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Diagnosing Asthma: Lung Function Tests
Diagnosing Asthma: Lung Function Tests
If a physician suspects a patient has asthma, there are several tests commonly used to diagnose asthma:
1. Spirometry
Process: You will be asked to put clips on your nose. You will put a mouthpiece in your mouth, inhale a big, deep breath, then exhale as forcefully as possible. The mouthpiece you breath into is connected to a spirometer (a device) or a laptop. The spirometer or laptop will measure the amount of air you are able to breath in and out (the air capacity of your lungs) and the rate of flow of the air. The test may be repeated several times to get the best results.
Results: Your physician will compare your results to normal values (which are calculated based on age, height, and gender). They will interpret the results for you and suggest diagnosis and treatment plans.
Risk: During the tests, breathing fast and forcefully can make you feel tired, cough, feel dizzy, or other forms of discomfort. You should be in open communication with your physician about your heart, lung, and overall health to ensure the safest process possible.
The Spirometry test is the most common and easily accessible test for helping in the diagnosis of asthma.
2. FeNO Test / Exhaled Nitric Oxide Level Test
The Exhaled Nitric Oxide Level Test will measure the amount of nitric oxide that is exhaled from a breath. Increased levels of nitric oxide are associated with inflammation of the lungs and airways. This test is typically used to determine ways to modify your asthma treatment plan with medication.
Process: You will be asked to put clips on your nose. You will exhale completely, breathing out so your lungs are empty. Then you will put a mouthpiece in your mouth and inhale slowly to fill your lungs with air. Finally, you will exhale slowly and steadily until you hear a beep or light comes on. You may have to repeat the test a few times to confirm your results. The machine you breath into measures the level of nitric oxide in your breath.
Results: Results that indicate a higher than normal level of nitric oxide mean that there is inflammation in the lining of the airways or lungs, or you could be experiencing allergic asthma. Physicians may modify your asthma treatment plan to include inflammation fighting medication (e.g., corticosteroid therapy).
Risk: This test is quick and safe.
3. Provocation Tests
The Provocation test may be administered if other results are normal but you have been experiencing signs and symptoms of asthma. Your physician may order a tests that produces a mild reaction under controlled laboratory conditions. There are several types of provocation tests including: Irritant challenge, Exercise challenge, Methacholine challenge.
Process: Irritant Challenge: Your physician will expose you to a specific asthma trigger to see if your airways and lungs react.
Exercise Challenge: You will run on a treadmill while your oxygen and heart rate are monitored.
Methacholine Challenge: Methacholine is a type of drug that will cause your airways to tighten up at a lower does if you have asthma or at a higher dose if you do not have asthma. Your physician will have you breathe in increasing doses of Methacholine, and then perform Spirometry tests to see if your lung function changes.
Results: The test will tell you how sensitive your lungs are. A physician may use this test to confirm you have asthma or to rule out asthma if other tests did not give a clear diagnosis.
Risk: If you do not have asthma, you will not react to the low doses of provocation that those with asthma will react to.
Classifying Asthma
Classifying Asthma
Mild Intermittent = Mild symptoms up to two days a week and up to two nights a month
Mild Persistent = Symptoms more than twice a week, but no more than once in a single day
Moderate Persistent = Symptoms once a day and more than one night a week
Severe Persistent = Symptoms throughout the day on most days and frequently at night
Treatment for Asthma
Treatment for Asthma
There is currently no cure for asthma, however there are several treatments to help control the symptoms.
People with asthma can live normal, active lives.
Medication: Inhalers
An Inhaler is a medical device used for delivering medicines into the lungs through the work of a person's breathing.
Inhalers:
a. relieve symptoms when they occur (reliever inhalers)
b. stop symptoms developing (preventer inhalers)
> Reliever Inhalers: Use a reliever inhaler to treat your symptoms when they occur. They should relieve your symptoms within a few minutes.
Most people with asthma will be given a reliever inhaler. These are usually blue.
> Preventive Inhalers: Use a preventer inhaler every day to reduce the inflammation and sensitivity of your airways, which stops your symptoms occurring. It's important to use it even when you do not have symptoms.
Preventer inhalers contain steroid medicine.
> Combination Inhalers: If using reliever and preventer inhalers does not control your asthma, you may need an inhaler that combines both. Combination inhalers are used every day to help stop symptoms occurring and provide long-lasting relief if they do occur. It's important to use it regularly, even if you do not have symptoms.
Bronchial Thermoplasty
Bronchial Thermoplasty is an innovative, new, non-drug procedure developed for the treatment of severe persistent asthma. The system uses thermal energy to reduce the muscle associated with airway constriction in asthma patients.
Procedure: Bronchial thermoplasty is performed under direct visualization through the working channel of a standard flexible bronchoscope that is introduced through a patient’s nose or mouth and into their lungs. The tip of the small diameter catheter is expanded to contact the walls of targeted airways reachable by the bronchoscope. Controlled thermal energy then is delivered to the airway walls to reduce the presence of airway smooth muscle that narrows the airways in patients with asthma.
Results: Clinical studies of this treatment have demonstrated sustained improvements in asthma control up to a year following the treatment. Treated patients not only enjoyed improved asthma-related quality of life for the year following treatment but also fewer severe asthma attacks, fewer visits to the emergency room for respiratory symptoms, and fewer days lost from work/school or other daily activities due to asthma symptoms.
Recovery: There is an expected transient increase in the frequency and worsening of respiratory-related symptoms immediately following bronchial thermoplasty. These events typically occur within one day of the procedure and resolve within seven days, on average, with standard care. An overnight hospital stay may be appropriate in the event of worsening asthma symptoms after the procedure.
Asthma Action Plan
An Asthma Action Plan provides a plan with information and instructions on how to manage your asthma. This plan can also help inform schools and other caregivers how to best care for your child's asthma.
Asthma Action Plan includes:
Medications
Recognizing when Symptoms Get Worse
What to Do in An Emergency
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