Diagnosing Asthma: When to Diagnose, Tests, and Procedures

Understanding if you have Asthma

Common Symptoms of Asthma

Asthma symptoms often appear differently depending on age and severity. Common signs include:

• Wheezing: A whistling or squeaky sound when breathing, especially during exhalation (breathing out).

• Shortness of breath: Feeling breathless during physical activity or even at rest in severe cases.

• Coughing: Persistent or recurrent cough, often worse at night or early morning.

• Chest tightness: A feeling of pressure or discomfort in the chest.
  
  

People with asthma may also have a history of eczema or hayfever, as these allergic conditions are often linked. Children may show more frequent coughing or difficulty during play, while adults might notice shortness of breath during exercise or at night. Recognising these patterns early helps prompt medical evaluation.

Importance of Early Diagnosis

Early asthma diagnosis is crucial for effective management. Identifying the condition promptly allows healthcare professionals to prescribe the right treatment, reduce flare-ups, and prevent worsening of symptoms. Early intervention helps people stay active, improves quality of life, and lowers the risk of serious asthma attacks.

Diagnosis & Tests for Asthma

Medical History and Physical Exam

The first step in diagnosing asthma is a detailed medical history and physical examination.

Your doctor will ask about:

• The frequency and pattern of symptoms such as wheezing, coughing, and breathlessness

• Triggers, including allergens, exercise, or infections

• Personal or family history of asthma, eczema, or hayfever

• Past hospitalisations or medications for breathing problems
  
  

During the physical exam, the doctor will listen to your lungs with a stethoscope to detect wheezing or other abnormal sounds. They may also check your nose, throat, and skin for allergic signs. This initial assessment helps determine which tests are most appropriate to confirm the diagnosis.

Spirometry

This is a key test that measures how much air you can breathe in and out and how quickly you can exhale. During the test, you will breathe into a tube connected to a machine called a spirometer. You may be asked to take a deep breath and blow out as forcefully and quickly as possible.

The results provide important information about your lung function. Reduced airflow may indicate asthma or other lung conditions.

This test is also repeated after using an inhaler (bronchodilator) which opens the lungs. Improvement in airflow on the test after bronchodilator use confirms airway reversibility, a hallmark of asthma. Spirometry can also help monitor asthma control over time, allowing your doctor to adjust treatment plans based on how well your lungs are functioning.

Allergy Testing

This can help identify triggers that worsen symptoms. Common tests include:

• Skin prick tests: Small amounts of allergens are applied to your skin to observe reactions.
  
  

• Blood tests: Measures specific antibodies to detect allergic responses.
  
  

Identifying allergens such as dust mites, pollen, or pet dander allows your doctor to recommend avoidance strategies or medications, helping to reduce asthma flare-ups. Allergy testing is especially useful for people with eczema, hayfever, or frequent respiratory symptoms.

Treatment Trial

A trial of asthma medication may be used when symptoms suggest asthma but test results are inconclusive. Your doctor may prescribe a short course of asthma medications, such as inhaled corticosteroids or bronchodilators, to see if symptoms improve.

During the trial, you may keep a diary of coughing, wheezing, or breathlessness. Improvement after using the medication confirms the diagnosis and helps your doctor determine the most effective treatment plan.

Other diagnostic tests for asthma may include:

• Peak flow monitoring: Measures how fast you can blow air out of your lungs.
  
  

• Bronchoprovocation challenge (e.g., mannitol, saline, metacholine): Tests airway hyper-responsiveness if spirometry results are not diagnostic but asthma is still suspected.
  
  

• Exhaled nitric oxide test: Assesses airway inflammation.

Diagnosis in Different Age Groups

Diagnosing Asthma in Children (5 Years Old and Younger)

Diagnosing asthma in young children can be challenging because standard lung tests, like spirometry, are often difficult for them to perform. Symptoms may appear as frequent coughing, wheezing, or shortness of breath. Symptoms are sometimes mistaken for repeated colds or viral infections.

To aid diagnosis, doctors may:

• Review video recordings of breathing difficulties at home

• Observe response to a treatment trial with asthma medications

• Consider family history of asthma or allergies

Early detection in children helps manage symptoms, reduce flare-ups, and support healthy growth and development.

