asthma specialist tests overview

Overview

Asthma is a long-term condition that affects the airways (the tubes that carry air in and out of your lungs). In asthma, these airways become narrow, swollen, and produce extra mucus, making it hard to breathe.

Yes, asthma is very common. It affects millions of people worldwide, including both children and adults.

Asthma can affect anyone, but it often runs in families. It is more common in children and in people who have allergies or a family history of asthma.

Symptoms

Common symptoms

• Wheezing (a whistling sound when you breathe)
• Coughing, especially at night or early morning
• Shortness of breath
• Chest tightness or pain

Symptoms in children

• Frequent coughing, especially during play or exercise
• Tiredness or lack of energy
• Fast breathing or chest retractions (skin pulling in between ribs)
• Trouble eating or feeding due to breathlessness

Symptoms in older adults

• Shortness of breath with everyday activities
• Fatigue or feeling worn out
• Difficulty sleeping due to coughing or wheezing
• Chest tightness that may be mistaken for heart problems

Causes

Main causes

• The exact cause of asthma is not fully understood, but it involves a mix of genetic and environmental factors.
• In people with asthma, the airways are extra sensitive and react to triggers by narrowing and swelling.

Risk factors

• Having a family history of asthma, allergies, or eczema
• Having allergies (like hay fever or dust mite allergy)
• Exposure to tobacco smoke as a child or during pregnancy
• Living in a polluted area or being exposed to certain chemicals at work
• Being born prematurely or having a low birth weight

When to see a doctor

See a doctor urgently if:

• If you have severe breathing trouble, call your local emergency number right away.
• If you have had an asthma attack that did not respond to your reliever medicine.
• If you are coughing up blood or have a high fever with breathing problems.

Book a routine appointment if:

• If you have new or worsening cough, wheeze, or shortness of breath.
• If you need to use your reliever inhaler more than twice a week.
• If your asthma is interfering with sleep, work, school, or exercise.

Diagnosis

Asthma is diagnosed based on your symptoms, medical history, and a series of breathing tests. A specialist (often a respiratory doctor) will use these tests to confirm whether you have asthma and how well your lungs are working.

Tests that may be done

• Spirometry – you blow into a machine that measures how fast and how much air you can exhale. This is the main test for asthma.
• Peak flow measurement – you blow into a handheld device that measures how fast you can blow air out. You may be asked to do this at home for a few weeks to track changes.
• FeNO test – you breathe into a machine that measures the level of nitric oxide in your breath. High levels can mean airway inflammation (swelling) that is common in asthma.
• Challenge test – you inhale a substance (like methacholine) or exercise to see if your airways react. This is only used when the diagnosis is not clear.
• Allergy tests – skin prick or blood tests to check for allergies that may trigger asthma symptoms.
• Chest X-ray or CT scan – to rule out other conditions that could cause similar symptoms.

What to expect at your appointment

The tests are painless and usually take 30 to 60 minutes. Your specialist will explain each step. You may be asked not to use your inhaler for a few hours before some tests. After the tests, the doctor will discuss the results and work with you to create a treatment plan.

Treatment

Asthma treatment focuses on controlling symptoms, preventing attacks, and helping you live an active life. Treatment is tailored to each person, using a step‑by‑step approach.

Self-care at home

• Identify and avoid your personal asthma triggers (e.g., dust, pollen, smoke).
• Use your inhalers exactly as prescribed – even when you feel well.
• Keep a written asthma action plan with instructions for daily management and what to do in an emergency.
• Monitor your symptoms and peak flow regularly to catch problems early.

Medical treatments

The main treatments are inhalers. There are two main types: preventer inhalers (taken daily to reduce airway inflammation) and reliever inhalers (used as needed to quickly open the airways during an attack). Some people need a combination inhaler. Your doctor may also prescribe tablets if inhalers are not enough. For severe asthma, there are biologic medicines given by injection. Treatment is stepped up or down based on your control.

When is surgery considered?

Surgery is not a standard treatment for asthma. In very rare cases, a procedure called bronchial thermoplasty may be considered for severe asthma that does not respond to other treatments. This involves using heat to reduce the thickness of the airway muscles.

Living with this condition

With good management, most people with asthma live full lives. You can work, exercise, travel, and do everything you enjoy. The key is to stay on top of your medicine, avoid triggers, and follow your action plan.

Lifestyle tips

• Keep your home clean and dust‑free.
• Avoid smoking and secondhand smoke.
• Use allergen‑proof covers on pillows and mattresses.
• Get a yearly flu vaccine.
• Stay active, but warm up before exercise and use your reliever inhaler if needed.

Diet and exercise

A healthy, balanced diet supports overall health, but there is no special 'asthma diet'. Exercise is safe and encouraged – many Olympians have asthma. Just be careful to manage exercise‑induced symptoms with your action plan.

Mental health and emotional wellbeing

Living with a chronic condition can sometimes cause stress, anxiety, or low mood. It is normal to feel worried. Talk to your doctor if asthma affects your mental health. Support groups and talking therapies can help.

Prevention

It is not possible to prevent asthma, but you can reduce the risk of attacks by controlling triggers and using preventer medicine as prescribed. In children, avoiding exposure to tobacco smoke during pregnancy and after birth may lower the risk of developing asthma.

Vaccines

Yes, it is recommended that people with asthma get the annual flu vaccine and the COVID‑19 vaccine. These help prevent respiratory infections that can trigger severe asthma attacks.

Screening programmes

There is no routine screening for asthma. If you have symptoms, see your doctor for evaluation. Children with a close family history of asthma or allergies may be monitored for early signs.

Complications

If left untreated

• Frequent asthma attacks that require emergency care or hospital stays
• Permanent narrowing of the airways (airway remodeling) that reduces lung function over time
• Missed school or work days due to illness
• Sleep problems and daytime fatigue
• In severe cases, life‑threatening asthma attacks

Long-term outlook

With proper treatment and self‑management, most people with asthma can keep symptoms under control and live a full, active life. The outlook is very good when you work closely with your healthcare team and follow your action plan. Even severe asthma can be managed effectively with modern medicines.

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