Exercise-induced asthma

Description

Exercise-induced asthma is when the airways narrow or tighten during physical activity. Cause shortness of breath, wheezing, coughing and other symptoms during or after exercise.

The medical term for this condition is exercise-induced bronchoconstriction (brong-koh-kun-STRIKES-shun). Many people with asthma have exercise-induced bronchoconstriction. But people without asthma can also have it.

Most people with exercise-induced bronchoconstriction may continue to exercise and stay active if the treatment of the symptoms. The treatment includes medications for asthma and the adoption of measures to prevent symptoms before physical activity begins.

Symptoms

The symptoms of exercise-induced bronchoconstriction usually begin during or shortly after exercise. These symptoms can last an hour or longer if not treated. The symptoms include:

  • Cough.
  • Wheezing.
  • Shortness of breath.
  • Chest tightness or pain.
  • Fatigue during exercise.
  • Worse-than-expected performance in sports.
  • Avoid activity, which occurs mostly in young children.

When to see a doctor

Consult your health care provider if you have symptoms of exercise-induced bronchoconstriction. Some conditions that can cause similar symptoms, so it is important to get a diagnosis as soon as you can.

Seek emergency medical treatment if you have:

  • Shortness of breath or shortness of breath that gets worse quickly, making it hard to breathe.
  • Does not improve after you use a prescription inhaler for asthma attacks.

Causes

It is not exactly clear what causes exercise-induced bronchoconstriction. For a long time, the cause was thought to be the cold air. However, recent studies have found that the dry air to be the more likely culprit. The cold air contains less moisture than warm air. Breathing in cold air, dry air dehydrates the air passages. This causes them to constrict, reducing the flow of air. Other factors, such as chlorine, or other gases, can irritate the lining of the airways and contribute to breathing difficulties as well.

Risk factors

Exercise-induced bronchoconstriction is more likely to occur in:

  • The people with asthma. About 90% of people with asthma have exercise-induced bronchoconstriction. However, the condition can also occur in people without asthma.
  • The elite athletes. Although any person may have exercise-induced bronchoconstriction, it is more common in high-level athletes.

Factors that may increase the risk of the condition or act as triggers include:

  • The dry air.
  • The cold air.
  • The air pollution.
  • Chlorine in swimming pools.
  • In a gym, the smoke of the perfume, paint, new equipment, or on the carpet.
  • Activities with long periods of deep breathing, such as running, swimming or football.

Complications

If not treated, the exercise-induced bronchoconstriction may result in:

  • Serious or life-threatening breathing problems, especially among people with poorly managed asthma.
  • Lower quality of life due to the inability to exercise.

Exercise-induced asthma

Diagnosis

To diagnose exercise-induced bronchoconstriction, your health care provider in the first place has a history and do a physical exam. You may have tests to check the functioning of the lungs and to rule out other conditions.

Current test of lung function

Your healthcare provider will likely perform a spirometry (spy-ROM-uh-tree) of the test. This test shows the function of the lungs when you are not doing exercise. A spirometer measures the amount of air you inhale, how much you exhale and how quickly you exhale.

Your doctor may need to repeat the test after taking an inhaled medicine to open your lungs. This medication is known as a bronchodilator. Your provider from the comparison of the results of the two measurements to see if the bronchodilator improves the flow of air. This first test of lung function is important to rule out chronic asthma as the cause of the symptoms.

Exercise challenge tests

During an exercise challenge test, which run on a treadmill or the use of other stationary exercise equipment to increase your breathing rate.

The exercise should be intense enough to trigger symptoms. If necessary, you may be asked to perform a real-life challenge of exercise, such as climbing stairs. The spirometry test before and after the task may provide the evidence of exercise-induced bronchoconstriction.

Methacholine challenge test of breath

This test consists of the inhalation to an agent, often methacholine, which narrows the airways in some people with exercise-induced bronchoconstriction. After, a spirometry, pulmonary function tests. This test simulates the conditions that may cause exercise-induced bronchoconstriction.

Treatment

Your health care provider may prescribe medications to take just before a workout or taking a daily basis for the long-term control.

Preexercise drugs

If your doctor prescribes a medicine for you to take before you exercise, ask how much time is required between taking the medication and start the activity.

