To diagnose asthma, your doctor will discuss your medical history with you and perform a physical exam. You may need a lung function test and maybe other tests, such as a chest or sinus X-ray.
Personal and medical history. Your doctor will ask you questions to understand your symptoms and their causes.. This includes any current physical problems. Shortness of breath, wheezing, coughing and tightness in your chest may show asthma. This also includes all previous medical conditions. A history of allergies or eczema increases your chance of asthma. A family history of asthma, allergies or eczema increases your chance of having asthma, too. Tell your doctor about any home or work exposure to environmental factors that can worsen asthma.
Physical examination. If your doctor thinks you have asthma, they will do a physical exam. They will look at your ears, eyes, nose, throat, skin, chest and lungs. This exam may include a lung function test to detect how well you exhale air from your lungs. You may also need an X-ray of your lungs or sinuses. A physical exam then allows your doctor to review your health.
Lung function tests. To confirm asthma, your doctor may have you take one or more breathing tests known as lung function tests. These tests measure your breathing. Lung function tests are often done before and after inhaling a medication known as a bronchodilator which opens your airways. If your lung function improves a lot with use of a bronchodilator, you probably have asthma. Common lung function tests used to diagnose asthma include:
Spirometry. This is the recommended test to confirm asthma. During this test, you breathe into a mouthpiece that’s connected to a device. It is called a spirometer. The spirometer measures the amount of air you’re able to breathe in and out and its rate of flow. You will take a deep breath and then exhale forcefully.
Peak airflow. This test uses a peak flow meter. It's a small, handheld device that you breathe into to measure the rate at which you can force air out of your lungs. During the test you breathe in as deeply as you can and then blow into the device as hard and fast as possible. If you're diagnosed with asthma, you can use a peak flow meter at home to help track your condition.
Trigger tests. If your other results are normal, but you’ve been experiencing signs and symptoms of asthma, your doctor may use known asthma triggers to try and provoke a mild reaction. If you don’t have asthma, you won’t react. But if you do have asthma, you likely will develop asthma symptoms.
If your doctor thinks you have something other than asthma or besides asthma, they may run other tests. These might include a chest X-ray, acid reflux test, sinus X-rays or other specialized tests. Your doctor may also perform allergy tests. Allergy tests aren’t used to determine if you have asthma. But, if you have allergies, they may be causing your asthma.
Even though we cannot cure asthma, we can control it. Each case of asthma is different, so you and your doctor need to create an asthma treatment plan just for you. This plan will have information about your asthma triggers and instructions for taking your medicines.
An inhaler allows the medicine to go directly to your lungs.
There are two types of inhalers: metered dose inhaler (MDI) and dry powder inhaler (DPI).
A nebulizer is a machine with tubing that takes liquid medicine and turns it into a mist that you inhale. Nebulizers are an option for anyone who has difficulty using an asthma inhaler.
What Are the Different Types of Asthma Medicine?
There are two types of asthma medicines: long-term controllers and quick-relievers
Long-Term Control Medicines
Long-term control medicines help you prevent and control asthma symptoms. You may need to take this type of medicine every day for best results. There are several kinds of long-term control medicines:
Inhaled corticosteroids prevent and reduce airway swelling. They also reduce mucus in the lungs. They are the most effective long-term control medicines available.
Inhaled long-acting beta agonists open the airways by relaxing the smooth muscles around the airways. If used, this type of medicine should always be taken in combination with an inhaled corticosteroid.
Combination inhaled medicines contain both an inhaled corticosteroid and a long-acting beta agonist. If you need both of these medicines, this is a convenient way to take them together.
Omalizumab (anti-IgE) is given every 2 or 4 weeks as a shot. This medicine prevents you from reacting to allergic triggers. It does this by blocking the antibody that causes allergies. Anti-IgE is a very expensive medicine. It usually is only prescribed if other asthma medicines have not controlled your asthma.
Leukotriene modifiers are taken in pill or liquid form. This type of medicine reduces swelling inside the airways and relaxes smooth muscles.
