Respiratory Physiology
This leaflet is intended for patients who have been advised by their chest specialist to undergo a test to assess the sensitivity of the airways of the lung using an inhaled drug called Mannitol.
The Mannitol challenge test will be carried out by a lung physiologist in the respiratory physiology department located at:-
Friarage Hospital Northallerton (FHN).
The Mannitol challenge test
The Mannitol challenge is a test to determine if your airways are over-sensitive. This can be caused by inflammation of the airways and is usually a feature of asthma. Your chest specialist has requested this test to be performed in the respiratory physiology department.
Mannitol is a naturally occurring sugar commonly used as an ingredient in tablets. When inhaled by patients with oversensitive airways, Mannitol causes the airways to narrow. This is monitored using a simple breathing test.
Airway narrowing can cause breathlessness, chest tightness, cough or wheeze. If any of these occur, it will be short lived and any effect will be quickly reversed with a salbutamol (Ventolin) inhaler.
The procedure
The procedure will be explained to you in detail on the day of the test. You will be asked to inhale increasing amounts of Mannitol and the response of your airways will be measured after each dose using a simple breathing test.
Is the investigation safe?
Although this specific investigation is very safe there are some general considerations that need to be taken into account prior to the test. The small risks may arise from any pre-existing conditions that may be made worse by performing the required respiratory manoeuvres.
These conditions are known as contra-indications and include:
- Current or recent chest infection within two weeks of the test or investigation
- We will need you to stop any iron tablets or iron supplements
- Uncontrolled high blood pressure, blood clot in lung (pulmonary embolus) or heart attack (MI) within the last month
- Recent stroke or cerebrovascular event
- Recent thoracic, abdominal or eye surgery
- Coughing up blood (haemoptysis)
- Collapsed lung (pneumothorax)
- Nausea, vomiting or chest pain
- Pregnant or breast feeding
You will be asked about contra-indications when you attend your appointment.
Please contact the department to check whether your investigation can go ahead if you are currently affected by one or more of the conditions stated above.
What preparations are needed before the test?
- To ensure that the test is carried out under the best possible conditions, please observe the following prior to your appointment:
- Do not smoke within 24 hours of the test.
- Do not eat a large meal within two hours.
- Do not consume alcohol within four hours.
- Do not take vigorous exercise within 30 minutes.
- Do not wear tight clothing that may restrict your breathing.
- Avoid all caffeinated drinks or food on the day of the test.
- Allow 60 to 90 minutes for the test or appointment
In preparation for the test, please stop taking the medication(s) for the length of time recommended in the table below.
| Time to withhold | Medication |
|---|---|
| 6 to 8 hours | Intal, Tilade |
| 8 hours | Salbutamol, Ventolin, Salamol, Terbutaline, Bricanyl |
| 12 hours | Beclomethasone, Clenil, Qvr, Budesonide, Pulmicort, Fluticasone, Flixotide, Asmabec, Ipatropium, Bromide, Altrovent |
| 24 hours | Tiotropium Bromide, Spiriva, Braitus, Anora Ellipta, Trimbow, Trelegy, Incruse Ellipta, Spiolto Respimat |
| 72 hours | |
| 72 hours | Antihistamines, for example, Cetirizine, Zyrtec, Chlorphenamine, Piriton, Fexofenadine, Loratadine, IIaxten, Acrivastin, Neoclarityn |
| 96 hours | Montelukast, Singulair, Accolate |
You will be asked about your current prescribed medication so please bring a list with you if possible. If you feel too breathless to stop taking any of the above before the test, please contact the department so that we can advise if it is still possible to carry out the test.
Results
Unless you are seeing your consultant immediately after your appointment, you will not be given the results on the day of your test. The results will be sent to your chest physician or specialist who will explain the result to you at your next clinic visit.
Contact information
If you require further clarification of any of the information in this leaflet, please contact the department during office hours:
- Deniece Chapman Brown Clinical Lead – RPCH
Telephone: 07443 165 696 - Respiratory Unit – FHN
Telephone: 01609 763114
A voicemail facility may be in use if you wish to leave a message, and your call will be returned at the end of clinic.
Email: [email protected]
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]