Among the diseases of the respiratory system, bronchial asthma occupies a special place. The specific symptoms of the disease make it possible to diagnose only on the basis of clinical data, but with the help of modern examination methods it is possible to establish the exact cause of the disease. Diagnosis of asthma begins with the collection of a detailed history, after which the doctor draws up a detailed study plan, including laboratory and instrumental tests.
Indications for examination
It is quite difficult to make a correct diagnosis without observing the sequence of the examination. Asthma often occurs disguised as diseases of the respiratory and cardiovascular systems, which is why it does not cause suspicion at an early stage. In addition, the options for clinical manifestations depend on the form of the disease, age, characteristics of a person’s lifestyle, and the presence of occupational hazards. Therefore, the first stage of diagnosis is a detailed study of the patient’s medical history and the collection of data to help identify a tendency to develop pathology. Information about past illnesses and conditions helps to collect anamnesis work and life, taking medications and other facts valuable for a doctor:
- In childhood , atopic or allergic asthma is more common. As a result of prolonged and regular exposure to the allergen, the child’s body is exposed to increased stress, and the immune system forms a pathological response.
- In people with heart disease, as well as in older patients, doctors are more likely to detect the aspirin form of the disease. Prolonged exposure to acetylsalicylic acid or individual intolerance to this substance can lead to negative changes and trigger the onset of the disease.
- In adults, an infectious-dependent form of the disease is often diagnosed. As a result of chronic infections of the respiratory tract, conditions are formed for the development of bronchial obstruction .
- In pregnant women, the development of the disease can be caused by a conflict of the Rh factor in the blood or unfavorable working and living conditions. It is necessary to diagnose the disease as early as possible in order to prevent the pathology in the child.
- A set of typical symptoms, which are characterized by periods of exacerbation and remission, helps to identify bronchial asthma. The detection at the prehospital stage of signs that are specific markers gives rise to suspicion. Dry paroxysmal cough, wheezing (especially at night), heaviness in the chest, shortness of breath not caused by physical exertion, allergic reactions – these symptoms are the basis for the examination. By the method of exclusion, as well as with the help of modern laboratory and instrumental tests, doctors are able to determine the diagnosis, understand the etiology of the disease and prescribe the necessary treatment.
Indications for differential diagnosis of bronchial asthma with diseases with a similar clinical picture are:
- Genetic predisposition.
- Chronic obstructive respiratory diseases.
- Allergic reactions of the type of obstruction.
- The presence of bad habits or occupational hazards.
- Increased symptoms in recurring circumstances.
These and a number of other signs indicate the need for advanced diagnostics in order to detect asthma at an early stage.
Types of diagnostic procedures
The difficulty of establishing a diagnosis is due to the fact that bronchial asthma rarely occurs in the form of an independent pathology and is accompanied by systemic changes characteristic of diseases of the heart and respiratory organs. Laboratory tests reveal abnormalities, and instrumental examination methods confirm the presence of pathology.
The diagnostic complex of procedures for asthma includes a wide range of studies, therefore, it is often carried out in a hospital setting . To obtain accurate information, it is important to properly prepare for the examination, therefore, it is necessary to adhere to the doctor’s recommendations, take samples on time and undergo functional testing. In a hospital, the diagnosis takes 3 to 7 days, but in difficult cases, a second hospital stay may be required. The study is relevant not only in terms of the primary diagnosis at the initial stage. Asthmatics undergo control testing at least once a year in order to determine the degree of progression and the rate of development of the pathology.
Analyzing body fluids and performing specific tests to identify the allergen provide the clinician with valuable diagnostic information. List of laboratory tests, which are recommended to do with suspected asthma:
General blood analysis
- Complete blood count. A basic test to determine the level of health and the main indicators of the work of human internal organs. Allows you to find signs of acute or chronic inflammation and the degree of compensation due to the reserve capacity of the body.
- Biochemical blood test. Additional study of the leukocyte formula, in particular the percentage of eosinophils, is important for the subsequent assessment of allergy tests. It is better to take blood on an empty stomach, in order to exclude natural distortion of data as a result of physiological reactions.
- Immunological analysis. A specific test for the presence of IgE immunoglobulin in the blood, an increase in which is typical for allergic diseases.
- Sputum analysis. Along with blood biochemistry , it is a marker for allergic diseases. The physical and biochemical parameters of sputum analysis in bronchial asthma differ from the analysis results in bronchitis, therefore it is important for differentiation.
- Stool analysis. Parasitic diseases are often the cause of an allergic reaction of the body, and the determination of signs of helminthic invasion serves as the basis for constructing the next stages of diagnosis.
- Urine analysis . It is recommended to take for the purpose of differential diagnosis with inflammatory diseases of the respiratory system.
- Allergy test. Plays a key role in the diagnosis. The evaluation criteria is the presence of a reaction to the controlled administration of an allergen, which is manifested by itching, redness, shortness of breath and other typical symptoms.
The results of laboratory tests are entered into a table, which is subsequently supplemented with data from instrumental examinations.
Methods of functional diagnostics using special equipment show changes in the respiratory system caused by bronchial asthma. Direct or indirect confirmation of the diagnosis can be obtained using the following studies:
- Radiography of the lungs. The method is not considered specific, but it allows to identify changes in the pulmonary pattern characteristic of emphysema, one of the complications of asthma at a late stage.
- Spirometry. A valuable method for diagnosing bronchial asthma, based on determining the function of external respiration. The device records deviations from the norm, which are further deciphered in a complex in other data.
- Peak flowmetry. An instrumental method of testing the expiratory flow rate is necessary for establishing a diagnosis in a hospital and for monitoring the patient’s condition at home . Using a device called a peak flow meter, bronchial patency and the degree of bronchial obstruction are measured.
The diagnostic set of procedures for asthma is a clear example of how a full examination using modern equipment helps in establishing a diagnosis and for monitoring during the period of treatment.
What indicators say about asthma
Evaluation of research data allows you to establish an accurate diagnosis as soon as possible. An increase in the percentage of eosinophils in the blood, determination of specific immunoglobulin IgE, positive results of an allergy test, along with an increase in resistance during exhalation with a fixed effort to achieve the desired ventilation of the lungs – these and other signs in combination confirm the diagnosis. Further management tactics depends on many factors and is determined individually for each patient.