The key to diagnosing and treating asthma properly is conducting a thorough review of the patient’s symptoms, lifestyle and current medical conditions. Additional tests, such as using a flow-volume loop can help narrow down a diagnosis.
To help my patients better understand asthma, I have created a handout, available in my office, to provide further education on this condition. Below is an excerpt taken from this handout:
Historically, we were taught that depending on the severity of asthma, treating our patients with a stepwise approach to more medications was advised. Recently, this approach has changed to what I believe is a more thoughtful and scientific approach. Currently it is recommended that a thorough patient evaluation should be done to look for triggers or concomitant factors that may make control of asthma difficult. These may include allergic factors such as allergic rhinitis or subacute bacterial infections such as mycoplasma, which may not be apparent on x-ray. Conditions such as acid reflux disease can also exacerbate your asthma symptoms. Moreover, sometimes diseases like vocal cord dysfunction, which is an upper airway problem, can mimic the symptoms of asthma. In this case, the vocal cords paradoxically close while breathing in, when normally they open. Simple tests conducted in our office such as a flow-volume loop can help differentiate between conditions.
After the problem is identified, appropriate interventions can be made which allow for more effective treatment of one’s asthma, and the use of less medications in the long run. Further medical research has also led to a change in what types of controller medications we should be using. Recent data suggests that inhaled, long-acting corticosteroids that are smaller in size may be more helpful in treating the small airways disease that is associated with asthma then some of the larger molecule inhaled steroids. Additionally, data has become more convincing for the use of a new technology looking at inhaled nitric oxide levels. This can help predict which patients are likely to respond to inhaled corticosteroids and it is another tool, besides spirometry, that allows us to monitor the effectiveness of our treatment recommendations.
If you or someone you love is experiencing symptoms that you believe are asthma-related, make an appointment with your physician or contact our office to learn more about this condition. When properly diagnosed and treated, asthma symptoms can be managed with relative ease.
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