Diagnosing Asthma

By editor | July 9, 2007

Finding out if your child has asthma isn’t always easy. There’s no one simple medical test for asthma, so the diagnosis depends on a child’s overall pattern of symptoms. For that reason, it’s important for parents to notice a variety of signs and symptoms that combine to form a pattern. If you suspect asthma, make an appointment with your child’s doctor, take notes about the symptom patterns you’ve observed, and share them with the doctor.

Is It Really Asthma?

Asthma is a common reason for wheezing and other breathing problems in children, but it’s not the only one. Many common childhood illnesses can make a child cough, wheeze, and have trouble breathing. To complicate matters, colds and other upper respiratory illnesses are asthma triggers.

One or two episodes of wheezing in combination with a respiratory infection are common among young children, but this doesn’t always mean asthma. With younger children especially, a doctor might decide that the wheezing and coughing are just from a bad cold or perhaps from a virus that causes bronchitis (inflammation of medium-size airways) or bronchiolitis (inflammation of the smaller airways). One such virus is called respiratory syncytial virus (RSV), but other viruses can cause wheezing as well. About half of all infants and toddlers who wheeze when they get colds will outgrow it.

Doctors tend to under diagnose asthma in young children for two reasons: (1) many youngsters do outgrow wheezing from colds; and (2) some children have severe asthma symptoms while they have a cold but don’t show any symptoms when they’re well. Under-diagnosis is a problem because early detection of asthma is important. The sooner asthma is diagnosed, the sooner treatment can begin. Treatment not only makes a child feel better, but it may also help keep the asthma from becoming more severe or even causing permanent lung damage.

Wheezing with a cold is a sign that a child might have asthma. Don’t ignore the warning. If your child has mild wheezing once or twice with a cold but recovers quickly and stops coughing and wheezing as soon as he starts to feel better, the symptoms probably were caused by the cold. It’s not unusual for a child to have frequent colds one a month or even more often is normal. A cold generally lasts for just a few days, and a child returns to normal quickly when it’s over. Recurrent wheezing with colds, however, is not normal and may mean a child has asthma.

Consider these patterns:

Similarly, if your child is diagnosed with a respiratory infection, such as bronchitis or bronchiolitis, more than once or twice in a year, asthma could be the culprit. Repeated bouts of coughing and wheezing, with or without an upper respiratory infection, are almost always due to asthma.

There’s a saying in medicine, however, that “all that wheezes is not asthma.”Sometimes a child’s health problem is diagnosed as asthma when it really isn’t. A foreign object a coin, a small piece of carrot or peanut-stuck in the child’s lower airways can cause coughing or wheezing. A number of other diseases, such as cystic fibrosis, heart disease, and certain immune deficiencies can also seem like asthma. If that’s the case, the symptoms won’t get better when the child is treated for asthma, and it will soon be clear that asthma isn’t the underlying problem.

Other medical conditions sometimes can make asthma worse. One example is gastroesophageal reflux disease (GERD), in which stomach acid regurgitates back up the esophagus (the tube between the mouth and stomach) and may spill over into the airways. That irritates the air-ways and causes inflammation and bronchospasm.


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