Asthma: Diagnosis and Treatment

Diagnosis

• The evaluation begins with a medical history and a physical examination.
• Lung function tests are used to diagnose asthma. Individuals are asked to blow forcefully into a tube and the force of exhalation is measured by a computer. During flare–ups or in patients who have had asthma for many years, the tests may show decreased force of breathing, obstruction to airflow, and decreased lung space.
• Blood testing is sometimes recommended, particularly in severe cases that require hospitalization.
• Skin testing may be used to identify allergens that may cause flare–ups.

Treatment

With optimal asthma management, individuals should have no symptoms or exercise limitation, no flare–ups or need for oral steroids, no need for albuterol inhalers, and, overall, minimal medications and side effects.

• Smoking cessation and avoidance of heavily polluted areas are beneficial.
• Commonly used medications include steroids, albuterol, salmeterol, leukotriene antagonists (e.g., montelukast), and theophylline. In addition, omalizumab is a new medication that may be useful for individuals with advanced asthma. In general, inhaled steroids are the most important medication, with additional use of albuterol during flare–ups.