Diagnosis of Asthma in Adults and Children
In diagnosis of asthma, to find out if a patient has asthma, doctors need to do a number of tests. But before the test is done, the doctor will usually ask questions about perceived symptoms, such as whether the patient likes to experience shortness of breath, chest pain, wheezing, difficulty speaking, and the condition of lips or nails change color to bluish.
If the answer is positive, then the next doctor will ask about the time of appearance of the symptoms. For example, whether during the night or early morning, when exercising, when smoking, when near the furry animals, when laughing, when feeling stressed, or unpredictable. In addition, doctors also need to ask if the patient has a family with a history of asthma or allergies.
If all the information given by the patient leads to asthma, then the next physical examination and laboratory tests. Laboratory tests can be done to strengthen the evidence. The most common test is spirometry. In this test, the patient will ask the doctor to take a deep breath and exhale it as quickly as possible to a device called a spirometer. The purpose of this test is to measure lung performance by referring to the volume of air that the patient can breathe in one second and the total amount of air released. The presence of resistance to the respiratory tract leading to asthma can be detected by the physician after comparing the data obtained with the size that is considered healthy in people the same age patients. In addition to a healthy size measure, asthma can also be detected through spirometry by comparing preliminary data with data after the patient is given an inhaler drug. If after the inhaler is given the result becomes better, then the patient most likely suffers from asthma.
The next test that can be used to diagnose asthma is a peak expiratory flow test. In a test assisted by a device called the peak flow meter (PFM), the air velocity of the lungs in one breath that can be exhaled by the patient will be measured to obtain peak expiratory flow rate data (PEFR). Doctors usually advise patients to purchase a PFM for home use, as well as make a PEFR note each day. In addition, patients will also be advised to record any symptoms that appear so that doctors can tell when asthma worsens.
If the patient feels that respiratory symptoms are often recovered while not working, the chances of the patient suffering from asthma are related to the condition of the job. Possible where the patient works there are substances that trigger recurrence of asthma symptoms. This usually happens to people who work as nurses, employees of chemical processing plants, laboratory staff, painters, welders, woodworking workers, caretakers, and food processing workers. To support the diagnosis, the doctor usually asks the patient to perform peak flow expiratory (PEFR) tests using a peak flow meter (PFM), either at work or outside the work environment. From the data obtained, doctors can estimate whether patients suffering from occupational asthma.
If you are diagnosed with asthma due to exposure to substances in the work environment, inform the diagnosis to the company where you work, especially in the occupational health services. The company has the responsibility to ensure the health of employees.
For example, if your asthma is triggered by the substance present in the production raw material, then ask the company to provide you with equipment that can protect itself from exposure to the substance or move you to another division that does not involve processing directly. This can be done if the company does not allow to replace the production materials with safer materials.
If within a year you stay frequently exposed to asthma while at work, then consider finding a new job.
In addition to spirometry and peak expiratory flow test, some other tests may require patients to strengthen the alleged asthma or help detect diseases other than asthma. Examples of such tests are:
- Test to see inflammation of the airways. In this test, the doctor will measure the levels of nitric oxide in the breath when the patient breathes. If the level of the substance is high, then it could be a sign of inflammation in the respiratory tract. In addition to nitric oxide, the doctor will also take a sample of sputum to check whether the patient’s lungs are inflamed.
- Respiratory airway responsiveness (bronchial provocation test). This test is used to ascertain how the patient’s respiratory tract reacts when exposed to one of the triggers of asthma. In this test, the patient will usually be asked to inhale the dry powder (mannitol). After that the patient will be asked to exhale into the spirometer to measure how high the rate of FEV1 and FVC changes after the trigger. If the results fall dramatically, then it can be estimated that patients suffering from asthma. In children, other than mannitol, the media that can be used to trigger asthma is exercise.
- Examination of allergy status. This examination is performed to determine whether the symptoms of asthma felt by the patient caused by allergies. For example allergies in food, mites, dust, pollen, or insect bites.
- CT Scan. This examination can be done by the doctor if suspected that the symptoms of shortness of breath in the patient is not caused by asthma, but infection in the lungs or abnormalities of the nasal cavity structure.
- X-rays. The purpose of this examination is the same as a CT scan, ie to see if the respiratory disorders are caused by other conditions.