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How Do Doctors Diagnose Asthma In Adults? – Symptoms

What Is Asthma?

Asthma is a chronic lung disease that causes episodes of difficulty in breathing. Asthma symptoms are caused primarily by chronic (long-term and on-going) inflammation of the breathing passages (or airways) of the lungs. This makes the airways of the patient with asthma is highly sensitive to various triggers.

When the airways inflammation is triggered by any number of external and internal factors, the airways swell and are fill up with mucus. Muscles within the airways will contract which can lead to further narrowing of the airways. The airways narrowing make it difficult for the air to be breathe out from the lungs and this lead to various symptoms of asthma. Asthma can affect people who are at risk and to all ages.

How do doctors diagnose asthma in adults?

Doctors can diagnose asthma in adults based on :

  1. Presence of symptoms which is suggestive of asthma
  1. Physical examination to detect signs of asthma, eventhough there are no signs when there is no asthma attack
  1. Objective measurement of decreased airflow in the lungs by using specific measurement like peak expiratory flow (PEF) meter and spirometry

What are the asthma symptoms?

Asthma symptoms can range from minor to severe and vary from patient to patient. The patient may have infrequent asthma attacks, have symptoms only at certain times such as at night or during exercise or have symptoms all the time.

Common symptoms of asthma include :

  • Coughing – often becomes worse at night or early in the morning that interrupt sleep
  • Wheezing – a whistling sound that occurs when the patient breathe out
  • Chest tightness – a sensation of something is squeezing or pressing the on patient’s chest
  • Shortness of breath – patients might feel that they cannot catch their breath or out of breath
  • Coughing or wheezing attacks that might be worsened by a respiratory infection

Sometimes, asthma symptoms are mild and resolve on their own or after minimal treatment with asthma medication. At times, asthma symptoms can continue to get worse and more intense thus the patient might have an asthma attack/ flare-ups/ exacerbations.

Why is it important to recognize asthma’s symptoms early?

Asthma can’t be cured, but it’s symptoms can be controlled by appropriate treatment. The patients have a better chance of controlling their asthma if it is diagnosed and treated early. With proper treatment, patients with asthma can have fewer or less severe asthmatic attacks. Without appropriate treatment, patients will experience more frequent and severe asthmatic attacks.

Asthma control often changes over time, therefore, it is important that the patients cooperate with their doctors to track their asthma symptoms and initiate and adjust treatment as needed.

What are the situations that can make an asthma symptom to flare?

Asthma symptoms can flare in certain conditions, for example :

  • Allergy-induced asthma, triggered by particular allergens, such as pet dander, cockroaches or pollen
  • Exercise-induced asthma, whereby the asthma is worse during exercise
  • On exposure to cold or dry air
  • Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust

What are the symptoms to suggest that the asthma is probably worsening?

Early recognition and treatment of asthma symptoms is important to prevent it from becoming worse but also to avoid a severe asthma attack. Not knowing severe asthma symptoms may delay treatment and pose a risk for hospitalization or even a life-threatening asthma attack.

Symptoms to suggest that the asthma is probably worsening include :

  • Asthma symptoms that are more frequent and bothersome during the day
  • Asthma symptoms that are more frequent and more bothersome during the night
  • Increasing difficulty in breathing (measurable with a peak flow meter, a device that is used to check how well the lungs are working)
  • The need to use a quick-relief inhaler more frequently

What are the symptoms to suggest that you need to seek emergency treatment?

Severe asthma attacks can be life-threatening. Symptoms of an asthma emergency include :

  • Shortness of breath rapid worsening
  • No improvement even after using a quick-relief inhaler for at least after 2 times
  • Shortness of breath when the patients are doing minimal physical activity

What are the impacts/ complication of undiagnosed or untreated asthma?

For some patients, asthma is only a minor nuisance because their symptoms are mild. They can have a mild attack any time if they are exposed to one of the triggers but the symptoms are reversible. However, asthma can be a major problem when :

  • Symptoms can be severe enough to distract with work, sleep or recreational activities
  • Asthmatics have to take frequent sick leave and absent from work or school during asthma attacks
  • Frequent emergency department or clinic visits and hospitalizations for severe asthma attacks
  • Side effects from prolonged use of certain medications used to treat severe asthma eg. systematic/oral steroids
  • May lead to a life-threatening asthma attack
  • May cause death

With proper treatment, asthma patients can have very few symptoms, if any, and they can lead a normal, active live and sleep through the night without interruption from asthma. Asthmatics who control their asthma well can lead a normal life as any other individuals.

In summary

Asthma is a chronic lung disease that can cause episodic symptoms which might interfere with daily activities or even leads to life-threatening attack. Early recognition of asthma symptoms with proper treatment make a big difference in asthma management in preventing both short-term and long-term complications caused by asthma.

References

  1. National Heart, Lung, and Blood Institute. What is asthma? http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/ Accessed May 6, 2013.
  1. McPhee SJ, et al. Current Medical Diagnosis & Treatment 2012. 51st ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=2740. Accessed May 6, 2013.
  1. Parker MJ. Asthma. Otolaryngologic Clinics of North America. 2011;44:667.
  1. Asthma and Allergy Foundation of America. Asthma overview – diagnosis. http://www.aafa.org/display.cfm?id=8&cont=7. Accessed May 6, 2013.
  1. Ronald B. George, Richard W. Light, Richard A. Matthay, Michael A. Matthay. Asthma. In Chest Medicine: Essentials Of Pulmonary And Critical Care Medicine May 2005, 5th edition.
  1. Ministry Of Health Malaysia. Clinical Practice Guidelines For Management Of Adult Asthma 2002.
  1. Global Strategy for Asthma Management and Prevention: Global Initiative for Asthma (GINA) (Updated 2012)

How do doctors diagnose asthma in adults? (Symptoms) (Quiz)

  1. Asthma symptoms can affect people of all ages, but it most often starts during adulthood.
  • True
  • False
  • Not sure

Answer: False

  1. Patient with asthma usually has symptoms of cough which is worsen at night or early in the morning and disturb sleep.
  • True
  • False
  • Not sure

Answer: True

  1. Asthma symptoms can be cured with appropriate asthma treatment.
  • True
  • False
  • Not sure

Answer: False

  1. Early recognition and treatment of asthma symptoms is important to prevent worsening of asthma symptoms and avoid a severe asthma attack.
  • True
  • False
  • Not sure

Answer: True

  1. With proper treatment, asthma patient can have very few symptoms and they can lead a normal, active live and sleep through the night without interruption from asthma.
  • True
  • False
  • Not sure

Answer: True