Some patients with an asthma diagnosis have a poor controlled asthma. One explanation may be an incorrect diagnosis. Aim. The aim of the study was to diagnose and classify patients with non-infectious lower respiratory tract problems in primary health care using internationally applied diagnostic criteria and diagnostic tests. Patients and Methods. New adult patients visiting a primary health care centre due to lower airway problems were included. The diagnostic tests included FEV1, FVC, PEF, two questionnaires, methacholine test, and skin prick test. Results. The patients ( ) could be divided into four groups: asthma (28%), asthma-like disorder (44%), idiopathic cough (12%), and a nonreversible bronchial obstructive group (16%). The asthma and asthma-like groups showed similar patterns of airway symptoms and trigger factors, not significantly separated by a special questionnaire. Phlegm, heavy breathing, chest pressure/pain, cough, and wheezing were the most common symptoms. Physical exercise and scents were the dominating trigger factors. Conclusions. Nonobstructive asthma-like symptoms seem to be as common as bronchial asthma in primary health care. Due to the similarities in symptoms and trigger factors the study supports the hypothesis that asthma and nonobstructive asthma-like disorders are integrated in the same “asthma syndrome,” including different mechanisms, not only bronchial obstruction. 1. Introduction Bronchial asthma is a common disease worldwide and good treatment could often be offered [1]. Its prevalence in the adult population in Sweden is up to 10% [2], being the highest in the north part and in younger people. The diagnosis is based on the presence of episodic breathing troubles and variable and reversible airway obstruction [1, 3]. Most cases are not difficult to diagnose and treat; however, some patients respond poorly to asthma treatment despite ongoing asthma-like symptoms. In those cases, other diagnoses must be considered [4–15]. Disorders with asthma-like symptoms mentioned in the literature are dysfunctional breathing [11, 16–18], vocal cord dysfunction [19], pseudoasthma [20], cough variant asthma [8], multiple chemical sensitivity [21], and airway sensory hyperreactivity (SHR) [22]. In GINA, the international guidelines for asthma diagnostics and treatment [1], two disorders with asthma-like symptoms are mentioned, vocal cord dysfunction (VC) [19] and hyperventilation syndrome (HVS) [7]. As the above conditions are presented under different names, it is not possible to know the prevalence. However, Marklund et al. found
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