not all wheezing is asthma


If you show signs of wheezing, and your asthma treatment is not working, if you are not clear what your asthma triggers are, then you should go and get a proper diagnosis. "Asthma is an umbrella term and your diagnosis might not be complete. There is no good test for asthma as there is for diabetes," noted Dr. Robin Gore, Consultant in Respiratory Medicine at the Royal Preston Hospital. To illustrate the difficulty of diagnosing asthma correctly, Dr. Gore presented four case studies at this month's British Science Festival in Birmingham.

At first sight, and without a battery of tests to hand, the patients in the case studies might have been diagnosed with asthma because they were wheezing. But they all had something else wrong with their breathing. An (incorrect) asthma diagnosis would have meant that treatment probably would not work and the patient would be left with their real problem untreated. So, for instance, if breathing in is hard there may be a problem with the vocal cords (although to complicate things, the patient might have asthma as well). People who suffer from asthma are more likely to have a problem in breathing out. Food allergies and even panic attacks may sometimes look like asthma too.

There are good tests which can pinpoint asthma but, unfortunately, these are not widely available at the moment. One of these is the histamine challenge test, another goes by the name of respiratory inductance plethysmography and it looks at the interaction between chest movements and breathing patterns. The take-home message of Dr. Gore's talk is that not all wheezing is asthma, but a proper diagnosis is both complex and time-consuming. While some people may be wrongly diagnosed with asthma, when they have something else, equally a diagnosis of asthma may be missed, so the patient goes untreated. "We really need more research into a good bedside test," Dr. Gore said. We totally agree.