How is asthma diagnosed?

The first step in diagnosing asthma is a good evaluation. In many cases, a diagnosis of asthma is made based upon your history and symptoms at the time of evaluation. The family history should also be considered, as a positive family history increases a person's chances of developing asthma.

Kinds of Tests Used to Diagnose Asthma

Your doctor may have you perform a number of tests to evaluate breathing. These may include:

• Detailed medical history and physical exam
• Breathing tests called spirometry
• Chest and sinus X-rays

Specific tests that may be conducted in diagnosing asthma are explained in more detail:

• Bronchial Provocation Test
• Exercise-Induced Bronchoconstriction Test
• Routine Pulmonary Function Test

Additional tests may be conducted in the management of asthma:

• Allergy Intradermal Skin Test
• Allergy Prick Skin Test
• Barium Swallow Study
• Bone Density Test
• Bone Scan
• CT Scan of Sinuses
• Exercise Tolerance/Exercise for Desaturation Test
• pH Probe Test
• Tailored Barium Swallow Study

When to Test for Asthma

Many people see their family doctor or internal medicine doctor for asthma care. You and your doctor may choose to have you seen by a specialist, such as an allergist or pulmonologist (lung specialist).

We recommend this if any one of the following occurs:

• Severe asthma episode
• Several visits to the hospital or emergency room in the last year
• Conditions that complicate asthma such as chronic sinusitis, nasal polyps, or vocal cord dysfunction
• Frequent treatment with steroid tablets or syrup
• Confusion with the diagnosis
• Allergies are being considered
• Asthma seems to be getting worse

No matter what type of doctor you establish a partnership with to provide your asthma care, it is important to ask the following questions:

• What is the doctor's overall philosophy about asthma treatment?
• Does the doctor or office staff take time to explain what is happening with you, provide education and answer your questions?
• What can you do to treat an asthma episode before you call the doctor?
• Who (specialist, non-specialist or an associate) will work with you to treat an asthma episode?
• Who is responsible for adjusting steroid doses?

In evaluating your progress, remember that asthma is a chronic condition that will change in course from time to time. If you feel that you are not making progress with your current treatment, talk with your doctor about your concerns. If things are not going well, ask your doctor about seeing a specialist. You should not feel embarrassed about asking for another opinion.

This information has been approved by David Tinkelman, MD (February 2006).