Asthma and Allergy Evaluation

Internal medicine evaluation in which asthma diagnosis and allergy causes are systematically investigated in patients with wheezing, cough, and shortness of breath.

Indication

• Recurrent cough, wheeze, chest tightness, or shortness of breath
• Respiratory complaints triggered by exercise, cold air, or allergens
• Seasonal or year-round nasal discharge, sneezing, and itching (allergic rhinitis)
• Adults with childhood asthma history whose symptoms recur in adulthood
• Identification of new triggers and medication updates in known allergy
• Suspected link between symptoms and smoking, occupational, or household triggers
• Efficacy review of current asthma treatment and assessment of attack frequency

Preparation

• If pulmonary function testing (spirometry) is planned, avoid short-acting bronchodilators 4-6 hours beforehand (with physician approval)
• Smokers should avoid smoking for at least 1 hour before testing
• List current asthma/allergy medications, frequency of use, and your response to them
• Note in which seasons, environments, or situations symptoms worsen
• Bring prior pulmonary function, blood, and allergy skin test results

How it's performed

1. The physician takes a detailed history of symptoms, onset, triggers, and family background
2. Nose, throat, lungs, and skin are examined for allergic findings
3. Pulmonary function testing (spirometry) measures airway narrowing and reversibility
4. Allergy skin testing (prick) or blood allergen-specific IgE testing is arranged if needed
5. Controller (inhaled corticosteroid) and reliever (short-acting) medications are prescribed based on diagnosis
6. Correct inhaler technique and steps to take during an attack are demonstrated

Post-procedure

• Follow-up symptom and spirometry assessment 4-8 weeks after starting treatment
• Once symptoms are controlled, follow-up every 3-6 months with stepwise medication reduction when appropriate
• Annual review of flu and pneumococcal vaccinations
• Recommendations to reduce indoor triggers (dust, mold, pets)
• Support to avoid cigarette smoke, stove smoke, and occupational exposures

Risks

• Diagnostic tests (spirometry, prick) are generally safe; rarely transient cough or skin redness may occur
• Inhaled corticosteroids may cause oral thrush or hoarseness; rinsing the mouth helps reduce this
• Uncontrolled asthma can lead to recurrent attacks, hospital visits, and loss of lung function
• Patients with a history of severe allergy (anaphylaxis) may need an emergency plan and adrenaline auto-injector evaluation
• Self-discontinuation of treatment increases attack risk

FAQ

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