Asthma symptoms can vary greatly from patient to patient. They can range from a persistent nighttime cough in people with mild asthma symptoms, to breathing difficulty requiring hospitalization in patients with severe asthma symptoms. However, it is extremely important to recognize that most asthma patients will fall somewhere in between, having intermittent symptoms of coughing, wheezing, tightness in the chest, shortness of breath and occasional difficulty breathing.
Patients with mild asthma, especially children with childhood asthma, may present with only a nagging, persistent cough. Frequently, the coughing and wheezing reported children with asthma is worse at night. The “classic” asthma symptoms of wheezing, tightness in the chest, shortness of breath and difficulty breathing are frequently absent with asthma in children. This fact is critical to recognize, as many children with asthma are incorrectly diagnosed with respiratory infections, gastro-esophageal reflux, or other conditions, thereby subjecting them to unnecessary medications and delaying the correct asthma diagnosis and the onset of asthma treatment.
Asthma symptoms can be quite varied in terms of frequency and severity. Guidelines for the Diagnosis and Management of Asthma were developed by the National Institutes of Health (NIH) to help asthma care providers provide the most up to date treatment of asthma. Recommendations are based on a classification of asthma severity. Commonly used and helpful categories are: Intermittent, Mild-Persistent, Moderate-Persistent, and Severe-Persistent. Criteria to determine which category an asthma patient falls into include: asthma symptom frequency, presence and frequency of nighttime awakenings, frequency of need for short acting Bronchodilators such as albuterol, level of interference with normal activity, and lung function.
Asthma symptoms are sometimes difficult to recognize, even to the asthma patient. This is especially true in children. It is for this reason that tools are available to recognize worsening of asthma even before the patient is aware. A peak flow meter may be recommended to help detect an impending episode or to follow treatment progress. An asthma specialist should be consulted to help to determine the proper treatment for a patient’s specific asthma symptoms.