Asthma Diagnosis Asthma Guide Asthma Guide Symptoms Causes Diagnosis Treatment Coping How Asthma Is Diagnosed By Pat Bass, MD twitter linkedin Dr. Bass is a board-certified internist, pediatrician, and a Fellow of the American Academy of Pediatrics and the American College of Physicians. Learn about our editorial process Pat Bass, MD Medically reviewed by Medically reviewed by Daniel More, MD on October 31, 2019 Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California. Learn about our Medical Review Board Daniel More, MD Updated on February 18, 2021 Print Table of Contents View All Table of Contents Self Checks/At-Home Testing Intake and Physical Exam Labs and Tests Imaging Differential Diagnoses Next in Asthma Guide An Overview of Asthma Treatment Asthma is diagnosed based on a combination of symptoms, physical exam, and various tests, including pulmonary function tests to evaluate breathing. Because the tell-tale symptoms of asthma, such as wheezing and shortness of breath, are common in other respiratory conditions, differential diagnosis also may be necessary to rule out causes other than asthma. Signs and Symptoms of Asthma FatCamera / Getty Images Self Checks/At-Home Testing Asthma is not a disease that can be self-diagnosed, but becoming familiar with the most common symptoms can alert you to the possibility you (or your child or other person in your household) might have asthma, in particular: Wheezing: A high-pitched noise produced when you exhaleShortness of breath (dyspnea): The feeling that you can't catch your breathChest tightness that accompanies dyspneaCough: Dry, unproductive, and most common at night If you develop these symptoms and they become frequent and persistent, make an appointment to see your doctor or a pulmonologist (a physician who specializes in respiratory diseases). Before you see your doctor, begin keeping a written record of your symptoms Jot down the nature of the symptom, when and where it occurs, and what you're doing at the time. Note, for example, if you experience symptoms when you dust, are around animals or smokers, or when there are changes in the weather (cold dry air is a common asthma trigger). This will reveal a pattern of asthma flare-ups that will help pin down your diagnosis and reveal what your asthma triggers may be. What to Expect From a Spirometry Test Physical Examination To diagnose asthma, your doctor will start by asking about your medical history and ongoing health issues. Asthma is especially common in people who have atopic conditions such as hay fever (allergic rhinitis) or atopic dermatitis. Your family health history will be important as well, as asthma tends to run in families. They'll next want as many details about your symptoms as you can provide. This is when keeping a record of your symptoms can be invaluable. Also share with the doctor any changes you've made in your daily life that might have been prompted by asthma symptoms: Are you having groceries delivered because you feel winded when carrying packages or even walking around a store? Has your child had to sit out in gym class more often than not because of breathing difficulties? The next step in diagnosing asthma will likely be a physical exam that focuses on your breathing. The doctor will listen carefully for wheezing, which isn't present all the time in people with asthma but if it happens to occur during your appointment it will provide a strong clue as to your diagnosis. The doctor will also check inside your nose for inflammation—swelling of the nasal cavities that can indicate allergic rhinitis. Allergic Asthma: A Common Type of Asthma Labs and Tests If your doctor feels certain you have asthma, they may run certain tests to get more information about the type and severity of your condition. Pulmonary Function Tests These are quick, noninvasive tests that reveal how well your lungs are functioning: Peak expiratory flow rate (PEFR): PEFR is a measurement of how powerfully you can exhale. This is gauged with a simple hand-held device called a peak flow meter. A normal PEFR is 80% or greater than what would be predicted for the person being tested. Spirometry: A test that measures how much air you breathe in and out and how quickly. You'll likely do at-home spirometry testing as part of your asthma care plan. Bronchodilation and Bronchoprovocation Tests These tests gauge how well the lungs respond to either a quick-relief asthma medication or an intentional disturbance to normal airflow. They usually are done if spirometry is normal in spite of asthma symptoms. Bronchodilator responsiveness testing: A bronchodilator is a fast-acting medication that provides quick relief