Tips and pitfalls in the diagnosis and treatment of bronchial asthma

Abstract

Bronchial asthma (BA) is one of the common presentations in the outpatient clinic. In most cases, diagnosis of BA is straightforward with typical history and pertinent physical examination. However, a significant number of patients who present or referred as BA, yet they lack the classical signs and symptoms of BA. The pattern of symptoms and past history of similar episodes are crucial in the diagnosis. Several diseases can mimic asthma presentation including air hunger, acute bronchopulmonary aspergillosis, and vocal cord dysfunction need to be identified and managed accordingly. Even if BA can be easily managed in most cases, there are several obstacles that can prevent a good asthma control. Compliance with medication, incorrect use of different devices, and steroid phobia may lead to a poor control of BA. A better control of BA can be obtained by additional measures in the treatment plan. These include step-up and step-down method of therapy, offering influenza and pneumococcal vaccines, attention to comorbidities, and utilizing telemedicine for easy approach and follow-up.