Take allergies, for example. People who are allergic to mold could develop a cough or wheeze if they’re exposed to the fungus, and those with insect allergies can experience chest tightness and difficulty breathing if they’re stung by a bee or wasp. One way to distinguish between allergy and asthma symptoms: Allergies occur in the upper-respiratory system and go hand-in-hand with nasal congestion, sinus pain, and nasal drip, which can cause airway irritation and coughing, says Thomas Asciuto, MD, the medical director of pulmonary services at Orange Coast Memorial Medical Center in Fountain Valley, California. Asthma, on the other hand, affects the airways that carry air to and from your lungs. Complicating matters, some people experience asthma attacks if they’re exposed to certain allergens, especially cockroaches, mold, and dust mites. And while asthma is by far the most common cause of a chronic, persistent cough, other culprits can include postnasal drip, sleep apnea, gastric reflux, and COPD, says Dr. Asciuto. RELATED: The Basics of Post-Nasal Drip RELATED: Could Your Sore Throat Be Caused By ‘Silent Reflux’?
The Basics of Diagnosing Asthma
Your doctor will probably start your examination by delving into your past medical history and asking whether any of your relatives have allergies or asthma. You’ll also be asked to describe your symptoms, their severity, and what, if anything, is triggering them. “Triggers could include cold air, dust, hairsprays, perfumes, household cleaner vapors, cigarette or cigar smoke, and air pollution,” Asciuto says. Doctors also try to narrow down the list of culprits by asking these additional questions:
Is your cough worse at night?Do you have more symptoms when you’re at home or at work?Do you have other health problems that could be causing these symptoms, such as a sinus infection or acid reflux?
Next, your doctor will listen to your breathing with a stethoscope and may order one or more of these diagnostic tests:
Spirometry, a breathing test that shows how well your lungs are functioning by measuring how much air you can breathe in and out. Spirometry also measures how fast you can exhale. You’ll be asked to repeat the test after using a bronchodilator, an inhaled medication that opens airways, to see whether it improves your breathing. If it does, you most likely have asthma, says Stanley Fineman, MD, who practices with the Atlanta Allergy and Asthma Clinic and is a past president of the American College of Allergy, Asthma and Immunology.Allergy testing, which can determine if any allergens are negatively affecting your breathing. This is often done by means of a skin test, in which the suspected allergens are diluted and applied to your skin through a prick or puncture or with a very thin needle. The allergist then observes your skin for about 15 minutes to see whether you develop an allergic response.Chest X-ray, which creates a picture of your lungs and ribs to determine whether your airways are blocked. An X-ray is often used to rule out other causes of asthma-like symptoms, such as pneumonia, heart failure, lung cancer, and tuberculosis.IgE blood test, which detects your levels of immunoglobulin E. IgE is an antibody that fights foreign invaders; if your levels are elevated, you may have allergic asthma.
It’s also important to note that you can have asthma without experiencing any of the hallmark symptoms. There’s no single patient profile for asthma, says Dr. Fineman. “Some will have more coughing, some more wheezing, and some have more problems breathing with exercise,” he says.
When to See a Specialist About Your Asthma
Asthma is not always easy to diagnose, Fineman says, but you should see your doctor if you’re having repeated episodes of wheezing and coughing or shortness of breath. If you’re diagnosed with the condition, work with your doctor to develop an asthma management and action plan. Although your primary care doctor may be able to diagnose and treat your asthma, if your symptoms don’t respond to a first-line therapy of inhaled corticosteroids and short-acting bronchodilators, Asciuto recommends that you see a lung specialist or allergy and asthma specialist.