Diagnosing Asthma in Adults

Asthma diagnosis in adults typically involves more definitive lung function tests, such as spirometry or peak flow monitoring. Adults may have longer-term symptoms, or triggers may differ, such as occupational exposures or smoking history. Unlike children, adults can usually perform standard tests reliably, which helps confirm airway obstruction and response to asthma medication. Age-specific considerations include ruling out other lung conditions, such as chronic obstructive pulmonary disease (COPD), which can have similar symptoms.

How to get a diagnosis

If you notice asthma-like symptoms, the first step is to schedule an appointment with your GP. The doctor will assess your medical history, review symptoms, and may perform lung function or allergy tests. Early evaluation is key to managing asthma effectively and preventing serious flare-ups.

Preparing for the Appointment

Preparation can make your asthma assessment more accurate and efficient. Consider these tips:

• Keep a symptom diary: Record coughing, wheezing, chest tightness, or shortness of breath. Note the time of day, triggers, and severity.

• List past medical history: Include childhood illnesses, allergies, eczema, or hayfever.

• Bring medications: Include inhalers, supplements, or prescriptions.

• Prepare questions: Ask about tests, treatment options, and lifestyle management.

• Record breathing episodes: Videos can help your doctor see patterns not obvious in the clinic.
  
  

Being well-prepared helps your doctor make a faster and more accurate diagnosis.

Questions your doctor may ask you

During the appointment, your doctor may ask:

• When did your symptoms start, and how often do they occur?

• What triggers your symptoms (exercise, pollen, dust, stress)?

• Do you have a history of allergies, eczema, or hayfever?

• Have you had previous asthma or respiratory treatments?

• Do symptoms worsen at night or in certain environments?

• Is there a family history of asthma or other lung conditions?

After the Diagnosis

Understanding the Severity of Your Asthma

Asthma severity is classified based on the frequency and intensity of symptoms and lung function tests. The main categories are:

• Intermittent: Symptoms occur less than twice a week, with normal lung function between episodes.

• Mild persistent: Symptoms happen more than twice a week but not daily; mild limitation in activity may occur.

• Moderate persistent: Daily symptoms, with some interference in daily life; lung function may be slightly reduced.

• Severe persistent: Symptoms are continuous, greatly limiting daily activities; lung function is significantly affected.

Understanding your asthma severity helps doctors tailor your asthma action plan, including the type and dosage of medications, lifestyle recommendations, and monitoring strategies. It ensures that treatment is appropriate for your individual needs and helps prevent serious flare-ups.

Creating an Asthma Action Plan

An asthma action plan is a personalised guide that helps you manage your asthma day-to-day and during flare-ups. It typically includes:

• Daily treatment: Preventer medications such as inhaled corticosteroids, and relievers for quick relief.

• Symptom monitoring: How to recognise early warning signs of worsening asthma.

• Action steps: Instructions on what to do if symptoms worsen or if an asthma attack occurs.

• Emergency contacts: When to seek urgent medical help.

Having a clear action plan improves control over asthma, reduces hospital visits, and gives you confidence in managing your condition effectively.

Regular Follow-ups and Monitoring

Ongoing monitoring to ensure treatment remains effective and symptoms are controlled. Routine check-ups with your doctor allow for:

• Review of symptom patterns and inhaler technique

• Adjustment of medications as needed based on severity or lifestyle changes

• Early detection of worsening asthma or complications
  
  

Regular monitoring helps prevent flare-ups, supports long-term lung health, and ensures your asthma action plan stays up to date. Even when symptoms feel under control, follow-ups are essential for effective asthma management.

Speak to a doctor today

If you suspect you may have asthma, it’s important to schedule an appointment with a GP. Myhealth’s GPs, available across NSW, QLD, and VIC, can help with:

• Assessing your symptoms and medical history

• Conducting lung function tests and allergy checks

• Developing a personalised asthma action plan
  
  

Early diagnosis and proper management can improve your quality of life and help prevent serious asthma attacks. Don’t wait! Speak to a Myhealth GP today to take control of your respiratory health.