Cromolyn sodium is an inhaled non-steroid medicine. It prevents airways from swelling when they come into contact with an asthma trigger.
Theophylline comes as a tablet, capsule, solution and syrup to take by mouth. This medicine helps open the airways by relaxing the smooth muscles
Oral corticosteroids are taken in pill or liquid form. This medicine may be prescribed for the treatment of asthma attacks that don’t respond to other asthma medicines. They also are used as long-term therapy for some people with severe asthma. Corticosteroids are not the same as anabolic steroids taken by some athletes and banned in many athletic events.
You use quick-relief medicines to help relieve asthma symptoms when they happen. These medicines act fast to relax tight muscles around your airways. This allows the airways to open up so air can flow through them. You should take your quick-relief medicine when you have asthma symptoms. If you use this medicine more than 2 days a week, talk with your doctor about your asthma control. You may need to make changes to your treatment plan.
Short-acting beta agonists are inhaled and work quickly to relieve asthma symptoms. These medicines relax the smooth muscles around the airways and decrease swelling that blocks airflow. These medicines are the first choice for quick relief of asthma symptoms.
Anticholinergics are inhaled but act slower than the short-acting beta agonist medicines. These medicines open the airways by relaxing the smooth muscles around the airways. They also reduce mucous production.
Combination quick relief medicines contain both an anticholinergic and a short-acting beta agonist. This combination comes either as an inhaler or nebulizer for inhalation.
Can Medicine Alone Help My Asthma?
Not usually. Although medicines help a lot, they may not be able to do the job alone. You have to avoid the things that cause or trigger your asthma symptoms as much as you can. Asthma triggers can be found outside or inside your home, school or work place.
Will I Always Have to Take the Same Amount of Medicine?
Not always. You will probably take more medicine when you begin treatment to get control of your asthma. After a while, you and your doctor will learn which medicine(s) control your asthma best and how much you need. Once your asthma is well controlled, it may be possible to reduce the amount of medicine you take. The goal of this step-down method is to gain control of your asthma as soon as possible and then control it with as little medicine as possible. Once long-term, anti-inflammatory therapy begins, your doctor will want to monitor you every 1 to 6 months.
Will I Have to Take Medicine All the Time?
Maybe not. Asthma is a chronic condition that is controllable, but not curable. For that reason, you will likely have asthma symptoms when exposed to triggers for a long time. This is the case even if you don’t have symptoms very often. Your treatment will depend on the severity and frequency of your symptoms. If your asthma is controlled, your treatment will focus on quick relief from acute symptoms and treatment of episodes when they occur.
If your symptoms occur at certain times and you know what caused them, you and your doctor can use this information to determine the best treatment. If, for example, you have seasonal asthma because of a specific pollen allergy, you may take medicines only when that pollen is in the air. But asthma that specific is not common. Many people with asthma take some form of medicine most or all of the time.
Will Medicine Help Me Sleep Better?
Yes. Asthma symptoms often occur at night. Many people wake up with asthma symptoms such as coughing or wheezing. You can control nighttime symptoms by taking asthma controller medicines on a regular basis.
Many people are allergic to dust mites and mold found in bedding materials. Using mattress or pillow encasements can help contain those allergens. Dehumidifiers can also be helpful reducing the humidity in your home that dust mites and mold need to exist. Using air filters in your bedroom may also help reduce your nighttime symptoms caused by other allergens such as pets.
Will Medicine Help Me Breathe Better When I Exercise?
Yes. Exercising, particularly in cold air, may cause airway inflammation or exercise-induced bronchospasm (EIB). Quick-relief asthma medicines, taken before and during exercise, usually control this. Thanks to these medicines, many Olympic and professional athletes have successful sports careers even with their asthma.
Do Asthma Medicines Have Side Effects?
Yes. All medicines have side effects. You should give your doctor your entire health history, not just your asthma symptoms. Tell your doctor how you are responding to the treatment and whether you have any side effects. Follow-up often with your doctor so you can control your asthma with the least amount of medicines and with the fewest side effects.