, Dr. Anderson-Cowell has more than two decades of experience diagnosing and treating patients with asthma.

If you suspect you have asthma, please reach out so we can help you. 

If you’re looking for expert diagnostic experience and effective treatment history, Dr. Anderson-Cowell can help. For a consultation, please call (503) 297-4779 or request an appointment online.