What to do next...

Hi all. Would like to see if anyone can help me out on this one. I first started experiencing chest tightness, breathlessness back in 2005, went to my GP and did test and said it was not asthma but gave me some ventolin syrup to try out to see if that helped which it did so i was given the inhaler version. Did not need to use it much initially but around 18 months later i found i had to use it more frequently and began suffering from headaches so i went back to GP and she said it could have been a side effect from the ventolin so i was given Becotide 100 to take twice a day. I don't get much trouble from my chest now but i would just like to know why further tests were not done to see if it is or isn't asthma because i am at the stage where i would like to know. Any ideas?

Thanks

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Hi Claire,

Sorry to hear that you've been having these problems, it all sounds quite frustrating. I can sympathise with your desire to know exactly what is going on and whether you do have asthma or not.

The first thing to say is that asthma is predominantly a clinical diagnosis, at least initially. That is to say that it is made on the basis of the history from the patient and the examination findings, as well as the response to treatment, rather than by doing large numbers of complex tests. It is usual for GPs to measure a patient's peak flow, if asthma is suspected, but that may not be definitive, as asthma is episodic and most asthmatics will have a normal peak flow when they are well controlled or in a good phase. The same thing applies to spirometry, which is a slightly more detailed 'breathing test' - it can be normal at times even in quite severe asthma, so it is not necessarily useful. There is no one definitive test for asthma.

Response to treatment is an important factor in the diagnosis of asthma, and in fact most people with suspected asthma will be started on salbutamol (Ventolin) to see what happens. Significant improvement in symptoms and/or peak flow with salbutamol pretty much confirms the diagnosis. The same can be said of response to inhaled steroids such as beclomethasone (Becotide) - they take a little longer to work, but a significant improvement within a couple of weeks of starting an inhaled steroid is very suggestive of asthma.

I don't know your history, of course, but I would guess that your GP is perhaps fairly confident that you do have asthma, based on your symptoms and the fact that you have got some benefit from the treatments that you have been given. Clearly, though, she has not communicated that particularly clearly to you. I would suggest you go back to your GP and ask her to clarify whether she does feel that you have asthma.

If you don't get much trouble from your chest at the moment, that would suggest that the treatment that you are on is appropriate and that your asthma is well controlled, which is great. Beclomethasone is a very safe drug with a minimum of side effects, so there is no reason that you can't stay on it. Obviously, if you do experience increased symptoms or increased need to use your salbutamol, you should go back to your GP for consideration of further treatment.

Hope this helps

Em H