of asthma symptoms. This test involves administering a bronchodilater and, 10 to 15 minutes later, repeating an initial spirometry test and comparing the results. If the medication brings about an increase in airflow of 12%, it is an indication that asthma is the cause of symptoms.Bronchoprovocation challenge testing: This test involves inhaling either aerosolized chemicals or cold air, or performing exercises, to see if it induces asthma symptoms. By measuring lung function after exposure to these triggers, a doctor may be able to diagnose asthma. Fractional Exhales Nitric Oxide (FeNO) Test If after routine testing, including spirometry and bronchodilator responsiveness, an asthma diagnosis isn't certain, a FeNO test may be performed, according to National Institutes of Health recommendations for asthma management,This test determines the presence of inflammation in the lungs and is performed using a portable device that measures the level of nitric oxide in parts per billion (PPB) in exhaled air. Requirements for Asthma Diagnosis An asthma diagnosis requires:Presence of symptoms compatible with asthma such as cough, wheezing, or shortness of breath.Objective measurement of decreased airflow in your lungs that either partially or completely improves spontaneously or with treatment. Imaging Most people with asthma have normal chest X-rays, but some doctors order them for patients who are experiencing wheezing for the first time. This is because if asthma has gone undiagnosed for a long time, a chest X-ray may reveal hyperexpansion (overinflated lungs). Differential Diagnoses Because wheezing can be symptomatic of diseases other than asthma, your doctor may need to rule them out in order to definitively diagnose asthma: Gastroesophageal reflux disease (GERD): GERD may lead to wheezing and cough; it's also commonly responsible for nighttime symptoms. Patients commonly experience a painful burning sensation as well as a sour or bitter taste in the back of the mouth.Congestive heart failure: This is condition where the heart's pump is failing and unable to provide adequate blood supply. In addition to asthma-like symptoms, there may be swelling in both legs and difficulty breathing while lying down.Chronic obstructive pulmonary disease (COPD): A significant difference between COPD and asthma is that COPD often is characterized by a morning cough, while asthma symptoms can occur at any time and often only after exposure to triggers. Pulmonary embolism (PE): A PE sometimes leads to wheezing, but The sudden onset of shortness of breath and chest pain are the most common symptom of PE but the condition sometimes causes wheezing that could initially be mistaken for asthma.Cystic fibrosis (CF): CF patients will wheeze, as well as experience shortness of breath and cough. However, this chronic illness is also associated with poor growth and a number of other problems in early childhood. A Word From Verywell Because asthma is a progressive disease—one that can worsen without treatment—it's imperative to see a doctor as soon as symptoms arise. An early diagnosis is key to effective treatment and preventing the disease from interfering with your quality of life. How Asthma Is Treated Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Horak F, Doberer D, Eber E, et al. Diagnosis and management of asthma - Statement on the 2015 GINA Guidelines. Wien Klin Wochenschr. 2016;128(15-16):541–554. doi:10.1007/s00508-016-1019-4 Nasreen S, Nessa A, Islam F, et al. Changes of peak expiratory flow rate in adult asthmatic patient. Mymensingh Med J. 2018;27(2):245-250. Cloutier MM, Baptist AP, Blake KV, et al. 2020 focused updates to the asthma management guidelines: A report from the national asthma education and prevention program coordinating committee expert panel working group. Journal of Allergy and Clinical Immunology. 2020;146(6):1217-1270. doi:10.1016/j.jaci.2020.10.003 American Academy of Allergy Asthma & Immunology. What Is aFeNO Test? Sept 28 2020. Eid NS, Shepherd RW, Thomson MA. Persistent wheezing and gastroesophageal reflux in infants. Pediatr Pulmonol. 1994;18(1):39-44. doi:10.1002/ppul.1950180110 Ren CL, Konstan MW, Rosenfeld M, et al. Early childhood wheezing is associated with lower lung function in cystic fibrosis. Pediatr Pulmonol. 2014;49(8):745–750. doi:10.1002/ppul.22894 Additional Reading Asthma. Centers For Disease Control and Prevention. Asthma. In Chest Medicine: Essentials Of Pulmonary And Critical Care Medicine. Editors: Ronald B. George, Richard W. Light, Richard A. Matthay, Michael A. Matthay. May 2005. National Heart, Lung, and Blood Institute. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma.