Breathing problems are not always easy to understand. A cough may be caused by an infection, allergy, asthma or another lung condition. Breathlessness may happen because of weak lungs, narrowed airways, low oxygen levels or even a sleep-related breathing problem.
A pulmonologist, also known as a lung specialist, first asks about your symptoms, medical history, lifestyle and past illnesses. After examining you, the doctor may recommend certain tests to understand how well your lungs are working and what may be causing the problem.
Not every patient needs every test. The pulmonologist selects tests based on your symptoms and health condition. Let’s understand the Tests a Pulmonologist may recommend
1. Spirometry or Pulmonary Function Test
Spirometry is one of the most common breathing tests. It measures how much air you can breathe out and how quickly you can blow it out.
During the test, you take a deep breath and blow forcefully into a mouthpiece connected to a machine. You may need to repeat the test a few times to get an accurate result.
Spirometry may be recommended when you have:
- Frequent breathlessness
- Wheezing or noisy breathing
- A long-lasting cough
- Suspected asthma
- Chronic obstructive pulmonary disease, or COPD
- Reduced exercise capacity
The doctor may repeat the test after giving you an inhaler. This helps check whether the airway narrowing improves with medicine. Spirometry is commonly used to diagnose and monitor conditions such as asthma and COPD.
2. Complete Lung Function Test
Sometimes, spirometry alone may not provide enough information. In such cases, a pulmonologist may recommend a complete lung function test.
This test gives more details about:
- The amount of air your lungs can hold
- How easily air moves in and out
- How well oxygen passes from the lungs into the blood
- Whether the lungs are restricted or unusually expanded
A complete lung function test can be helpful in conditions such as pulmonary fibrosis, interstitial lung disease, COPD and unexplained breathlessness. It generally includes different breathing measurements, such as spirometry, lung volume testing and gas-transfer testing.
3. Pulse Oximetry
Pulse oximetry is a quick and painless test used to measure the oxygen level in your blood. A small clip-like device is placed on your finger.
Low oxygen levels may be seen in pneumonia, severe asthma, COPD, lung infection, pulmonary fibrosis and other breathing conditions.
The pulmonologist may check your oxygen level while you are resting and, in some cases, after walking or exercising. This helps the doctor understand whether your oxygen level drops during physical activity.
4. Chest X-Ray
A chest X-ray gives a basic picture of the lungs, heart and surrounding structures. It is often one of the first tests advised for a persistent cough, fever, chest pain or breathing difficulty.
A chest X-ray may help identify:
- Pneumonia
- Tuberculosis
- Fluid around the lungs
- Lung collapse
- Certain lung growths
- Signs of chronic lung disease
However, an X-ray may not show every problem clearly. If more detailed images are required, the pulmonologist may recommend a CT scan.
5. CT Scan of the Chest
A CT scan provides detailed, cross-sectional images of the lungs. It can show smaller changes that may not be visible on a regular chest X-ray.
A CT scan may be recommended for:
- Unexplained or persistent cough
- Lung nodules or growths
- Interstitial lung disease
- Bronchiectasis
- Repeated chest infections
- Suspected blood clot in the lungs
- Lung cancer evaluation
- Complicated pneumonia
CT scans use radiation, so they should be performed only when medically necessary and advised by the treating doctor.
6. Blood Tests
Blood tests can provide useful information about infections, allergies, inflammation and oxygen levels.
A pulmonologist may recommend blood tests to check:
- Signs of infection
- Allergy-related markers
- Anaemia
- Inflammation in the body
- Autoimmune conditions affecting the lungs
- Oxygen and carbon dioxide levels
An arterial blood gas test may be performed in patients with severe breathing problems. It measures the oxygen, carbon dioxide and acidity levels in the blood.
7. Allergy Tests
Allergies can cause sneezing, blocked nose, coughing, wheezing and asthma attacks. When allergy is suspected, the pulmonologist may recommend an allergy blood test or skin prick test.
During a skin prick test, very small amounts of common allergens are placed on the skin. The test may help identify triggers such as:
- Dust mites
- Pollen
- Mould
- Pet dander
- Certain foods
- Other environmental allergens
Knowing the trigger can help the doctor create a better treatment and prevention plan.
8. Sputum Test
Sputum is the mucus or phlegm that comes out when you cough deeply. A sputum sample may be sent to a laboratory to look for bacteria, fungi or tuberculosis germs.
This test may be recommended when a patient has:
- A cough with phlegm
- Repeated chest infections
- Fever and weight loss
- Blood in the sputum
- Suspected tuberculosis
- Pneumonia that is not improving
For suspected lung tuberculosis, the doctor may use a combination of medical history, chest imaging and laboratory testing of sputum samples.
9. Bronchoscopy
Bronchoscopy is a procedure that allows the pulmonologist to look directly inside the breathing tubes. A thin, flexible tube with a small camera is passed through the nose or mouth into the airways.
It may be recommended to investigate:
- A long-lasting unexplained cough
- Blood in the sputum
- Abnormal findings on a CT scan
- Repeated lung infections
- A blockage in the airway
- A suspected lung tumour
- A foreign object in the airway
During bronchoscopy, the doctor may collect mucus, fluid or a small tissue sample for laboratory testing.
10. EBUS
Endobronchial ultrasound, commonly called EBUS, is an advanced type of bronchoscopy. It uses ultrasound to examine lymph nodes and structures around the airways.
The doctor can also collect tissue samples using a small needle. EBUS may help diagnose infections, inflammation and certain cancers without the need for a larger surgical procedure.
11. Sleep Study
A sleep study may be recommended if you snore loudly, feel sleepy during the day, wake up with headaches or stop breathing for short periods during sleep.
The test records information such as:
- Breathing pattern
- Oxygen level
- Heart rate
- Snoring
- Sleep stages
- Body movements
A sleep study helps diagnose sleep-related breathing disorders such as obstructive sleep apnoea. Depending on the patient’s condition, it may be conducted at home or in a sleep centre.
Which Lung Test Do You Need?
The right test depends on your symptoms. A person with wheezing may need spirometry, while someone with loud snoring may need a sleep study. A patient with repeated chest infections may require a chest CT scan, sputum examination or bronchoscopy.
Avoid choosing a test on your own. Consult a qualified pulmonologist who can examine you and recommend only the investigations that are necessary.
Consult Dr Sneha Tirpude, Pulmonologist in Pune
Dr Sneha Tirpude is a pulmonologist in Pune experienced in evaluating breathing difficulties, asthma, allergies, COPD, chest infections, sleep-related breathing problems and other lung conditions.
Depending on the patient’s symptoms, she may recommend investigations such as spirometry, allergy testing, bronchoscopy, EBUS, sleep study or other lung function tests.
If you have a cough lasting several weeks, repeated chest infections, wheezing, breathlessness, loud snoring or unexplained low oxygen levels, an early consultation with a lung specialist can help identify the cause and guide the right treatment.
This blog is for general awareness and should not replace medical consultation. Tests should be performed only when advised by a qualified doctor.
