What Are the Lungs?
Your lungs are organs in your chest that allow your body to take in oxygen from the air. They also help remove carbon dioxide (a waste gas/toxic) from your body.
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What Are the Signs and Symptoms of Asthma?
Common asthma symptoms include:
- Coughing from asthma is often worse at night or early in the morning, making it hard to sleep.
- Wheezing. Wheezing is a whistling or squeaky sound that occurs when you breathe.
- Chest tightness. This may feel like something is squeezing or sitting on your chest.
- Shortness of breath. Some people who have asthma say they can't catch their breath or they feel out of breath. You may feel like you can't get air out of your lungs.
Not all people who have asthma have these symptoms. Likewise, having these symptoms doesn't always mean that you have asthma. A lung function test, done along with a medical history (including type and frequency of your symptoms) and physical exam, is the best way to diagnose asthma for certain.
The types of asthma symptoms you have, how often they occur, and how severe they are may vary over time. Sometimes your symptoms may just annoy you. Other times they may be troublesome enough to limit your daily routine.
Severe symptoms can threaten your life. It's vital to treat symptoms when you first notice them so they don't become severe.
With proper treatment, most people who have asthma can expect to have few, if any, symptoms either during the day or at night.
What Causes Asthma Symptoms To Occur?
A number of things can bring about or worsen asthma symptoms. Your doctor will help you find out which things (sometimes called triggers) may cause your asthma to flare up if you come in contact with them. Triggers may include:
- Allergens found in dust, animal fur, cockroaches, mold, and pollens from trees, grasses, and flowers
- Irritants such as cigarette smoke, air pollution, chemicals or dust in the workplace, compounds in home décor products, and sprays (such as hairspray)
- Certain medicines such as aspirin or other nonsteroidal anti-inflammatory drugs and nonselective beta-blockers
- Sulfites in foods and drinks
- Viral upper respiratory infections such as colds
- Exercise (physical activity)
Other health conditions - such as runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea - can make asthma more difficult to manage. These conditions need treatment as part of an overall asthma care plan.
Asthma is different for each person. Some of the factors listed may not affect you. Other factors that do affect you may not be on the list. Talk to your doctor about the things that seem to make your asthma worse.
How Is Asthma Diagnosed?
Your primary care doctor will diagnose asthma based on your medical history, a physical exam, and results from tests. He or she also will figure out what your level of asthma severity is - that is, whether it's intermittent, mild, moderate, or severe. Your severity level will determine what treatment you will start on.
You may need to see an asthma specialist if:
- - You need special tests to be sure you have asthma
- - You've had a life-threatening asthma attack
- - You need more than one kind of medicine or higher doses of medicine to control your asthma
- - You have overall difficulty getting your asthma well controlled
- - You're thinking about getting allergy treatments
Medical History
Your doctor may ask about your family history of asthma and allergies. He or she also may ask whether you have asthma symptoms, and when and how often they occur. Let your doctor know if your symptoms seem to happen only during certain times of the year or in certain places, or if they get worse at night.
Your doctor also may want to know what factors seem to set off your symptoms or worsen them.
Your doctor may ask you about related health conditions that can interfere with asthma management. These conditions include a runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea.
Physical Exam
Your doctor will listen to your breathing and look for signs of asthma or allergies. These signs include wheezing, a runny nose or swollen nasal passages, and allergic skin conditions such as eczema.
Keep in mind that you can still have asthma even if you don't have these signs on the day that your doctor examines you.
Lung Function Test
Your doctor will use a test called spirometry to check how your lungs are working. This test measures how much air you can breathe in and out. It also measures how fast you can blow air out. Your doctor also may give you medicines and then test you again to see whether the results have improved.
If the starting results are lower than normal and improve with the medicine, and if your medical history shows a pattern of asthma symptoms, your diagnosis will likely be asthma.
Other Tests
Your doctor may order other tests if he or she needs more information to make a diagnosis. Other tests may include:
- - Allergy testing to find out which allergens affect you, if any.
- - A test to measure how sensitive your airways are. This is called a bronchoprovocation test. Using spirometry, this test repeatedly measures your lung function during physical activity or after you receive increasing doses of cold air or a special chemical to breathe in.
- - A test to show whether you have another disease with the same symptoms as asthma, such as reflux disease, vocal cord dysfunction, or sleep apnea.
- - A chest x ray or an EKG (electrocardiogram). These tests will help find out whether a foreign object or other disease may be causing your symptoms.
Diagnosing Asthma in Young Children
Most children who have asthma develop their first symptoms before 5 years of age. However, asthma in young children (aged 0 to 5 years) can be hard to diagnose. Sometimes it can be difficult to tell whether a child has asthma or another childhood condition because the symptoms of both conditions can be similar.
Also, many young children who have wheezing episodes when they get colds or respiratory infections don't go on to have asthma after they're 6 years old. These symptoms may be due to the fact that infants have smaller airways that can narrow even further when they get a cold or respiratory infection. The airways grow as a child grows older, so wheezing no longer occurs when the child gets a cold.
A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if:
- - One or both parents have asthma
- - The child has signs of allergies, including the allergic skin condition eczema
- - The child has allergic reactions to pollens or other airborne allergens
- - The child wheezes even when he or she doesn't have a cold or other infection
A lung function test along with a medical history and physical exam is the most certain way to diagnose asthma. However, this test is hard to do in children younger than 5 years. Thus, doctors must rely on children's medical histories, signs and symptoms, and physical exams to make a diagnosis. Doctors also may use a 4 to 6 week trial of asthma medicines to see how well a child responds.
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