Classification of Asthma, Types of Asthma and Diagnosis

Asthma is a chronic disease of the airways that causes inflammation of the bronchial lining and increases mucus production, resulting in restricted airflow. Asthmatics may experience chest tightness, shortness of breath, and wheezing.

Traditionally, asthma is classified into intrinsic and extrinsic asthma; however, modern classification distinguishes asthma into four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent.

It is important to classify a patient’s condition to schedule an appropriate treatment plan depending on the severity. These classifications are determined based on lung function tests and symptoms.

Regardless of the classification, patients may experience periodic attacks that may be life-threatening; therefore, seek immediate medical attention if you experience extreme discomfort.

Classification of Asthma

Mild Intermittent

If you have mild intermittent asthma, you may be symptom-free for an extended period or experience short exacerbations less frequently. This means you may experience an asthma attack up to 2 days per week or nighttime symptoms twice a month. This type of asthma has less interference with daily activities.

Symptoms of mild intermittent asthma include:

  • Coughing
  • Inflamed airways
  • Wheezing when breathing

Since mild intermittent asthma is usually not life-threatening, you may not require medication daily and can use a simple rescue inhaler such as albuterol to treat symptomatic episodes. Your doctor may prescribe steroidal medication such as prednisone to treat an occasional flare-up.

Exercise-induced asthma falls under this category. It usually occurs during physical stress and can be controlled by pretreating using an inhaler such as cromolyn or albuterol before engaging in physical activities.

While these attacks are often mild, failure to pretreat before engaging in physical activities can lead to a medical emergency.

Mild Persistent

If you are diagnosed with mild persistent asthma, you will experience mild symptoms more than twice per week and nighttime symptoms more than twice per month.

Symptoms of mild persistent asthma include:

While your doctor may prescribe a rescue inhaler to ease discomfort and minimize symptoms, it does not decrease airways inflammation. Alternatively, your doctor may prescribe a low dose of inhaled corticosteroids to treat mild persistent asthma.

Moderate Persistent Asthma

At this stage, you will experience symptoms at least once each day. You may also experience nighttime symptoms at least one night every week.

Symptoms of Moderate persistent asthma include:

  • Coughing
  • Inflamed airways
  • Wheezing when breathing
  • Excessive mucus production in the airways
  • Chest tightness or pain

If you are diagnosed with moderate persistent asthma, Your doctor may recommend a rescue inhaler to treat the onset of symptoms.

Alternatively, your doctor may also prescribe a combination of low to medium-dose inhaled corticosteroid and a long-acting beta-agonist. While other treatment options exist, this option is best for moderately persistent attacks.

Excessive use of rescue inhalers is a poor control system and should be reevaluated for a better treatment plan.

Severe Persistent Asthma

Severe persistent asthma is the highest classification of asthma. This form of asthma is symptomatic and occurs several times, disrupting daily activities.

Symptoms of severe persistent asthma include:

  • Coughing
  • Inflamed airways
  • Chest tightness or pain
  • Wheezing when breathing
  • Excessive mucus production in the airways

The severe persistent asthmatic is usually best treated with a high dose inhaled corticosteroid combined with a long-acting beta-agonist. Oral corticosteroids are often needed to control with the lowest daily dose possible, reducing systemic side effects.


When you undergo a physical examination, your doctor may ask you about your health history. Your doctor may order additional tests such as chest X-rays, blood tests, and skin tests based on your examination result.

Additionally, your doctor may perform spirometry to quantify the level of obstruction to airflow. A lung test may also be ordered to a lung test to examine pulmonary functions.

Risk Factors for Asthma

There is a greater chance of developing asthma if you have certain risk factors. These include:

  • family history of asthma
  • exposure to smoke
  • allergies
  • obesity
  • exposure to occupational chemicals, pollutants, and fumes

While living with respiratory disease may pose several difficulties and discomfort, it is crucial to provide your doctor with accurate information to prescribe optimal therapy and treatment. Your asthma attack category can change (either up or down) over time base.