Asthma is a
disease that is diagnosed by history. In
other words, one cannot make a diagnosis of asthma the very first time a child
wheezes. It's like your friend who show
up late to your home for dinner; it would be premature to label them
"tardy" after one episode, but if they come late multiple dinners in
a row, they are likely "tardy" friends. With every subsequent wheezing episode, the
more likely these are not one time events but a sign that there is underlying
asthma.
If asthma is
suspected, your child may be referred to a lung specialist for a series of
pulmonary function tests - this is typically needed in the more severe cases
while the milder cases can be handled by an experienced pediatrician. Not only will this confirm the diagnosis, it
will help define the severity of the disease.
These tests are
designed to measure lung volume and respiratory muscle function, but must be
performed correctly in order to be accurate. It's not very easy to measure lung
function in small children, which is why pediatricians rely heavily on history.
The more episodes of wheezing and shortness of breath a child experiences, the
more likely the child is asthmatic.
Another way to
diagnose asthma is to start children on asthma medications and see if they
respond. If they respond positively, meaning they experience an easing of
symptoms, they probably have asthma. If the medication does not help, the
wheezing and coughing is probably secondary to a cold virus.
The diagnosis of
asthma can be tricky, and while there are tools to help, it requires the
combination of history, tests, and serial exams to be as precise as possible.
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