Accurate Asthma Diagnosis

The first step in controlling asthma is an accurate diagnosis. Fusco-Walker says doctors diagnosed her kids with all kinds of illnesses before she knew the problem was asthma. According to Kathleen Sheerin, M.D., an asthma specialist with the Atlanta Allergy and Asthma Clinic, this is a common problem, and both consumers and doctors play a role.

"Some people are scared of the word 'asthma' because they only think of an emergency room scene on TV," she says. "I tell them there are a whole range of asthma symptoms, and the disease doesn't have to be scary if it's properly managed."

Cough Variant Asthma

Cough variant asthma is seen especially in young children. Cough is the principal symptom; because this frequently occurs at night, examinations during the day may be normal. Monitoring of morning and afternoon PEF variability and/or therapeutic trials with anti-inflammatory or bronchodilator medication may be helpful in diagnosis. Once the diagnosis is established, treat according to the stepwise approach to long-term management of asthma.

Asthma Diagnosis cont..

Doctors may call asthma other things like wheezy bronchitis or reactive airway disease.

Asthma symptoms vary by individual, and the disease can look like other lung diseases. Also, asthma symptoms usually surface before age 6, but it can be difficult to establish a firm diagnosis in young children. "Babies up to age 2 or 3 may wheeze only when they get a cold, and we call them 'transient wheezers,'" Sheerin says. "For other kids, the wheezing continues as they grow." These children, often considered "persistent wheezers," have chronic asthma. ODD and ADHD Info

"What we do is look for factors that make it more likely that a child's asthma will persist," Sheerin says. These factors include having a family history of asthma. Asthma is also more likely to persist if symptoms aren't only associated with a cold, but if there are also symptoms associated with other triggers such as smoke. People with asthma that persists also tend to experience wheezing that occurs at night, with exercise, or with seasonal changes. They also may have other allergic symptoms, such as allergic rhinitis or eczema, an itchy skin condition.

Sheerin participates in a state education program called Breathe Georgia, which uses the slogan "Call it what it is" to encourage doctors to accurately diagnose asthma. "You have to know that you have it in order to understand it and manage it," she says. "And an earlier diagnosis usually means better health outcomes."

The older someone is, the easier asthma is to diagnose. Doctors rely on a combination of a medical history, response to medications, and lung function tests. Such tests are generally hard to use in children under 6. One common lung function test, spirometry, involves inhaling and exhaling through a tube for several seconds. In some cases, allergy tests are performed to help determine asthma triggers.

Doctors determine whether asthma is intermittent (occurring from time to time), or persistent, defined as having symptoms at least twice a week during the day or twice a month during the night. Asthma that is considered persistent is further categorized as mild, moderate or severe. Fusco-Walker, who was diagnosed with mild asthma in her thirties, says these categories help doctors determine an appropriate treatment plan. "But remember that regardless of the type, you still have asthma and it is still a life-threatening illness," she says. "Some people hear the word 'mild' and think they don't have to worry about it. But they do."

Though asthma can't be cured, it typically can be treated, and scientists are currently studying whether untreated asthma causes a permanent change in the airways. As a natural part of aging, we begin losing lung function in our twenties. Untreated asthma might further accelerate that loss.

Asthma Information