Asthma in Adults: Diagnosis and Care

Asthma can start at any age, and in adults it can look like other causes of cough and breathlessness. Dr. David Kupferberg, a pulmonary and critical care physician with more than 25 years of experience, checks the diagnosis with breathing tests in his clinic, looks for other causes, and gives you a written plan in English, Hebrew or French.

Dr. Kupferberg sees patients aged 16 and over.

Dr. David KupferbergPulmonary & Critical Care Physician

What is asthma?

Asthma is a long-term condition of the airways, the tubes that carry air in and out of the lungs. The airways are inflamed and extra sensitive, so when something irritates them they tighten and narrow, and breathing gets harder.

Symptoms tend to come and go. They are often set off by colds and chest infections, allergens, cold air, smoke, fumes or exercise. The most common symptoms are:

  • Wheezing, a whistling sound when you breathe
  • Shortness of breath
  • A feeling of tightness in the chest
  • Cough, often at night or early in the morning

When should I see a lung specialist about asthma?

A lung specialist can help when asthma starts in adulthood, or when it may not be asthma at all. Book a visit if:

  • Your breathing symptoms keep coming back and nobody has confirmed the diagnosis
  • You need your reliever inhaler more than twice a week
  • Asthma wakes you at night
  • You’ve needed steroid tablets or an emergency visit in the past year

How does Dr. Kupferberg evaluate asthma?

The breathing test usually happens at the same visit as the consultation and is charged in addition to it. The evaluation includes:

  1. A full history: your symptoms, triggers, exposures at work and at home, and the inhalers you’ve tried.
  2. An examination.
  3. A breathing test in the clinic: spirometry before and after a bronchodilator, and lung volumes when needed.
  4. A check of how you use your inhaler.
  5. A written plan to take home, in English, Hebrew or French.

How is asthma followed up?

Asthma varies over time, so your plan is reviewed at follow-up visits. These can be in the clinic in Jerusalem or Efrat, by video, or at home when needed and feasible, where spirometry can be done with a portable spirometer.

If your regular doctor is abroad, Dr. Kupferberg can send them a medical report in English.

Frequently asked questions

Can asthma start in adulthood?

Yes. Asthma can start at any age, including after 40. Adult-onset asthma often follows a chest infection, a new exposure at work or home, or allergies. It can look like a cough that won’t settle or breathlessness with exercise, so a breathing test is important to confirm it and rule out other causes.

Can asthma go away?

Asthma can become quiet for long periods, especially with the right treatment, but it usually doesn’t disappear completely. The aim of treatment is no daytime symptoms, no night waking and no attacks, with the lowest effective dose of medicine. Don’t stop a controller inhaler on your own; talk to your doctor about stepping down.

How do I know if it’s asthma or I’m just out of shape?

Being unfit makes you breathless in proportion to the effort, and it settles quickly. Asthma tends to cause wheeze, chest tightness or cough, often at night or with cold air, smoke or exercise, and it improves with a reliever inhaler. Spirometry before and after a bronchodilator can show reversible airway narrowing, which supports an asthma diagnosis.

What test confirms asthma?

Spirometry measures how much air you can blow out and how fast. It’s repeated about 15 minutes after an inhaled bronchodilator, and a clear improvement supports asthma. A normal result doesn’t rule it out, because asthma varies over time, so your history and sometimes repeat testing matter. Dr. Kupferberg does this test in the clinic, usually at the same visit, for an additional charge.

Should I stop my asthma inhalers before the breathing test?

Only if you know you’re booked for spirometry or lung volumes; for a regular visit, keep taking your inhalers as usual. Stop short-acting relievers such as Ventolin or Airomir 6 hours before the test, Atrovent 12 hours before, twice-daily long-acting or combination inhalers such as Symbicort or Seretide 24 hours before, and once-daily ones such as Spiriva or Relvar 48 hours before. Steroid-only inhalers can usually be continued. If you become short of breath, use your reliever inhaler. Your safety comes first. Tell us when you arrive. Bring all your inhalers.

Is asthma genetic?

Asthma often runs in families, together with allergies and eczema, but genes are only part of the story. Infections, allergens, smoke, workplace fumes and air pollution also play a role. Having a parent with asthma raises your chance of having it, but many people with asthma have no family history.

Sources

Book an asthma evaluation

Book a visit in Jerusalem or Efrat for an evaluation with a breathing test and a written plan.

Book Efrat ClinicBook Jerusalem Clinic (Wolfson)

In an emergency, such as severe shortness of breath or chest pain, call Magen David Adom at 101 or go to the nearest emergency room.

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