Asthma is a disease that requires diagnosis by a healthcare professional. If you have symptoms such as wheezing, frequent coughing, shortness of breath, or chest tightness, it is important to consult a doctor to determine whether these symptoms indicate asthma.

In diagnosing asthma, doctors evaluate the existing symptoms, take a complete medical history, perform a physical examination, and review the results of supporting tests.

1. Medical History

Patients will be asked questions including:

- Complaints felt, such as chest tightness, wheezing, coughing, difficulty breathing, or respiratory problems worsened by physical activity or periodically/episodically after exposure to triggers.

- Symptoms/complaints that worsen at night or in the early morning. Symptoms could be chest tightness, coughing, wheezing, or shortness of breath. This could be due to cold or dust mites in the bed.

- Family members who have asthma.

- Allergy history (could be like a cold or sneezing, allergies on the skin, allergies in the eyes after exposure to triggers).

- Family members who have a history of allergies.

- Smoking habits or passive smoking.

- Exposure to pollutants in your workplace.

1. Physical Examination

- Check the nose, throat, and upper airway.

- Examine the lungs. To listen to breathing, whether there is wheezing when exhaling.

- Examine the skin to see skin allergies such as eczema and itching on the limbs.

1. Supporting tests, to exclude other causes such as:

- Chest X-ray or CT scan of the chest.

- Sinus X-ray or CT scan of the sinuses.

- Blood tests such as complete blood count, total IgE, or specific IgE tests to determine the allergic factors that cause asthma in patients.

- Gastroesophageal examination and assessment (on GERD).

- Sputum examination from the lungs to determine bacterial or viral infections.

- Spirometry test

▪ Spirometry Test

Spirometry is the most common test used to examine the lungs and respiratory system. This easy, painless and quick test determines how well the lungs are functioning by having the patient take a deep breath and exhale into a tube connected to a spirometer. The spirometer records the volume of air exhaled and the speed of exhalation. If the reading is below normal for the patient's age, it may indicate that they have asthma, which has narrowed their airways.

After conducting the test, the doctor may ask the patient to inhale an asthma medication and repeat the test. If the results show improvement after the medication, it can be concluded that the patient has asthma. Additionally, spirometry can be used to monitor asthma over time, evaluate the effectiveness of asthma treatment, and assess the response of the airways during exercise.

References:

Centers for Disease Control and Prevention (CDC). Accessed January 2023. You can control your Asthma

Mayo Clinic. Accessed January 2023. Asthma.

Mayo Clinic. Accessed January 2023. Spirometry.

Asthma and Allergy Foundation of America. Accessed January 2023. Lung Function Test

Author: Dr. Afi Falizia (Medical Doctor at PRAMITA Clinic Branch Ngagel Jaya No.18 Surabaya)