Asthma, also called bronchial asthma, is a condition that affects your lungs. The World Health Organisation (WHO) defines it as a chronic health condition involving muscle tightening and inflammation around the air passageways. Since it is a chronic condition, asthma does not go away with time and needs ongoing medical management. Symptoms can include coughing, wheezing, shortness of breath and chest tightness. These symptoms can be mild or severe and can come and go over time. Dr Sandeep Nair, Principal Director and HOD - Chest and Respiratory Diseases at BLK-Max Super Speciality Hospital, said that despite being a common disease, it is still misdiagnosed worldwide. He underscored that there is both over and underdiagnosis of asthma. Overdiagnosis leads to unnecessary treatment and a delay in diagnosing the patient's actual disease. On the other hand, not being able to diagnose asthma may result in the progression of the disease and difficult to treat.Asthma Can Go Undetected For YearsAccording to Dr. Nair, one may continue to have symptoms and go undiagnosed for years together as they take symptomatic treatment and don't bother to get it fully investigated. Routine investigations like chest X-ray and another blood test may be normal, giving a false sense of well-being. To diagnose asthma, one needs to get a Pulmonary Function Test (PFT), which may not be easily available, especially in remote rural areas and is often difficult to interpret. Bronchoconstriction with reversibility on Pulmonary Function Testing is a hallmark to diagnose asthma. PFT is a very underutilised investigation as it is either not advised by a doctor or patients themselves avoid getting it. Another problem in diagnosing asthma is that asthmatics do not have continuous symptoms, as the airway constriction occurs intermittently. So patient may not have any signs or symptoms during routine physical examination. Careful history and thorough investigation help in clinching the diagnosis," he said. Another problem in diagnosis is the acceptability of the disease by the patient, and hence, he may be labelled as bronchitis or by some other name. The patient will take treatment for some time and leave it once they feel better, and will also not get further investigated. Many patients may consult quacks who would control their symptoms by giving them medicines on their own, which may contain steroids. Patients feel better and continue to take steroid-containing medication from them without consulting a specialist. Unfortunately, these patients become resistant and dependent on steroids and then fail to control their asthma symptoms over a period of time. These patients then visit a specialist to realise that they were suffering from asthma and were being administered steroids for the past many months or even years.Asthmatics Can Live For Years Without Getting DiagnosedDr. Nair concluded that asthmatics may live for years together without getting it diagnosed. Some of them may be lucky to have mild or seasonal symptoms, which would be controlled by getting treatment from local doctors. But on the other hand, some patients may not be lucky enough and may be either taking self-medication or consulting quacks who would have put them on steroids to control their symptoms. Hence, it is advised to consult a specialist whenever you have a symptom of cough or wheezing or chest tightness or breathlessness.