Spirometry for asthma
When you need it and whyDownload PDF
If you have symptoms that could be asthma, your doctor should perform a simple breathing test to confirm whether you have that disease or another health problem. Otherwise, you could be treated with asthma drugs when you don’t have the disease, or go untreated for asthma when you do. But many people who need the test don’t receive it. Here’s why that’s a bad idea.
The test helps diagnose and manage asthma.
Some doctors rely only on symptoms such as wheezing, shortness of breath, and coughing to decide whether a patient has asthma. But those symptoms can also stem from the common cold, bronchitis, pneumonia, heart disease, or other common conditions. On the other hand, you and your doctor might dismiss those symptoms, assuming they reflect a mild problem when in fact they indicate asthma. That’s why you should have spirometry—a test that measures air flow in and out of your lungs—if you have symptoms that could be asthma. The test can help confirm if asthma is the cause and if it is, help determine your treatment, and see how well that treatment is working. If your asthma is well controlled, your doctor may cut back your medication so you don’t use more than you need. If it is poorly controlled, you might need to step up your medication to prevent an asthma attack.
Skipping the test can pose risks.
If your doctor assumes you have asthma when you don’t, you could be prescribed unneeded asthma drugs while the real problem is over-looked. On the other hand, untreated or poorly controlled asthma can lead to severe asthma attacks. About nine people die from such an attack every day in the U.S. Untreated or poorly managed asthma may even lead to a condition in which the lungs become scarred and asthma medicines don’t work as well.
The test can prevent needless expense.
Spirometry costs about $42, according to HealthcareBlueBook.com. But unnecessary use of an inhaled corticosteroid can cost $200 to $300 a month. An emergency room visit for an asthma attack can total $3,500. All told, the disease costs the U.S. more than $56 billion a year.
When should you have it?
People five or older who have symptoms that could be asthma should undergo spirometry along with a physical exam and detailed medical history. To confirm the diagnosis, your doctor should give you asthma medicine and then retest you to see if your results improve. In many cases, spirometry should be repeated four to six weeks after you start treatment, when symptoms worsen, and at least every one to two years.
Using This Information
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Published by Consumer Reports © 2012 Consumers Union of U.S., Inc., 101 Truman Ave., Yonkers, NY 10703-1057. Developed in cooperation with AAAAI for Choosing Wisely, a project of the ABIM Foundation. Portions of this report are derived from AAAAI's “Five Things Physicians and Patients Should Question” list. © 2012 AAAAI. All Rights Reserved.
Consumer Reports' Advice
How should you manage asthma?
The following steps can help diagnose and control it:
- Ask for spirometry if you have symptoms. Many physicians have the test in their office. If not, your doctor can refer you to another physician to have it done, including an asthma specialist. Be sure to mention asthma symptoms that only occur during exercise.
- Take your medicine. Persistent asthma generally requires daily use of an inhaled corticosteroid, such as beclomethasone or fluticasone, to prevent attacks; plus a short acting inhaled medicine such as albuterol to relieve symptoms quickly. If you need the quick-relief medicine more than twice a week, see a doctor.
- Avoid triggers. Asthma symptoms can stem from allergies to pollen, mold, pets, cockroaches, or dust mites. For hay fever, limit time outdoors when the pollen count is high. For indoor allergies, wash bedding in hot water weekly, run an air conditioner or dehumidifier, and enclose bedding in allergy-proof covers.
- Stay active. If exercise worsens your asthma, ask about taking a short acting medicine first.
- Guard against respiratory infections. They can spark asthma symptoms. Wash hands frequently, get an annual flu shot, and have the pneumonia vaccine if you’re older than 65 or your doctor advises it.