  • Short-acting beta agonists (SABAs) are the most commonly prescribed medications to take before you exercise. These medications include albuterol (ProAir HFA, Proventil-HFA, Ventolin HFA) and levalbuterol (Xopenex HFA). short-acting beta2-agonists (SABAs) are inhaled medicines that help open the airways. Do not take these medications every day because it can make them less effective.
  • Ipratropium (Atrovent HFA) is an inhalation of a drug that relaxes the airways, and can be effective for some people. A generic version of this medicine this medication may be taken with a device called a nebulizer.

Long-term control medicines

Your doctor may prescribe a long-term control medicine to manage underlying asthma or the symptom control when preexercise treatment alone does not work. These medications are usually taken daily. They include:

  • Inhaled corticosteroids, which help to calm the inflammation in the airways. Taking these drugs through breathing them in. You might need to use this treatment for up to four weeks before you have maximum benefit.
  • The combination inhaler containing a corticosteroid and a time of action beta-agonist (LABA), a drug that relaxes the airways. These inhalers prescribed for the long-term control, but your doctor may recommend the use of it before exercising.
  • Leukotriene modifiers,which are drugs that block the activity of inflammatory for some people. These medications are taken by mouth. Can be used daily or before exercise if you take at least two hours in advance. Possible side effects of leukotriene modifiers include behavioral and mood changes and suicidal thoughts. Talk with your doctor if you have these symptoms.

Leukotriene modifiers, which are drugs that block the activity of inflammatory for some people. These medications are taken by mouth. Can be used daily or before exercise if you take at least two hours in advance.

Possible side effects of leukotriene modifiers include behavioral and mood changes and suicidal thoughts. Talk with your doctor if you have these symptoms.

Do not rely only on the quick-relief medicines

You can also use preexercise medications as a quick-relief treatment for the symptoms. However, you should not have to use your preexercise inhaler more often than recommended.

Keep a record of:

  • How many applications will use each week.
  • The frequency of use of your preexercise inhaler for prevention.
  • How often are used to treat the symptoms.

If you use your inhaler on a daily basis or that are frequently used for the relief of symptoms, your doctor may adjust their long-term control medication.

Self-care

The exercise is an important part of a healthy lifestyle for everyone, including most people with exercise-induced bronchoconstriction. In addition to taking the medicine, you can take these measures to prevent or reduce the symptoms:

  • Do about 15 minutes of warming that varies in intensity before starting regular exercise.
  • Breathe in through the nose to warm and humidify the air before it enters the lungs.
  • Use a mask or handkerchief when you exercise, especially in cold and dry weather.
  • If you have allergies, avoid the triggers. For example, do not exercise outside when the pollen count is high.
  • Try to avoid areas with high levels of air pollution, such as roads with heavy traffic.

In the school

If your child has exercise-induced bronchoconstriction, talk with your health care provider about providing a plan of action. This document provides a step-by-step instructions for the teachers, the nurses, and coaches to explain:

  • What treatments your child needs.
  • When treatments should be given.
  • What to do if your child has symptoms.

Alternative medicine

There is limited clinical evidence that any of the alternative treatments for the benefit of people with exercise-induced bronchoconstriction. For example, it has been suggested that fish oil, vitamin C or vitamin C supplements may help prevent exercise-induced bronchoconstriction, but there is not enough evidence to show if they are useful.

Preparing for your appointment

It is likely to start by seeing your primary health care provider. Your doctor can refer you to someone who specializes in asthma, such as an allergist-immunologist or pulmonologist.

Be prepared to answer the following questions:

  • What symptoms have you had?
  • Begin immediately at the start to do exercise, at any time during a workout or after?
  • How long do the symptoms last?
  • Do you have difficulty breathing when you're not exercising?
  • What are the typical exercise or recreational activities?
  • Have you recently made changes to your exercise routine?
  • The symptoms occur every time you exercise, or only in certain environments?
  • Have been diagnosed with allergies or asthma?
  • What other medical conditions do you have?
  • What medications do you take? What is the dose of each medication?
  • What dietary supplements or herbal medicines that you take?
Symptoms and treatment of Exercise-induced asthma