Introduction

Obtaining a diagnosis of asthma is just the beginning of a potentially lifelong endeavor to manage the condition. This is easier for some than for others, depending on the severity, frequency, and duration of asthma attacks. This article covers how an asthma diagnosis is obtained, as well as some of the most common treatments available to manage asthma.

Obtaining a Diagnosis

In order to obtain an asthma diagnosis, you'll need to see your doctor for a general examination. Depending on his experience with asthma, you may also be referred to another specialist, such as an allergist or a pulmonologist.

Before you visit your doctor, help him as much as possible in achieving a knowledgeable diagnosis. You can do this by writing down your symptoms, when they occur, and whether they occur at certain times of the day, or certain seasons of the year. You should also mention if you've noticed factors that lead to, or contribute to your asthma attacks, including things like dust, cold air, or stress.

Be prepared for your visit with a list of questions for your doctor. Whenever possible, take someone else along, so that you have another set of ears to help you remember things the doctor said or to help you take notes.

• Your impression of the severity of your symptoms
• Does anything seem to worsen your symptoms?
• Does asthma or allergies affect anyone else in your family, or does your family have a history of asthma?
• Have you been diagnosed with additional health problems?
• When did you first notice your symptoms? What exactly are they? And how severe are they?
• One of the most important things your doctor may ask is the frequency and severity of your asthma attacks
• Your doctor will also want to know if you're allergic to anything, or if you've been diagnosed with other conditions such as hay fever or atopic dermatitis.

In addition to a physical exam, your doctor may perform additional tests, including what is called the peak flow meter test, and spirometry. A peak flow meter test requires you to breathe into a tube that measures the force of your exhalation.

Lung function tests may also be performed prior to, and following, administration of medications called bronchodilators, such as Albuterol. Albuterol opens the airways. Doctors determine whether such bronchodilators improve your lung function. In cases where they do, asthma is often indicated.

Additional tests, including a nitric oxide test, or a methacholine test, may be recommended. Measurements of the amount of nitric oxide contained in your breath may be analyzed to determine whether you have asthma. This test measures higher than normal levels of nitric oxide, but isn't routinely used.

An inhalation test called a methacholine challenge may be administered. You'll be asked to inhale methacholine, which is known to trigger asthma. In many cases, this test will be performed if other lung function tests have produced normal results, but you still experience symptoms of asthma.

Spirometry testing is common and utilizes a device that measures dilation or constriction of bronchial tubes. This is done by determining how much air, and how fast, you can exhale after taking a deep breath.

This test is done in a doctor's office, often used to diagnose other lung conditions, including COPD and emphysema, and takes a few minutes to perform. You may or may not be given an inhaled medication prior to the test (a bronchodilator). Your doctor may take more than one test, requiring you to wait a short period between tests.

You'll be asked to take a deep breath and then exhale as forcefully as possible into a tube attached to a machine called a spirometer. Your exhale should last several seconds. You may be asked to exhale three or four times to ensure the accuracy of the test.

The force of your exhalation is measured in two different ways:

• Forced expiratory volume - Known as FEV-1, this aspect of the test determines the force of your exhalation.
• Forced vital capacity - Called FVC, this aspect of the test determines the amount of air that you can exhale after inhaling as deeply as possible. The lower the forced vital capacity reading, the more restricted your breathing is determined to be.

Medications

Asthma medications can be over-the-counter or prescribed. Prescription inhalers are common among those diagnosed with asthma. Regardless of the type of medication, always follow your doctor's instructions regarding dosage and use of the medication; report any unusual side effects to your doctor.

Be prepared for your medication or dosage to change as your condition also changes. In most cases, asthma is chronic and requires chronic treatment approaches. You may be required to take medication for the rest of your life. At times, your asthma may improve or worsen, and your physician needs to be aware of these changes to alter or monitor your medication dose and frequency.

Throughout the course of your treatment, your doctor will likely require you to perform regular and routine lung function tests to evaluate your condition over time. You may also need to adjust your medications, frequency, and dosage depending on the season, your environment, your activity and exercise levels, and any changes in your work environment.

You may also be required to adapt your medication, depending on whether you are diagnosed with additional medical conditions or complications. The goal of asthma medication is to control and prevent asthma symptoms, reduce severity and frequency of asthma attacks, and to maintain lung function at optimal levels.

Medication may be considered for long-term control, or for quick relief. Long-term medications are often prescribed as a preventive measure to reduce inflammation of lung passageways. Quick relief medications are designed for acute attacks or episodes that immediately provide relief of sudden airway constriction, or obstruction to the airway.

Some of the most common long-term medications for asthma include:

• Corticosteroids (anti-inflammatory drugs) - Corticosteroids may included to flunisolide, mometasone and prednisolone.
• Long-acting bronchodilators - (inhalers) - oral Albuterol, Foradil, formoterol or salmeterol.
• Combination corticosteroids and inhaled bronchodilators
• Anticholinergic medications- Often combined with short-acting inhaled bronchodilators, anticholinergic medications are designed to help block neurotransmitters that increase and encourage mucus production.
• Oral corticosteroids - These are also known as systemic corticosteroids; your doctor may prescribe such medications to slow or control symptoms that appear to be worsening over time. However, individuals with asthma should ask their doctor about long-term or adverse side effects of oral corticosteroids. Be aware that doctors often prescribe oral corticosteroids only as a last resort to manage increasingly severe asthma symptoms.

Inhalers

Inhalers are one of the most common and effective delivery systems of medication into the airways of individuals diagnosed with asthma. They're convenient to carry, quick-acting, and provide near instant relief. Inhalers provide different medications at different dosages, and individuals should be advised to take their doses correctly.

Talk to your doctor about proper usage and function of an inhaler to ensure adequate delivery of medication. Studies have shown that the majority of individuals using inhalers use them improperly or incorrectly, thereby reducing their overall effectiveness in managing asthma symptoms.